Perceived familiarity with and importance of family health history among a medically underserved population

Abstract

Inadequate knowledge of family health history (FHH) continues to be a major obstacle limiting its usefulness in public health and clinical practice; strategies to facilitate FHH dissemination are needed. Data (N = 1,334) were obtained through waiting-room surveys completed by a diverse sample of patients attending three community health centers. Perceptions about the importance of genetic information (β = 0.13, p < 0.001; β = 0.11, p < 0.001) and higher genetic self-efficacy (β = 0.14, p < 0.001; β = 0.23, p < 0.001) were significantly associated with higher levels of perceived familiarity with and importance of FHH, respectively. Furthermore, beliefs about genetic causation of illnesses (β = 0.12, p < 0.001) and a wider reach of health communication within one's family (β = 0.15, p < 0.001) were associated with higher levels of perceived familiarity with one's FHH. Participants in the oldest group (>50 years) reported higher familiarity than those in the youngest (18-25 years). Those with higher familiarity were significantly less likely to answer "don't know" when reporting diabetes and heart disease diagnoses among immediate (OR = 0.35 and OR = 0.29, respectively) and extended (OR = 0.50 and OR = 0.46, respectively) family members. Having a wider health communication reach within a family may be beneficial in increasing familiarity with FHH; however, the reported levels of communication reach were limited among most participants. Women, older-generation family members, and those who believe in the importance of genetics in health or feel confident about using genetic information may be particularly important as targets of public health interventions to facilitate FHH dissemination within families.

Social determinants of family health history collection

“…Of the social determinants that we measured, only gender and age were associated significantly with FHH in the multivariate logistic regression analysis in the total sample. The gender differences we found are consistent with the results of prior studies, but other work has shown that older adults are more familiar with their FHH compared to younger individuals (Ashida et al 2012;Yoon et al 2004). For instance, women feel responsible as Bgatherers^or Bkin keepers^of family health data including genomic medical information (Green et al 1997;Richards 1996;Koehly et al 2009).…”

“…However, the racial disparities observed for health care, morbidity, and mortality overall are observed in genomic medicine (Armstrong et al 2005;Armstrong et al 2003). Previous studies have shown that African Americans have limited knowledge about basic genomic concepts and specific applications of FHH to disease (Ashida et al 2012;Kessler et al 2007). Further, recent research has shown that African Americans may not record their FHH in writing, even though many believe that FHH tools are effective for tracking this information (Thompson et al 2013).…”

Family health information sharing among older adults: reaching more family members

“…Considering that FHH information about first-and second-degree relatives is particularly important in determining disease risks (Scheuner et al 1997), these findings suggest the need to further facilitate FHH communication within the families of older adults and highlight the importance of older individuals acting as role models. Consistent with the previous studies with a general adult population (Ashida et al 2012), individual perceptions such as familiarity with one's own FHH and self-efficacy to share FHH may be important on the extent to which older adults disseminate this information. Although the effect of selfefficacy may partly be explained by respondents' perceived familiarity with FHH, these variables were not significantly correlated in this current study (r=0.10) suggesting their distinct importance.…”

“…Furthermore, the social and behavioral theories posit that individuals' perceptions about their own knowledge of family health information (familiarity) and confidence in communicating (self-efficacy) can contribute to the extent to which older adults share FHH information (McAlister et al 2008). In fact, previous studies showed that one's perception about the importance of sharing (Ashida et al 2013), ability to obtain FHH information, and familiarity with own FHH (Ashida et al 2012) were associated with its communication in a general population sample.…”

Genomics in Clinical Practice: Lessons from the Front Lines

“…In contrast, risk assessment for common diseases is based on family history even though this is of en incomplete or inaccurate (1,2). Genetic diagnosis and risk assessment can be achieved through traditional genetic testing (at the individual gene or gene panel level), but there are limitations.…”