Brief report
Willingness of Mexican-American Adults to Share Family Health History with Healthcare Providers

https://doi.org/10.1016/j.amepre.2011.02.013Get rights and content

Background

Collecting family health history (FHH) information to share with healthcare providers is an important aspect of health-risk assessment.

Purpose

To examine associations between the content of FHH-informed risk feedback and willingness to share the information with a healthcare provider.

Methods

Data were collected between June 2008 and July 2009 from 475 Mexican-origin adults residing in 161 households. Participants completed surveys 3 months after receiving FHH-informed risk feedback. Households were randomly assigned to feedback conditions in which household members received one or more of the following: an FHH pedigree, personalized risk assessments (PRAs), and tailored behavioral recommendations. Logistic regression models were fitted using generalized estimating equations, with exchangeable covariances, to account for the clustering of responses within and the random assignment of feedback condition to household. Analyses were completed in May 2010.

Results

Participants who received personalized risk assessments were more willing to share their feedback with a provider than those who received a pedigree only (OR=2.25, p=0.02). The receipt of tailored behavioral recommendations did not significantly increase willingness to share feedback with a provider (OR=0.79, p=0.48).

Conclusions

The provision of PRAs in FHH assessments appears to motivate participants to consider sharing their FHH with a healthcare provider.

Introduction

Sharing family health history (FHH) with healthcare providers is critical for personalized health care.1 Individuals with higher than average disease risks based on FHH may need to undergo medical screening more frequently at younger ages and implement preventive behaviors.2, 3, 4 However, FHH is underutilized within the primary care setting.5, 6

In an effort to move collection of FHH outside the clinical setting, various tools have been developed to assist the general public in compiling their FHH.7, 8, 9 Some tools generate a list of affected relatives or pedigree representing the constellation of disease within the family,8, 10, 11 whereas others provide personalized risk assessments (PRAs) and tailored behavioral recommendations.12, 13, 14 Currently, there is limited information regarding which content elements provided by FHH tools might motivate individuals to share the information with their healthcare providers.7 The current paper identifies the elements of FHH-based feedback (i.e., an FHH pedigree; PRAs15; and tailored behavioral recommendations) associated with willingness to share feedback with a healthcare provider within a sample of Mexican-origin families.

Section snippets

Procedures

Participants for the project Risk Assessment for Mexican Americans were recruited from the Mexican American Cohort Study, a population-based cohort of Mexican-origin households maintained by the Department of Epidemiology at the University of Texas MD Anderson Cancer Center.16 A total of 162 multigenerational households with at least three adult members (i.e., 497 adults aged 18–70 years) participated, of 347 contacted households. During a home visit, each participant completed the baseline

Results

On average, participants were aged 41 years (SD=15 years); female (55%); married (70%); parents (74%); Mexican immigrants (69%); and had not completed high school (57%). Participants were affected by one (M=0.87, SD=1.07) condition associated with metabolic syndrome; the majority (64%) had health insurance; and half normally received health care through a private physician (see Table 1).

At follow-up, 71% (n=338) indicated that they read their feedback. Feedback readers were more likely to be

Discussion

Provision of PRAs with a pedigree was associated with increased willingness to share FHH information with providers compared to those receiving a pedigree only. Interpretation of the pedigree requires a conceptual understanding of the complex interactions resulting in disease risk. Levels of genetic knowledge required to interpret the pedigree may be limited among the general public,18, 19 as many have insufficient levels of health literacy.20 Thus, providing an interpretation of family risk

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