Brief reportWillingness of Mexican-American Adults to Share Family Health History with Healthcare Providers
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
References (30)
- et al.
Family history of heart disease and cardiovascular disease risk-reducing behaviors
Genet Med
(2004) - et al.
Family history-taking in community family practice: implications for genetic screening
Genet Med
(2000) - et al.
Providers' knowledge of genetics: a survey of 5915 individuals and families with genetic conditions
Genet Med
(2007) Genetics of common disease: a primary care priority aligned with a teachable moment
Genet Med
(2008)- et al.
Social influence and motivation to change health behaviors among Mexican origin adults: Implications for diet and physical activity
Am J Prev Med
(2010) - et al.
Perspective: prospective health care and the role of academic medicine: lead, follow, or get out of the way
Acad Med
(2008) Screening for Type 2 diabetes
Diabetes Care
(2004)- et al.
Family history: the three-generation pedigree
Am Fam Physician
(2005) - et al.
Reconsidering the family history in primary care
J Gen Intern Med
(2004) - et al.
National Institutes of Health State-of-the-Science Conference Statement: family history and improving health
Ann Intern Med
(2009)