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Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the general population using convenience sampling. Bivariate and multivariate tests were applied to analyze the obtained data. Binary regression indicated a statistically significant association between the presence of heart disease, stroke, breast cancer, ovarian/cervical cancer, prostate cancer, colon cancer, and diabetes, and the perception of risk for the particular disease as noted in the FHH. A familial history of stroke appeared to be the strongest predictor of perception of disease risk. Moreover, increasing age, particularly within the age range of 40 to 57, was associated with increasing levels of perception of disease risk for heart disease, stroke, and prostate cancer. Individuals from the general population significantly indicated higher-than-average risk for colon cancer compared to those from health care facilities. Social change implication of this study may be the widespread implementation of a familial health history questionnaire that leads to an impactful, higher degree of disease risk awareness, prompting preventive action on the part of the individual, and leading to improved individual and population health.

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Family health history (FHH) has been recognized as an important tool in cancer prevention and health promotion. To date, literature on FHH discussions about cancer have largely focused on patient-physician communication or the dissemination of cancer-specific genetic tests results within the family. Fewer studies have sought to identify family factors that may promote FHH discussions, yet this type of information could be used to identify families needing support in having these conversations. Thus, the present study examined relations between family organization (cohesion and flexibility), communication openness, and FHH communication about cancer within a diverse group of women recruited from an urban, safety-net women's health clinic. Participants were enrolled in a randomized control trial examining the effects of an educational intervention on family communication about hereditary breast and colon cancers (Kin Fact Study). For the present study, baseline survey data for 472 women were analyzed. Participants completed measures on demographics, family organization, communication openness, and FHH communication. Average age was 34 years and 59% reported being Black. Thirty-one percent had graduated high school and 28% reported having commercial health insurance. Seventy-five percent of women reported a family history of cancer in a first or second degree relative. Descriptive statistics, correlations, and multiple linear regression and hierarchical logistic regressions, adjusting for key factors, were performed. Nineteen percent of women actively collected FHH information about cancer and 11% reported actively sharing cancer risk information with relatives. Being older, having a greater educational attainment, and having a family history of cancer was associated with having collected FHH; while being older and reporting higher levels of cohesion/flexibility was associated with sharing cancer risk information. Adjusting for demographic variables, cohesion, flexibility, and openness were not significant predictors of collecting or sharing FHH. Family history of cancer did not moderate the relationship between family organization and FHH. Cohesion and flexibility levels did significantly predict communication openness. This study contributes to a small but emergent literature in the field of FHH communication about cancer as it explores family context factors that may aid in the development of prevention interventions. Clinical implications and directions for future research are discussed.

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No description available.

A detailed family health history is currently the most potentially useful tool for diagnosis and risk assessment in clinical genetics. We developed and evaluated the usability and analytic validity of a patient-driven web-based family health history collection and analysis tool. Health Heritage © guides users through the collection of their family health history by relative, generates a pedigree, completes risk assessment, stratification, and recommendations for 89 conditions. We compared the performance of Health Heritage to that of Usual Care using a nonrandomized cohort trial of 109 volunteers. We contrasted the completeness and sensitivity of family health history collection and risk assessments derived from Health Heritage and Usual Care to those obtained by genetic counselors and genetic assessment teams. Nearly half (42%) of the Health Heritage participants reported discovery of health risks; 63% found the information easy to understand and 56% indicated it would change their health behavior. Health Heritage consistently outperformed Usual Care in the completeness and accuracy of family health history collection, identifying 60% of the elevated risk conditions specified by the genetic team versus 24% identified by Usual Care. Health Heritage also had greater sensitivity than Usual Care when comparing the identification of risks. These results suggest a strong role for automated family health history collection and risk assessment and underscore the potential of these data to serve as the foundation for comprehensive, cost-effective personalized genomic medicine.