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Kumerow MT, Rodriguez JL, Dai S, Kolor K, Rotunno M, Peipins LA. Prevalence of Americans reporting a family history of cancer indicative of increased cancer risk: Estimates from the 2015 National Health Interview Survey. Prev Med 2022; 159:107062. [PMID: 35460723 PMCID: PMC9162122 DOI: 10.1016/j.ypmed.2022.107062] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
The collection and evaluation of family health history in a clinical setting presents an opportunity to discuss cancer risk, tailor cancer screening recommendations, and identify people with an increased risk of carrying a pathogenic variant who may benefit from referral to genetic counseling and testing. National recommendations for breast and colorectal cancer screening indicate that men and women who have a first-degree relative affected with these types of cancers may benefit from talking to a healthcare provider about starting screening at an earlier age and other options for cancer prevention. The prevalence of reporting a first-degree relative who had cancer was assessed among adult respondents of the 2015 National Health Interview Survey who had never had cancer themselves (n = 27,999). We found 35.6% of adults reported having at least one first-degree relative with cancer at any site. Significant differences in reporting a family history of cancer were observed by sex, age, race/ethnicity, educational attainment, and census region. Nearly 5% of women under age 50 and 2.5% of adults under age 50 had at least one first-degree relative with breast cancer or colorectal cancer, respectively. We estimated that 5.8% of women had a family history of breast or ovarian cancer that may indicate increased genetic risk. A third of U.S. adults who have never had cancer report a family history of cancer in a first-degree relative. This finding underscores the importance of using family history to inform discussions about cancer risk and screening options between healthcare providers and their patients.
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Affiliation(s)
- Marie T Kumerow
- Tanaq Support Services, LLC, 3201 C St Site 602, Anchorage, AK 99503, USA.
| | - Juan L Rodriguez
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS S107-4, Atlanta, GA 30341, USA.
| | - Shifan Dai
- Cyberdata Technologies, Inc., 455 Springpark Pl # 300, Herndon, VA 20701, USA.
| | - Katherine Kolor
- Office of Genomics and Precision Public Health, Centers for Disease Control and Prevention, 2500 Century Parkway NE, MS V25-5, Atlanta, GA 30345, USA.
| | - Melissa Rotunno
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr RM 4E548, Bethesda, MD 20892, USA.
| | - Lucy A Peipins
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS S107-4, Atlanta, GA 30341, USA.
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2
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Hereditary Cancer Risk Using a Genetic Chatbot Before Routine Care Visits. Obstet Gynecol 2021; 138:860-870. [PMID: 34735417 PMCID: PMC8594498 DOI: 10.1097/aog.0000000000004596] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
A clinical chatbot can be used effectively to perform cancer risk assessment by remotely collecting and analyzing personal and family cancer history before appointments. To examine user uptake and experience with a clinical chatbot that automates hereditary cancer risk triage by collecting personal and family cancer history in routine women's health care settings.
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3
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Yoon S, Goh H, Fung SM, Tang S, Matchar D, Ginsburg GS, Orlando LA, Ngeow J, Wu RR. Experience and Perceptions of a Family Health History Risk Assessment Tool among Multi-Ethnic Asian Breast Cancer Patients. J Pers Med 2021; 11:jpm11101046. [PMID: 34683187 PMCID: PMC8536959 DOI: 10.3390/jpm11101046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
A family health history-based risk assessment is particularly valuable for guiding cancer screening and treatment strategies, yet an optimal implementation depends upon end-users' values and needs. This is not only true prior to disease development, but also for those already affected. The aim of this study is to explore perceptions of the value of knowing one's family health history (FHH)-based risk, experience using a patient-facing FHH tool and the potential of the tool for wider implementation. Twenty multi-ethnic Asian patients undergoing breast cancer treatment in Singapore completed an FHH-based risk assessment. Semi-structured one-on-one interviews were conducted and data were thematically analyzed. All participants were female and slightly more than half were Chinese. The acceptance and usage of an FHH risk assessment tool for cancers and its broader implementation was affected by a perceived importance of personal control over early detection, patient concerns of anxiety for themselves and their families due to risk results, concerns for genetic discrimination, adequacy of follow-up care plans and Asian cultural beliefs toward disease and dying. This study uniquely sheds light on the factors affecting Asian breast cancer patients' perceptions about undergoing an FHH-based risk assessment, which should inform steps for a broader implementation in Asian healthcare systems.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Center for Population Health Research Institute, Duke-NUS Medical School, Singapore Health Services, 8 College Road, Singapore 169857, Singapore;
| | - Hendra Goh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (H.G.); (S.T.); (D.M.)
| | - Si Ming Fung
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (S.M.F.); (J.N.)
| | - Shihui Tang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (H.G.); (S.T.); (D.M.)
| | - David Matchar
- Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (H.G.); (S.T.); (D.M.)
- Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA
| | - Geoffrey S. Ginsburg
- Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA; (G.S.G.); (L.A.O.)
| | - Lori A. Orlando
- Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA; (G.S.G.); (L.A.O.)
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (S.M.F.); (J.N.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Rebekah Ryanne Wu
- Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, 304 Research Dr. Box 90141, Office 264, Durham, NC 27708, USA
- Correspondence:
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Li M, Zhao S, Young CM, Foster M, Huei-Yu Wang J, Tseng TS, Kwok OM, Chen LS. Family Health History-Based Interventions: A Systematic Review of the Literature. Am J Prev Med 2021; 61:445-454. [PMID: 34226092 DOI: 10.1016/j.amepre.2021.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT National efforts have advocated for the need to deliver family health history-based interventions to the lay public for more than a decade. Yet, the numbers, characteristics, and outcomes of such interventions are unknown. This first-of-its-kind systematic literature review examines the characteristics and effectiveness of the existing family health history-based interventions. EVIDENCE ACQUISITION The research team systematically searched peer-reviewed articles published between January 2003 and July 2020 in MEDLINE, Embase, CINAHL, and Google Scholar. EVIDENCE SYNTHESIS A total of 35 articles met the inclusion criteria. These studies assessed various behaviors, including family health history collection/communication with family members, family health history communication with healthcare providers, healthy diet adoption, physical activity level, uptake of medical screenings and genetic tests, and being proactive in healthcare matters. The average methodologic quality score of the studies was 9.9 (SD=1.6) of a theoretical range from 2 to 16. CONCLUSIONS Many family health history-based interventions exist to examine a variety of behaviors. Yet, there is room for improvement in methodology because few studies used a randomized or quasi-experimental design. In addition, most included studies did not report objective or longer-term outcome data to examine the effectiveness of family health history-based interventions.
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Affiliation(s)
- Ming Li
- Department of Health Sciences, College of Health Professions, Towson University, Towson, Maryland
| | - Shixi Zhao
- Department College of Health Professions, Exercise & Sports Sciences, College of Education & Human Sciences, The University of New Mexico, Albuquerque, New Mexico
| | | | - Margaret Foster
- Medical Science Library, Texas A&M University, College Station, Texas
| | - Judy Huei-Yu Wang
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Tung-Sung Tseng
- Behavioral & Community Health Sciences Program, LSU School of Public Health, LSU Health New Orleans, New Orleans, Louisiana
| | - Oi-Man Kwok
- Department of Educational Psychology, College of Education & Human Development, Texas A&M University, College Station, Texas
| | - Lei-Shih Chen
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas.
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5
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Wang H, Yeh YL, Li M, Ma P, Kwok OM, Chen LS. Effects of family health history-based colorectal cancer prevention education among non-adherent Chinese Americans to colorectal cancer screening guidelines. PATIENT EDUCATION AND COUNSELING 2021; 104:1149-1158. [PMID: 33176978 DOI: 10.1016/j.pec.2020.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/15/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study examined the effects of the first family health history (FHH)-based colorectal cancer (CRC) prevention education on 1) FHH of CRC communication with family members and primary care physicians (PCPs), 2) fecal occult blood test (FOBT) uptake, and 3) CRC preventive lifestyle modifications among 50- to 75-year-old Chinese Americans non-adherent to CRC screening guidelines. METHODS Using a community-based participatory research approach, we developed and implemented 62 culturally and linguistically appropriate, theory-driven, FHH-based CRC prevention educational workshops across Texas for 344 Chinese Americans (mostly with low education/income) aged 50-75 years who were non-adherent to CRC screening guidelines. RESULTS Linear mixed modeling analyses showed that participants' FHH of CRC communication with PCPs and family members significantly increased two-week post-workshop compared to pre-workshop data (ps<0.001). Moreover, at two-weeks post-workshop, 91.9 % of participants underwent FOBT. Nevertheless, no significant changes were found in participants' lifestyles. CONCLUSION Our educational workshops successfully increased Chinese Americans' FHH of CRC communication and FOBT uptake. Personalized education with longer follow-ups may be needed in future studies to promote lifestyle changes among Chinese Americans. PRACTICE IMPLICATIONS Health and public health professionals may adopt our workshop educational materials to provide patient and public CRC prevention education for Chinese Americans.
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Affiliation(s)
- Haocen Wang
- Department of Health and Kinesiology, Texas A&M University, College Station, USA
| | - Yu-Lyu Yeh
- Department of Health and Kinesiology, Texas A&M University, College Station, USA
| | - Ming Li
- Department of Health Sciences, Towson University, Towson, USA
| | - Ping Ma
- Department of Health Promotion & Community Health Sciences, Texas A&M University, College Station, USA
| | - Oi-Man Kwok
- Department of Educational Psychology, Texas A&M University, College Station, USA
| | - Lei-Shih Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, USA.
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Kuang K, Gettings PE. Interactions among Actual Uncertainty, Desired Uncertainty, and Uncertainty Discrepancy on Anxiety and Information Seeking. JOURNAL OF HEALTH COMMUNICATION 2021; 26:127-136. [PMID: 33739242 DOI: 10.1080/10810730.2021.1883774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study investigated the role of uncertainty in information management processes by integrating insights from uncertainty management theory and the theory of motivated information management. Specifically, we examined the extent to which uncertainty appraisals moderated the effects of uncertainty on anxiety and information seeking about family health history (FHH) from spouses. Data from 626 married individuals suggested that desired uncertainty moderated uncertainty's effect on anxiety such that uncertainty led to more anxiety when individuals wanted to be more certain. Uncertainty also exerted stronger effects on anxiety and information seeking when one's actual uncertainty was low. Efficacy remained a predictor of information seeking, consistent with the literature. Findings offer theoretical implications about the interaction effects among different conceptualizations of uncertainty (i.e., actual, desired, and uncertainty discrepancy) and practical applications for encouraging information seeking about FHH.
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Affiliation(s)
- Kai Kuang
- Department of Communication Studies, Bloomsburg University, Bloomsburg
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7
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Haga SB, Orlando LA. The enduring importance of family health history in the era of genomic medicine and risk assessment. Per Med 2020; 17:229-239. [PMID: 32320338 DOI: 10.2217/pme-2019-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Improving disease risk prediction and tailoring preventive interventions to patient risk factors is one of the primary goals of precision medicine. Family health history is the traditional approach to quickly gather genetic and environmental data relevant to the patient. While the utility of family health history is well-documented, its utilization is variable, in part due to lack of patient and provider knowledge and incomplete or inaccurate data. With the advances and reduced costs of sequencing technologies, comprehensive sequencing tests can be performed as a risk assessment tool. We provide an overview of each of these risk assessment approaches, the benefits and limitations and implementation challenges.
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Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 101 Science Drive, Box 3382, Durham, NC 27708, USA
| | - Lori A Orlando
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 101 Science Drive, Box 3382, Durham, NC 27708, USA
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8
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Allen CG, Duquette D, Guan Y, McBride CM. Applying theory to characterize impediments to dissemination of community-facing family health history tools: a review of the literature. J Community Genet 2020; 11:147-159. [PMID: 31267271 PMCID: PMC7062972 DOI: 10.1007/s12687-019-00424-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/30/2019] [Indexed: 10/26/2022] Open
Abstract
Uptake of community-facing family health history (FHH) tools to identify those at highest risk of disease and target prevention efforts has been consistently low. This review uses the diffusion of innovations (DOI) as a framework to organize the FHH evidence base and identify potential strategies to improve uptake of community-facing FHH tools. Methods for this literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We completed systematic searches in PubMed, Embase, and Web of Science databases for studies from 2009 to 2017 and hand searched bibliographies of relevant literature to identify additional articles. We abstracted and synthesized results, which were then organized by the DOI including the innovation-decision making process and characteristics of the innovation likely to influence diffusion (e.g., compatibility, relative advantage, complexity, trialability, observa/bility). Of the 290 unique articles identified, 65 were eligible for full-text review after title and abstract screening; a total of 27 were included in the final abstraction. Eleven unique tools were identified. The most commonly used tool was the Surgeon General's My Family Health Portrait (n =9/27). Only six studies directly evaluated participant perceptions shown to be associated with tool uptake. Studies tended to focus on improving compatibility by customizing tools to the target population's needs and use of educational interventions. Results from this review suggest the need to evaluate strategies to increase the pace of uptake of community-facing FHH tools. These include pragmatic trials that compare different approaches to engage and evaluate participant perceptions of the relative advantage and complexity of tools. Ancillary support strategies may include collaborations with community networks to facilitate use and implementation study designs for rigorous evaluation.
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Affiliation(s)
- Caitlin G Allen
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30308, USA.
| | - Debra Duquette
- Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL, 60611, USA
| | - Yue Guan
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30308, USA
| | - Colleen M McBride
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30308, USA
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9
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Lee SI, Patel M, Dutton B, Weng S, Luveta J, Qureshi N. Effectiveness of interventions to identify and manage patients with familial cancer risk in primary care: a systematic review. J Community Genet 2020; 11:73-83. [PMID: 31062229 PMCID: PMC6962422 DOI: 10.1007/s12687-019-00419-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/05/2019] [Indexed: 12/15/2022] Open
Abstract
This systematic review evaluated the effectiveness of strategies to identify and manage patients with familial risk of breast, ovarian, colorectal and prostate cancer in primary care to improve clinical outcomes. MEDLINE, EMBASE, CINAHL and Cochrane library were searched from January 1980 to October 2017. We included randomised controlled trials (RCT) and non-randomised studies of interventions (NRSI). Primary outcomes were cancer incidence, cancer-related clinical outcomes or the identification of cancer predisposition; secondary outcomes were the appropriateness of referral, uptake of preventive strategies and cognitive and psychological effect. From 11,842 abstracts, 111 full texts were reviewed and three eligible studies (nine articles) identified. Two were cluster RCTs and one NRSI; all used risk assessment software. No studies identified our primary outcomes, with no consistent outcome across the three studies. In one RCT, intervention improved the proportion of genetic referrals meeting referral guidelines for breast cancer (OR 4.5, 95% CI 1.6 to 13.1). In the other RCT, there was no difference in screening adherence between the intervention and control group. However, there was borderline increased risk perception (OR 1.89, 95% CI 0.99 to 3.59) in the subgroup that under-estimated their colon cancer risk. In the NRSI, there was no change in psychological distress in patients at increased familial breast cancer risk, but population risk patients had reduced anxiety after intervention (state anxiety mean change - 3, 95% CI - 5 to - 2). Future studies should have better-defined comparator groups and longer follow-up and assess outcomes using validated tools.
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Affiliation(s)
- Siang Ing Lee
- Division of Primary Care, School of Medicine, University of Nottingham, 13th Floor, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - Mitesh Patel
- Division of Primary Care, School of Medicine, University of Nottingham, 13th Floor, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - Brittany Dutton
- Division of Primary Care, School of Medicine, University of Nottingham, 13th Floor, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - Stephen Weng
- Division of Primary Care, School of Medicine, University of Nottingham, 13th Floor, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | | | - Nadeem Qureshi
- Division of Primary Care, School of Medicine, University of Nottingham, 13th Floor, Tower Building, University Park, Nottingham, NG7 2RD, UK.
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Cerda Diez M, E. Cortés D, Trevino-Talbot M, Bangham C, Winter MR, Cabral H, Norkunas Cunningham T, M. Toledo D, J. Bowen D, K. Paasche-Orlow M, Bickmore T, Wang C. Designing and Evaluating a Digital Family Health History Tool for Spanish Speakers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4979. [PMID: 31817849 PMCID: PMC6950582 DOI: 10.3390/ijerph16244979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 12/20/2022]
Abstract
Digital family health history tools have been developed but few have been tested with non-English speakers and evaluated for acceptability and usability. This study describes the cultural and linguistic adaptation and evaluation of a family health history tool (VICKY: VIrtual Counselor for Knowing Your Family History) for Spanish speakers. In-depth interviews were conducted with 56 Spanish-speaking participants; a subset of 30 also participated in a qualitative component to evaluate the acceptability and usability of Spanish VICKY. Overall, agreement in family history assessment was moderate between VICKY and a genetic counselor (weighted kappa range: 0.4695 for stroke-0.6615 for heart disease), although this varied across disease subtypes. Participants felt comfortable using VICKY and noted that VICKY was very likeable and possessed human-like characteristics. They reported that VICKY was very easy to navigate, felt that the instructions were very clear, and thought that the time it took to use the tool was just right. Spanish VICKY may be useful as a tool to collect family health history and was viewed as acceptable and usable. The study results shed light on some cultural differences that may influence interactions with family history tools and inform future research aimed at designing and testing culturally and linguistically diverse digital systems.
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Affiliation(s)
- Maria Cerda Diez
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA; (M.C.D.); (M.T.-T.); (C.B.); (T.N.C.)
| | - Dharma E. Cortés
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, MA 02141, USA;
- Department of Psychiatry, Harvard Medical School, Cambridge, MA 02139, USA
| | - Michelle Trevino-Talbot
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA; (M.C.D.); (M.T.-T.); (C.B.); (T.N.C.)
| | - Candice Bangham
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA; (M.C.D.); (M.T.-T.); (C.B.); (T.N.C.)
| | - Michael R. Winter
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA 02118, USA;
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA;
| | - Tricia Norkunas Cunningham
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA; (M.C.D.); (M.T.-T.); (C.B.); (T.N.C.)
| | - Diana M. Toledo
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA;
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | | | - Timothy Bickmore
- College of Computer and Information Science, Northeastern University, Boston, MA 02115, USA;
| | - Catharine Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA; (M.C.D.); (M.T.-T.); (C.B.); (T.N.C.)
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Menghi R, Papetti A, Germani M. Product Service Platform to improve care systems for elderly living at home. HEALTH POLICY AND TECHNOLOGY 2019. [DOI: 10.1016/j.hlpt.2019.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Vogel RI, Niendorf K, Lee H, Petzel S, Lee HY, Geller MA. A qualitative study of barriers to genetic counseling and potential for mobile technology education among women with ovarian cancer. Hered Cancer Clin Pract 2018; 16:13. [PMID: 29997716 PMCID: PMC6031189 DOI: 10.1186/s13053-018-0095-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/22/2018] [Indexed: 12/25/2022] Open
Abstract
Background National guidelines recommend genetic counseling for all ovarian cancer patients because up to 20% of ovarian cancers are thought to be due to hereditary cancer syndromes and effective cancer screening and prevention options exist for at-risk family members. Despite these recommendations, uptake of genetic counselling and testing is low. The goal of this study was to identify barriers to and motivators for receipt of genetic counseling along with preferences regarding potential use of a mobile application to promote genetic counseling. Methods Three focus groups were conducted including 14 women with a diagnosis of epithelial ovarian, primary peritoneal or fallopian tube cancer. Topics included understanding of genetic counseling, perceived pros and cons, preferences for receiving health information, and familiarity with mobile phone technology. Transcripts were analyzed using standard procedures of qualitative thematic text analysis and descriptive coding techniques. Results Six major themes regarding barriers to and motivators of genetic counseling and use of mobile technology in promoting genetic counseling emerged: (1) need for information, (2) relevance, (3) emotional concerns, (4) family concerns, (5) practical concerns, and (6) mobile application considerations. Conclusions These data reiterate previously reported barriers to genetic counseling as observed in other populations. Participants were supportive of the use of mobile technology for promoting uptake of genetic counseling.
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Affiliation(s)
- Rachel Isaksson Vogel
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Kristin Niendorf
- 2Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN USA
| | - Heewon Lee
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Sue Petzel
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Hee Yun Lee
- 3School of Social Work, College of Education and Human Development, University of Minnesota, Minneapolis, MN USA
| | - Melissa A Geller
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
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Lin J, Marcum CS, Wilkinson AV, Koehly LM. Developing Shared Appraisals of Diabetes Risk Through Family Health History Feedback: The Case of Mexican-Heritage Families. Ann Behav Med 2018; 52:262-271. [PMID: 29538667 PMCID: PMC6693036 DOI: 10.1093/abm/kax037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Collecting complete and accurate family health history is critical to preventing type 2 diabetes. Purpose We seek to identify the optimal risk feedback approach that facilitates risk communication between parents and their adult children and helps them develop shared appraisals of family history of type 2 diabetes. Methods In a sample of parent-adult child dyads from 125 Mexican-heritage families residing in Houston, Texas, we examine change in parent-child dyadic (dis)agreement with respect to their shared family health history from baseline to 10 months after receipt of risk feedback generated by Family Healthware. A 2 × 2 factorial design is applied to test how the recipient (one parent or all family members) and the content (risk assessment with or without behavioral recommendations) of the feedback affect (dis)agreement through interpersonal ties, particularly dyadic risk communication. Results Providing risk assessment without behavioral recommendations to the parent, but not the adult child, shifts the dyads toward agreement (relative risk ratio [RRR]= 1.78, 95% confidence interval [CI] [1.18-2.67]), by activating reciprocal risk communication between parents and children (RRR =2.70, 95% CI [1.81-4.03]). Dyads with close interpersonal ties are more likely to shift toward agreement (RRR = 3.09, 95% CI [1.89-5.07]). Conclusion Programs aimed at improving family health history knowledge and accuracy of reports should tailor risk feedback strategically for better intervention effect and leverage a network approach in disease prevention among at-risk minority and/or immigrant populations. Trial Registration Number NCT00469339.
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Affiliation(s)
- Jielu Lin
- National Human Genome Research Institute, Bethesda, MD, USA
| | | | | | - Laura M Koehly
- National Human Genome Research Institute, Bethesda, MD, USA
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de Heer HD, de la Haye K, Skapinsky K, Goergen AF, Wilkinson AV, Koehly LM. Let's Move Together. HEALTH EDUCATION & BEHAVIOR 2016; 44:141-152. [PMID: 27198532 DOI: 10.1177/1090198116644703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Due to shared health behaviors and disease risk, families may be more effective targets for health promotion. This study assessed whether providing family health history (FHH)-based risk information for heart disease and diabetes affected encouragement to engage in physical activity (PA) and healthy weight (HW) maintenance and co-engagement in physical activity among 320 Mexican-origin parents and their 1,081 children. METHOD At baseline and 10 months, parents indicated who they encouraged and who encouraged them to engage in PA/HW, and with whom they co-engaged in PA. Households were randomized to receive FHH-based assessments either by one or all adult household members. Primary analyses consisted of regression analyses using generalized estimating equations. RESULTS At baseline, parents reported encouraging their child for both PA and HW in 37.6% of parent-child dyads and reported receiving children's encouragement for both in 12.1% of dyads. These increased to 56.8% and 17.5% at 10 months ( p < .001). Co-engagement in PA increased from 11.4% to 15.7% ( p < .001), with younger children (30.4%) and mother-daughter dyads (26.8%) most likely to co-engage at 10 months. Providing FHH-based risk information to all adult household members (vs. one) was associated with increased parent-to-child encouragement of PA/HW ( p = .011) at 10 months but not child-to-parent encouragement. New encouragement from parent-to-child ( p = .048) and from child-to-parent ( p = .003) predicted new 10-month PA co-engagement. DISCUSSION Providing FHH information on a household level can promote parental encouragement for PA/HW, which can promote greater parent-child co-engagement in PA. In this high-risk population with a cultural emphasis on family ties, using FHH-based risk information for all adult household members may be a promising avenue to promote PA.
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Affiliation(s)
- Hendrik Dirk de Heer
- 1 Northern Arizona University, Flagstaff, AZ, USA.,2 National Human Genome Research Institute, Bethesda, MD, USA
| | | | - Kaley Skapinsky
- 2 National Human Genome Research Institute, Bethesda, MD, USA
| | | | - Anna V Wilkinson
- 4 The University of Texas School of Public Health, Austin, TX, USA
| | - Laura M Koehly
- 2 National Human Genome Research Institute, Bethesda, MD, USA
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Rodríguez VM, Corona R, Bodurtha JN, Quillin JM. Family Ties: The Role of Family Context in Family Health History Communication About Cancer. JOURNAL OF HEALTH COMMUNICATION 2016; 21:346-55. [PMID: 26735646 PMCID: PMC4852547 DOI: 10.1080/10810730.2015.1080328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Family health history about cancer is an important prevention and health promotion tool. Yet few studies have identified family context factors that promote such discussions. We explored relations among family context (cohesion, flexibility, and openness), self-efficacy, and cancer communication (gathering family history, sharing cancer risk information, and frequency) in a diverse group of women enrolled in a randomized control trial. Baseline survey data for 472 women were analyzed. The women's average age was 34 years, 59% identified as Black, 31% had graduated high school, and 75% reported a family history of any cancer. Results showed that greater family cohesion and flexibility were related to higher communication frequency and sharing cancer information. Women who reported greater self-efficacy were more likely to have gathered family history, shared cancer risk information, and communicated more frequently with relatives. Openness was not associated with communication but was related to greater family cohesion and flexibility. Adjusting for demographic variables, self-efficacy, and family cohesion significantly predicted communication frequency. Women with higher self-efficacy were also more likely to have gathered family health history about cancer and shared cancer risk information. Future research may benefit from considering family organization and self-efficacy when developing psychosocial theories that in turn inform cancer prevention interventions.
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Affiliation(s)
- Vivian M. Rodríguez
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Rosalie Corona
- Department of Psychology, Virginia Commonwealth University
| | - Joann N. Bodurtha
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University
| | - John M. Quillin
- Department of Human and Molecular Genetics, Virginia Commonwealth University
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