Social sharing of genetic information in the family: a study on hereditary breast and ovarian cancers

Electronic health record access by patients as an indicator of information seeking and sharing for cardiovascular health promotion in social networks: Secondary analysis of a randomized clinical trial

We investigated electronic health record (EHR) access as an indicator of cardiovascular health promotion by patients in their social networks, by identifying individuals who viewed their coronary heart disease (CHD) risk information in the EHR and shared this information in their social networks among various spheres of influence. In a secondary analysis of the Myocardial Infarction Genes trial, Olmsted County MN residents (2013-2015; n = 203; whites, ages 45-65 years) at intermediate CHD risk were randomized to receive their conventional risk score (CRS; based on traditional risk factors) alone or also their genetic risk score (GRS; based on 28 genomic variants). We assessed self-reported and objectively quantified EHR access via a patient portal at three and six months after risk disclosure, and determined whether this differed by GRS disclosure. Data were analyzed using logistic regression and adjusted for sociodemographic characteristics, family history, and baseline CRS/GRS. Self-reported EHR access to view CHD risk information was associated with a high frequency of objectively quantified EHR access (71(10) versus 37(5) logins; P = 0.0025) and a high likelihood of encouraging others to be screened for their CHD risk (OR 2.936, CI 1.443-5.973, P = 0.0030), compared to the absence of self-reported EHR access to view CHD risk information. We thereby used EHR access trends to identify individuals who may function as disseminators of CHD risk information in social networks, compared to individuals on the periphery of their social networks who did not exhibit this behavior. Partnering with such individuals could amplify CHD health promotion. Clinical Trial Registration: Myocardial Infarction Genes (MI-GENES) Study, NCT01936675, https://clinicaltrials.gov/ct2/show/NCT01936675.

From older to younger: intergenerational promotion of health behaviours in Portuguese families affected by familial amyloid polyneuropathy

The role of older generations in families with hereditary diseases has been recognised and associated to their function as guardians of the family's medical history. However, research is scarce in examining the roles that older generations play in terms of health promotion and risk management towards younger generations, which is particularly evident with incurable genetically inherited disorders such as familial amyloid polyneuropathy (FAP) ATTR Val30Met. This qualitative exploratory study examines the roles that older generations play towards younger generations, in terms of health promotion and risk management, in families with FAP. It also explores the intergenerational flow by analysing who from the older generation plays what role(s) towards whom from the younger generation. This study adopts the critical incidents technique. The sample comprises 18 participants that reported 76 critical incidents. The interviews were audio-taped and submitted for content analysis with the main findings suggesting four roles performed by the older family members towards the younger ones: modelling, encouraging, informing and supporting. The intergenerational flow takes place mostly between women, from mother to daughter, and from older affected individuals to young pre-symptomatic carriers. The older generations can be involved in the clinical practice as partners in supporting younger relatives in families with FAP. Clinical genetic services and the health-care system more broadly might want to consider these roles and the intergenerational flow of support so that this information can be used to maximise health promotion behaviours in at-risk families.

Latino men and familial risk communication about prostate cancer

PURPOSE/OBJECTIVES

To investigate how familial communication about prostate cancer (PCa) risk and screening affects sons of men with PCa.

RESEARCH APPROACH

Qualitative grounded theory.

SETTING

Southern California.

PARTICIPANTS

17 Latino sons of PCa survivors.

METHODOLOGIC APPROACH

The team conducted semistructured interviews and follow-up interviews. Therefore, the sample includes 25 transcripts. Data were analyzed with a mix of a priori topical codes and grounded theory techniques.

FINDINGS

Sons were in need of information about familial risk and screening options. They became sensitized to PCa, desired information, and held protective intentions. Hopeful intentions came up against cultural taboos around sex, reproductive health, and intimacy that limited discussions between fathers and sons. Fathers were a valued source of information but play various roles, which affect sons' screening intentions. Open communication between father and son promoted awareness of screening and familial risk.

CONCLUSIONS

Uncertainty about familial risk and screening options, especially early detection strategies, was exacerbated by cultural taboos around PCa. Fathers could have been primary and credible advocates for shared decision making, but sons had difficulty learning from their fathers' experience.

INTERPRETATION

FINDINGS from the study can help inform community-based interventions with Latino families, help to culturally tailor health messaging, and sensitize clinicians to a group that needs concerted counseling about PCa risk and screening.

Making sense of risk diagnosis in case of prenatal and reproductive genetic counselling for neuromuscular diseases

This study explored the processes of significance about the risk communication in prenatal/preconception setting within 1 month to the end of genetic counselling intervention. Participants were all attending a programme of Cardiomyology and Medical Genetics in Naples, Italy, for the first time. Transcripts of 18 semi-structured interviews were analysed using interpretative phenomenological analysis. Themes arising included the following: the familiar outcomes of genetic counselling, the risk representation and the impacts on decision-making. The findings suggest the significance of the experience of genetic risk and the implications for the support of individuals and their family after the conclusion of the genetic counselling intervention.

The importance of older family members in providing social resources and promoting cancer screening in families with a hereditary cancer syndrome

PURPOSE

This study evaluates the role of older family members as providers of social resources within familial network systems affected by an inherited cancer susceptibility syndrome. 

DESIGN AND METHODS

Respondents who previously participated in a study that involved genetic counseling and testing for Lynch syndrome and their family network members were invited to participate in a onetime telephone interview about family communication.

RESULTS

A total of 206 respondents from 33 families identified 2,051 social relationships (dyads). Nineteen percent of the respondents and 25% of the network members were older (≥60 years). Younger respondents (≤59 years) were more likely to nominate older network members as providers of social resources than younger members: instrumental support (odds ratio [OR] = 1.68), emotional support (OR = 1.71), help in crisis situation (OR = 2.04), and dependability when needed (OR = 2.15). Compared with younger network members, older members were more likely to be listed as encouragers of colon cancer screening by both younger (OR = 3.40) and older respondents (OR = 1.90) independent of whether support exchange occurred in the relationship.

IMPLICATIONS

Engaging older network members in health interventions to facilitate screening behaviors and emotional well-being of younger members within families affected by inherited conditions may be beneficial. Findings can be used to empower older individuals about their important social roles in enhancing the well-being of their family members and to inform younger individuals about their older relatives' resourcefulness to facilitate positive social interactions.