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Oliveira CR, Seidi C, Sequeiros J, Sousa L, Mendes Á. Health-related roles of older generations in families with inherited genetic conditions: a scoping review. J Community Genet 2024; 15:351-361. [PMID: 38795255 PMCID: PMC11411034 DOI: 10.1007/s12687-024-00713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/20/2024] [Indexed: 05/27/2024] Open
Abstract
Inherited genetic conditions are family diseases. They affect consanguineous relatives, in lineage for several generations, and impact the family dynamics. Older generations have been considered highly influential in the health management of families with inherited genetic conditions. To our knowledge, no reviews so far addressed the health-related roles of older generations in these families. This scoping review aims to fill that gap by mapping the existent research about the health-roles roles performed by the older generations in families living with autosomal dominant inherited genetic conditions. Four electronic databases were searched: Scopus, Web of Science, PubMed, PsycInfo. Eleven studies were included, and relevant findings were extracted. Main roles included: informers vs. blockers of disease-related information; encouragers vs. discouragers of health screening or genetic testing; (non-)supporters; and role models in living and coping with the disease. The roles played by older generations are relevant to the health management of other family members and can be beneficial to themselves (reciprocal interactions). Acknowledging and understanding these roles is important for professionals and health-services. Results suggest the relevance of an intergenerational perspective when working with families with inherited genetic conditions.
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Affiliation(s)
- Carla Roma Oliveira
- Associação dos Lares Ferroviários, Entroncamento, Portugal.
- CINTESIS@RISE, Department of Education and Psychology, Universidade de Aveiro, Aveiro, Portugal.
- CGPP - Centre for Predictive and Preventive Genetics, IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal.
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
| | - Catarina Seidi
- CINTESIS@RISE, Department of Education and Psychology, Universidade de Aveiro, Aveiro, Portugal
- CGPP - Centre for Predictive and Preventive Genetics, IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Jorge Sequeiros
- CGPP - Centre for Predictive and Preventive Genetics, IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal
| | - Liliana Sousa
- CINTESIS@RISE, Department of Education and Psychology, Universidade de Aveiro, Aveiro, Portugal
| | - Álvaro Mendes
- CGPP - Centre for Predictive and Preventive Genetics, IBMC - Institute for Molecular and Cell Biology, Universidade do Porto, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Allen CG, McBride CM, Escoffery C, Guan Y, Hood C, Zaho J, Brody G, An W. Developing and assessing a kin keeping scale with application to identifying central influencers in African American family networks. J Community Genet 2023; 14:593-603. [PMID: 37648941 PMCID: PMC10725405 DOI: 10.1007/s12687-023-00665-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023] Open
Abstract
Promoting family communication about inherited disease risk is an arena in which family systems theory is highly relevant. One family systems' construct that can support promotion of family communication regarding inherited disease risk is the notion of "kin keeping." However, kin keeping and whether it might be capitalized on to encourage family communication about inherited risk has been understudied. The goal of this report was to propose a broadened conceptualization of kin keeping that distinguishes between a structural functional perspective (role conceptualization) and transitional behaviors (skill conceptualization), and to develop and evaluate a scale that would enable this assertion to be tested among a sample of African American community health workers. We developed a scale using four steps: item development using concept analysis and content validity, scale development among a national sample (n = 312), scale evaluation using exploratory factor analysis (n = 52), and scale reduction. We then posed suppositions of associations that would indicate whether the developed kin keeping measure was assessing a specific family role or set of behaviors. Our results included the development of the first quantitative measure of kin keeping (9- and 15-item scales). Model fit for 9-item scale (CFI = 0.97, AFGI = 0.89, RMSEA = 0.09, SMRM = 0.06) and model fit for 15-item scale (CFI = 0.97, AFGI = 0.89, RMSEA = 0.06, SMRM = 0.05). These findings allow us to move toward more rigorous research about the role of kin keeping on information sharing and health decision making. Results also suggest that, contrary to the historical structural functional conceptualization of kin keeping as a role, kin keeping might also be conceptualized as a behavior or set of modifiable behaviors. Ultimately, the kin keeping scale could be used to operationalize kin keeping in various theoretical models and frameworks, guide intervention development to encourage or train for kin keeping behaviors, and test assumptions of whether families vary in the density of kin keeping.
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Affiliation(s)
- Caitlin G Allen
- Medical University of South Carolina, Charleston, SC, USA.
- Emory University, Atlanta, GA, USA.
| | | | | | - Yue Guan
- Emory University, Atlanta, GA, USA
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Allen CG, Green RF, Dowling NF, Fairley TL, Khoury MJ. Understanding the Process of Family Cancer History Collection and Health Information Seeking. HEALTH EDUCATION & BEHAVIOR 2023; 50:572-585. [PMID: 36794801 PMCID: PMC10427738 DOI: 10.1177/10901981231152430] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PROBLEM ADDRESSED To better understand the factors associated with family cancer history (FCH) information and cancer information seeking, we model the process an individual undergoes when assessing whether to gather FCH and seek cancer information and compare models by sociodemographics and family history of cancer. We used cross-sectional data from the Health Information National Trends Survey (HINTS 5, Cycle 2) and variables (e.g., emotion and self-efficacy) associated with the Theory of Motivated Information Management to assess the process of FCH gathering and information seeking. We completed path analysis to assess the process of FCH gathering and stratified path models. RESULTS Those who felt they could lower their chances of getting cancer (emotion) were more confident in their ability to complete FCH on a medical form (self-efficacy; B = 0.11, p < .0001) and more likely to have discussed FCH with family members (B = 0.07, p < .0001). Those who were more confident in their ability to complete a summary of their family history on a medical form were more likely to have discussed FCH with family members (B = 0.34, p < .0001) and seek other health information (B = 0.24, p < .0001). Stratified models showed differences in this process by age, race/ethnicity, and family history of cancer. IMPLICATIONS FOR PUBLIC HEALTH RESEARCH AND PRACTICE Tailoring outreach and education strategies to address differences in perceived ability to lower chances of getting cancer (emotion) and confidence in the ability to complete FCH (self-efficacy) could help encourage less engaged individuals to learn about their FCH and gather cancer information.
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Affiliation(s)
| | | | | | | | - Muin J. Khoury
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Denton JJ, Cedillo YE. Investigating family history of diabetes as a predictor of fasting insulin and fasting glucose activity in a sample of healthy weight adults. Acta Diabetol 2023; 60:535-543. [PMID: 36637530 DOI: 10.1007/s00592-023-02030-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
AIMS Type 2 diabetes is a major public health problem for the global community. Having a family history of diabetes significantly increases risk for diabetes development and understanding how family history contributes to diabetes risk could lead to more effective prevention efforts for at-risk individuals. In a previous study, we showed family history of diabetes is a significant predictor of fasting insulin in healthy weight children. The present study aimed to use the National Health and Nutrition Examination Survey (NHANES 2017) to apply similar multiple regression models to a population of healthy weight adults to determine if family history is a significant predictor of fasting glucose and fasting insulin. METHODS Fasting glucose (mg/dL) and fasting insulin (pmol/L) were used as dependent variables in each model, respectively, with family history of diabetes as the independent variable. Covariates for each model included age, gender, race/ethnicity, waist circumference, and macronutrient intake. RESULTS The model significantly predicted the variance of fasting glucose [(F(11,364) = 34.80, p < 0.001, R2 = 0.2342] and fasting insulin [F(11,343) = 17.58, p < 0.001, R2 = 0.1162]. After adjusting for covariates, family history was a significant predicator of fasting glucose (p = 0.0193) as well as age, gender, non-Hispanic black ethnicity, waist circumference, and fat intake. Significant predictors of fasting insulin included gender and waist circumference, but not family history (p = 0.8264). In addition, fasting glucose was higher in individuals with a family history of diabetes (p = 0.033). CONCLUSIONS These results add to the understanding of how family history influences the biomarkers that contribute to diabetes development. Knowledge of how family history of diabetes relates to fasting insulin and fasting glucose activity in healthy weight individuals can be used to design personalized screening and early prevention strategies.
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Affiliation(s)
- Jessica J Denton
- University of Alabama at Birmingham, School of Health Professions Building, Room 448, 1720 2nd Ave S., Birmingham, Alabama, 35294, USA.
| | - Yenni E Cedillo
- University of Alabama at Birmingham, Webb Building, Room 544, 1720 2nd Ave S., Birmingham, Alabama, 35294, USA
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Mostafa SA, Mohammad MHS, Negm WA, Batiha GES, Alotaibi SS, Albogami SM, Waard MD, Tawfik NZ, Abdallah HY. Circulating microRNA203 and its target genes' role in psoriasis pathogenesis. Front Med (Lausanne) 2022; 9:988962. [DOI: 10.3389/fmed.2022.988962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Numerous microRNAs (miRNAs) have been found to have an aberrant expression in the peripheral blood or psoriasis patients' lesions. Psoriasis was shown to have the abnormal expression of microRNA-203 (miR-203). It is a skin-specific signal that governs cellular proliferation in a protein kinase C-dependent manner and is mostly generated by keratinocytes. This work evaluated the expression levels of the circulating miR-203 target genes SOCS3, SOCS6, TP63, TNF-, IL8, and IL24 in psoriasis patients. Using a relative quantitation PCR technique, we determined the expression levels of miR-203 and its target genes (SOCS3, SOCS6, TP63, TNF-, IL8, and IL24) in the plasma of 120 psoriatic patients and matched healthy controls. The disease characteristics of the patients were then correlated with the expression results. We also conducted numerous enrichment analyses for the diseases, functions, and pathways connected to the under-researched biomarkers. Compared to healthy controls, psoriatic patients had significantly increased levels of miR-203 expression; 7.1 (4.4–9.9). In contrast, psoriatic patients had significantly lower expression of all the examined genes compared to healthy controls. Regarding all the study biomarkers, the receiver operating characteristic (ROC) curve analysis demonstrated significant sensitivity and specificity for differentiating between psoriatic patients and healthy controls. According to the results of the disease matching score generated by miR-203 and its target genes, psoriasis was ranked first with a score of 4.45. The third-place finisher with a value of 3.98, it also demonstrated that miR-203 and its target genes are connected to various skin disorders. Our results show that miR-203 contributes to psoriasis pathogenesis not only locally in skin lesions but also in circulation, indicating that it may contribute to the systemic symptoms of the illness. MiR-203 overexpression in psoriasis suggests that miR-203 may be involved in an anti-inflammatory response because it targets both SOCS gene family members and pro-inflammatory cytokines.
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Liew SH, Lim JY, Yahya HM, Rajikan R. Knowledge and perception of inborn errors of metabolism (IEMs) among healthcare students at a selected public university in Klang Valley, Malaysia. Intractable Rare Dis Res 2022; 11:125-132. [PMID: 36200028 PMCID: PMC9437999 DOI: 10.5582/irdr.2022.01062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/27/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022] Open
Abstract
Healthcare providers play an important role in improving the health of Inborn Error of Metabolism (IEM) patients. However, IEM knowledge level among local healthcare students has yet to be determined. Thus, the aim of this study is to assess the knowledge and perception of IEM among local healthcare students. An online self-administered questionnaire was distributed to 378 students across the Faculty of Health Science, Pharmacy and Dentistry from a selected public university in Lembah Klang, Malaysia. For knowledge, a score of 1 is assigned to each correct answer with a maximum total score of 14. Likert scale was used to determine their perception of IEM. The total mean score of IEM knowledge among healthcare students is 5.8. There was no significant difference of mean score of IEM knowledge among the students from the Faculty of Health Science (6.1 ± 2.7), Pharmacy (5.5 ± 2.6) and Dentistry (5.8 ± 2.8). However, the score of knowledge is observed to be significantly different by ethnicity, religion and family history of IEM (p < 0.05). Furthermore, students with experience of meeting an IEM patient and attending IEM classes scored higher than those with no experience (p < 0.05). Most of the healthcare students (89.5%) perceived their knowledge to be insufficient and very poor. Majority of the students from faculty of pharmacy (70.8%) agreed that the IEM course should be mandatory compared to health sciences and dentistry (p < 0.05). This study identified an overall inadequacy of knowledge of IEM among healthcare students. There is a pressing need to improve the IEM-related knowledge and awareness of Malaysian healthcare students. This can be accomplished by incorporating online classes that emphasizes the treatment and management of IEMs in the university curriculum.
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Affiliation(s)
- Shi Hui Liew
- Nutritional Science Program, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jing Ying Lim
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Hanis Mastura Yahya
- Nutritional Science Program, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Roslee Rajikan
- Nutritional Science Program, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia
- Address correspondence to:Roslee Rajikan, Dietetics Programme & Centre of Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia. E-mail:
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Knowledge regarding diabetes mellitus among non-diabetic patients attending the outpatient department of the district hospital in Gorkha, Nepal. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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8
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Factors Influencing Family Health History Collection among Young Adults: A Structural Equation Modeling. Genes (Basel) 2022; 13:genes13040612. [PMID: 35456417 PMCID: PMC9027539 DOI: 10.3390/genes13040612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/17/2022] [Accepted: 03/26/2022] [Indexed: 02/03/2023] Open
Abstract
Family health history (FHH) can serve as an entry point for preventive medicine by providing risk estimations for many common health conditions. College is a critical time for young adults to begin to understand the value of FHH collection, and to establish healthy behaviors to prevent FHH-related diseases. This study seeks to develop an integrated theoretical framework to examine FHH collection behavior and associated factors among college students. A sample of 2670 college students with an average age of 21.1 years completed a web-based survey. Less than half (49.8%) reported actively seeking FHH information from their family members. Respondents’ knowledge about FHH were generally low. Structural equation modeling findings suggested an adequate model fit between our survey data and the proposed integrated theoretical framework. Respondents who were members of racial/ethnic minority groups exhibited higher levels of anxiety and intention to obtain FHH information but had lower confidence in their ability to gather FHH information than non-Hispanic White respondents. Therefore, educational programs designed to enhance the level of young adults’ FHH knowledge, efficacy, and behavior in FHH collection, and change subjective norms are critically needed in the future, especially for these who are members of racial/ethnic minority groups.
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Increased family history documentation in internal medicine resident continuity clinic at a community hospital through resident-led structured genetic education program. J Community Genet 2022; 13:347-354. [DOI: 10.1007/s12687-022-00581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022] Open
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Yin X, Chan CPY, Seow A, Yau WP, Seow WJ. Association between family history and lung cancer risk among Chinese women in Singapore. Sci Rep 2021; 11:21862. [PMID: 34750403 PMCID: PMC8575905 DOI: 10.1038/s41598-021-00929-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/01/2021] [Indexed: 11/22/2022] Open
Abstract
Risk factors of lung cancer unrelated to smoking are not well-studied, especially among women. Family history has been shown to play a role in predisposing individuals to lung cancer, but this relationship has not been investigated in the Southeast Asian population. A total of 1159 women were recruited in a case-control study conducted in public hospitals in Singapore from 2005 to 2008. After excluding participants with incomplete family history information, 374 cases and 785 controls remained in the final analysis. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression, adjusting for potential confounders. Overall, family history of lung cancer was associated with a higher risk for lung cancer (aOR 2.08, 95% CI 1.25-3.47). When stratified by smoking status, a significant association was observed among never-smokers (aOR 2.78, 95% CI 1.57-4.90). Further stratification by fruit consumption identified a significant association between family history of lung cancer and higher risk of lung cancer among never-smokers who had low fruit consumption (aOR 3.09, 95% CI 1.37-7.01). Our findings suggest that family history of lung cancer is a significant risk factor for lung cancer in Singaporean Chinese women, especially among never-smokers.
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Affiliation(s)
- Xin Yin
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Cheryl Pui Yi Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, 117559, Singapore
| | - Adeline Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Wai-Ping Yau
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, 117559, Singapore
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, 117597, Singapore.
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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: 5] [Impact Index Per Article: 1.7] [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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Lam V, Scott R, Billings P, Cabebe E, Young R. Utility of incorporating a gene-based lung cancer risk test on uptake and adherence in a community-based lung cancer screening pilot study. Prev Med Rep 2021; 23:101397. [PMID: 34040933 PMCID: PMC8142278 DOI: 10.1016/j.pmedr.2021.101397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/31/2021] [Accepted: 05/08/2021] [Indexed: 11/24/2022] Open
Abstract
Based on the results of randomized control trials, screening for lung cancer using computed tomography (CT) is now widely recommended. However, adherence to screening remains an issue outside the clinical trial setting. This study examines the utility of biomarker-based risk assessment on uptake and subsequent adherence in a community screening study. In a single arm pilot study, current or former smokers > 50 years old with 20 + pack year history were recruited following local advertising. One hundred and fifty seven participants volunteered to participate in the study that offered an optional gene-based lung cancer risk assessment followed by low-dose CT according to a standardised screening protocol. All 157 volunteers who attended visit 1 underwent the gene-based risk assessment comprising of a clinical questionnaire and buccal swab. Of this group, 154 subsequently attended for CT screening (98%) and were followed prospectively for a median of 2.7 years. A participant’s adherence to screening was influenced by their baseline lung cancer risk category, with overall adherence in those with a positive scan being significantly greater in the “very high” risk group compared to “moderate” and “high” risk categories (71% vs 52%, Odds ratio = 2.27, 95% confidence interval of 1.02–5.05, P = 0.047). Those in the “moderate” risk group were not different to those in the “high” risk group (52% and 52%, P > 0.05). In this proof-of-concept study, personalised gene-based lung cancer risk assessment was well accepted, associated with a 98% uptake for screening and increased adherence for those in the highest risk group.
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Affiliation(s)
- V.K. Lam
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
- El Camino Hospital, Mountain View, CA, USA
| | - R.J. Scott
- Department of Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland Hospital, New Zealand
- Corresponding author at: Medicine and Molecular Genetics, P. O. Box 26161 Epsom, Auckland 1344, New Zealand.
| | | | - E. Cabebe
- El Camino Hospital, Mountain View, CA, USA
| | - R.P. Young
- Department of Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland Hospital, New Zealand
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McKeague B, Maguire R. "The effects of cancer on a family are way beyond the person who's had it": The experience and effect of a familial cancer diagnosis on the health behaviours of family members. Eur J Oncol Nurs 2021; 51:101905. [PMID: 33601195 DOI: 10.1016/j.ejon.2021.101905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE People who are first-degree relatives of cancer patients are at an increased risk of developing cancer themselves. Despite this, relatives of cancer patients do not always make beneficial changes to their health behaviours. This study aimed to answer the following questions: (1) do the health behaviours of people who are first-degree relatives of cancer survivors change following cancer diagnosis, and if so, how, and why, (2) what motivations/barriers exist for first-degree relatives when seeking to engage with health promoting behaviours, and (3) what do first-degree relatives believe healthcare organisations can do to improve uptake of healthy lifestyle changes. METHOD Nine biological first-degree relatives of cancer survivors living in Ireland (6 children, 2 siblings, 1 parent) participated in semi-structured interviews which were later thematically analysed. RESULTS Findings revealed four superordinate themes: Being Conscious/Aware, Limited Lifestyle Changes, Psychosocial Consequences of Experience, and Unmet Needs, with each of these themes having two to three subordinate themes. Patient and public involvement emphasised Unmet Needs, including needs for information and family support, as the theme that was most reflective of participants' lived experience. CONCLUSIONS Results suggest that while family members tend not to change their lifestyle behaviours following cancer diagnosis, they do seem to make changes to their medical behaviours. Additionally, they can be negatively impacted by the experience in several other ways. Identifying means of support will allow relatives to cope better post diagnosis.
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Affiliation(s)
- Beth McKeague
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
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Zhu H, Chen X, Zhang B, Yang W, Xing X. Family History of Diabetes and the Effectiveness of Lifestyle Intervention on Insulin Secretion and Insulin Resistance in Chinese Individuals with Metabolic Syndrome. J Diabetes Res 2021; 2021:8822702. [PMID: 33490287 PMCID: PMC7803416 DOI: 10.1155/2021/8822702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
AIMS The current study aims to explore if a family history of diabetes can influence the efficiency of lifestyle intervention on insulin secretion and study the insulin resistance in Chinese men and women with metabolic syndrome in a cohort with a 2-year follow-up. METHODS 151 individuals (90 individuals did not have a family history of diabetes (DMFH (-)) and 61 with a family history of diabetes (DMFH (+)) with metabolic syndrome participated in the lifestyle intervention program at baseline and finished with 1-year follow-up. 124 individuals have two-year follow-up data. A family history of diabetes was ascertained by self-report. Lifestyle interventions were individual sessions on lifestyle changes. RESULTS During the 1-year follow-up, Ln Insulinogenic index (Δbaseline-1year = 0.29 ± 0.65, P = 0.001) and 30-min glucose (Δbaseline-1year = -0.41 ± 1.71, P = 0.024) changed significantly in the DMFH(-) group; in the DMFH(+) group, Ln ISIm (Δbaseline-1year = -0.22 ± 0.60, P = 0.022) and 30-min glucose (Δbaseline-1year = 0.53 ± 1.89, P = 0.032) changed significantly, and there was no significant change of other parameters. The change of 30 min glucose during a 1-year intervention has shown a significant difference between the two groups (P = 0.002). During the 2 years intervention, Ln Insulinogenic index changed significantly in the DMFH(-) group (Δbaseline-1year = 0.33 ± 0.66, P < 0.001 and Δbaseline-2year = 0.43 ± 1.17, P = 0.034). Fasting insulin (Δbaseline-2year = 2.95 ± 8.69, P = 0.034), 2 h insulin (Δbaseline-2year = 23.75 ± 44.89, P = 0.002), Ln HOMA-B (Δbaseline-2year = 0.43 ± 1.02, P = 0.009), Ln HOMA-IR (Δbaseline-2year = 0.53 ± 1.04, P = 0.002), Ln ISIm (Δbaseline-2year = 0.52 ± 0.95, P = 0.004), and Ln Insulinogenic index (Δbaseline-2year = 0.66 ± 1.18, P = 0.047) changed significantly after 2 years of intervention, compared to the baseline in the DMFH(+) group. The change of Ln ISIm (P = 0.023), fasting (P = 0.030), and 2 h insulin (P = 0.007) during the 2-year intervention has shown a significant difference between the two groups. Family history of diabetes was related with a 0.500 unit increase in 2-year ISIm (P = 0.020) modified by lifestyle intervention adjusted for age, baseline BMI, sex, and baseline waist circumference and a 0.476 unit increase in 2-year ISIm (P = 0.027) with extra adjustment for weight change. CONCLUSIONS Patients with a family history of diabetes benefit more from lifestyle intervention in regard to insulin resistance than those without a family history of diabetes adjusting for age, baseline BMI, sex, baseline waist circumference, and weight change.
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Affiliation(s)
- Haiqing Zhu
- Department of Endocrinology, Emergency General Hospital, Beijing, China
| | - Xiaoping Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Wenying Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoyan Xing
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
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Heji ES, Bukhari AA, Bahammam MA, Homeida LA, Aboalshamat KT, Aldahlawi SA. Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients. Eur J Dent 2020; 15:216-221. [PMID: 33285572 PMCID: PMC8184281 DOI: 10.1055/s-0040-1719208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The study investigates whether periodontal parameters can identify subjects with undiagnosed diabetes mellitus (DM) or pre-DM in patients seeking dental treatment at a university dental hospital. MATERIALS AND METHODS Adults older than 35 years, not being diagnosed with DM before and have at least one of the risk factors of DM were included in the study. All subjects received a complete periodontal examination, filled a medical history survey, and a fasting blood glucose measurement was obtained. A multiple logistic regression test using a backward elimination method to assess factors that predict if the participant is healthy, prediabetic or diabetic was done. A p-value of <0.05 was considered significant. RESULTS A total of 61 subjects were enrolled with an average age of 42.9 ± 9.4 years. Having a family member diagnosed with DM was reported by 64.5% of the subjects; 59% were diagnosed with advanced periodontal disease. The final logistic regression model included smoking, hypertension, family history of DM, and percentage of clinical attachment loss >3 mm was statistically significant (P < 0.001). The model explained 47.7% of the diabetes condition and correctly classified 69.4% of cases. Participants with a family history of diabetes are 4.98 times more likely to exhibit prediabetic or diabetic status. Each unit increase in the percentage of clinical attachment loss increases the likelihood of participant to be prediabetic or diabetic by 1.104 times. CONCLUSION Dental patients presenting with severe clinical attachment loss and family history of DM have increased likelihood of undiagnosed DM or pre-DM and would benefit from screening at the dental office.
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Affiliation(s)
- Esraa S Heji
- Dental Teaching Hospital, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Manal A Bahammam
- Dental Teaching Hospital, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lujain A Homeida
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Khalid T Aboalshamat
- Division of Dental Public Health, Department of Preventative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa A Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Dai HJ, Lee YQ, Nekkantti C, Jonnagaddala J. Family History Information Extraction With Neural Attention and an Enhanced Relation-Side Scheme: Algorithm Development and Validation. JMIR Med Inform 2020; 8:e21750. [PMID: 33258777 PMCID: PMC7738250 DOI: 10.2196/21750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/10/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Identifying and extracting family history information (FHI) from clinical reports are significant for recognizing disease susceptibility. However, FHI is usually described in a narrative manner within patients' electronic health records, which requires the application of natural language processing technologies to automatically extract such information to provide more comprehensive patient-centered information to physicians. OBJECTIVE This study aimed to overcome the 2 main challenges observed in previous research focusing on FHI extraction. One is the requirement to develop postprocessing rules to infer the member and side information of family mentions. The other is to efficiently utilize intrasentence and intersentence information to assist FHI extraction. METHODS We formulated the task as a sequential labeling problem and propose an enhanced relation-side scheme that encodes the required family member properties to not only eliminate the need for postprocessing rules but also relieve the insufficient training instance issues. Moreover, an attention-based neural network structure was proposed to exploit cross-sentence information to identify FHI and its attributes requiring cross-sentence inference. RESULTS The dataset released by the 2019 n2c2/OHNLP family history extraction task was used to evaluate the performance of the proposed methods. We started by comparing the performance of the traditional neural sequence models with the ordinary scheme and enhanced scheme. Next, we studied the effectiveness of the proposed attention-enhanced neural networks by comparing their performance with that of the traditional networks. It was observed that, with the enhanced scheme, the recall of the neural network can be improved, leading to an increase in the F score of 0.024. The proposed neural attention mechanism enhanced both the recall and precision and resulted in an improved F score of 0.807, which was ranked fourth in the shared task. CONCLUSIONS We presented an attention-based neural network along with an enhanced tag scheme that enables the neural network model to learn and interpret the implicit relationship and side information of the recognized family members across sentences without relying on heuristic rules.
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Affiliation(s)
- Hong-Jie Dai
- College of Electrical Engineering and Computer Science, Department of Electrical Engineering, National Kaohsiung University of Science and Technology, Kaohsiung City, Taiwan.,School of Post-Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - You-Qian Lee
- College of Electrical Engineering and Computer Science, Department of Electrical Engineering, National Kaohsiung University of Science and Technology, Kaohsiung City, Taiwan
| | | | - Jitendra Jonnagaddala
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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17
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El-Komy MHM, Mashaly H, Sayed KS, Hafez V, El-Mesidy MS, Said ER, Amer MA, AlOrbani AM, Saadi DG, El-Kalioby M, Eid RO, Azzazi Y, El Sayed H, Samir N, Salem MR, El Desouky ED, Zaher HAEM, Rasheed H. Clinical and epidemiologic features of psoriasis patients in an Egyptian medical center. JAAD Int 2020; 1:81-90. [PMID: 34409325 PMCID: PMC8362248 DOI: 10.1016/j.jdin.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 02/01/2023] Open
Abstract
Background Identification of epidemiologic and phenotypic variations of psoriasis among different ethnic groups can further our understanding of this perplexing disease, aiming at better management of patients worldwide. Objective To provide a descriptive analysis of psoriasis patients registered at Kasr Al-Ainy Psoriasis Unit Disease Registry. Methods This retrospective single-center registry study included patient records between November 2015 and November 2018 (2534 patients). Sociodemographic and phenotypic data were analyzed. Results The mean age of the registered patients was 39.3 years and 56.3% were men. Stress was the main precipitating factor (48.3%), whereas the most common symptom reported was itching (82.4%). The median body mass index was 27.5, and the median percentage of body surface area involved was 10.0. The mean Psoriasis Area Severity Index score was 8.7, and the mean Psoriasis Disability Index score was 13.0. Both parameters correlated positively, and both showed significantly higher means in smokers. Limitations Despite that the study was performed at a highly specialized tertiary care center with a high flow of patients, this was still a single-center registry. Conclusions This work shows that the characteristics of Egyptian patients with psoriasis are comparable to those of other studied ethnic groups, with minor differences.
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Affiliation(s)
- Mohamed Hussein Medhat El-Komy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba Mashaly
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khadiga S Sayed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Vanessa Hafez
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa S El-Mesidy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman R Said
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa A Amer
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya M AlOrbani
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina G Saadi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona El-Kalioby
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem O Eid
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yousra Azzazi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hagar El Sayed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nesrin Samir
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa R Salem
- Department of Public Health and Community, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman D El Desouky
- Department of Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hesham Abd El-Moaty Zaher
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hoda Rasheed
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Kasr Al-Ainy Psoriasis Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
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18
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Larasati T, Lipoeto NI, Mudjiran, Masrul, Hardisman, Sutomo AH. "GENOGRAM Physician Involvement Model" New Approach for Indonesian Physician Involvement with Family. Korean J Fam Med 2020; 41:325-331. [PMID: 32640771 PMCID: PMC7509123 DOI: 10.4082/kjfm.19.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 01/16/2020] [Indexed: 11/04/2022] Open
Abstract
Background The family, as the smallest social institution, has responsibilities across many functions, including maintaining family health. Increases in chronic diseases and life expectancy require more family support to prevent disease and implement treatment for family members with chronic diseases. Therefore, physician involvement in not only the treatment of diseases but also their prevention and rehabilitation is required In Indonesia. Hence, a new approach for physician involvement with families is required, especially with regard to comprehensiveness. This study aimed to develop a physician involvement program with the family model for primary healthcare in Indonesia. Methods A two-round Delphi method with family medicine experts from 17 of the highest accredited medical faculties in Indonesia as participants was conducted, and factor analysis performed thereafter. The items were considered relevant at ≤0.8 validity content ratio. The second step of this research is survey using e-questionnaire involving 101 primary care physician from all over Indonesia. They live scattered in several provinces in the main islands of Indonesia such Sumatra, Java, Kalimantan, Sulawesi dan Bali. Results Results showed an adequately measured sample and correlation for all items (Kaiser-Meyer-Olkin of sampling=0.821; Bartlett’s test <0.001). Seven dimensions were derived from results with eigenvalue of >1, and 25 items were filtered after determining the loading factor of >0.5. The Cronbach’s α for each factor varied from 0.602 to 0.829, and that for the total 25 items was 0.913, with a total variation documented as high as 66%. Conclusion A new physician involvement model with the family approach model, known as the “GENOGRAM model,” was developed, which consisted of seven dimensions and 25 items.
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Affiliation(s)
- Ta Larasati
- Medical Faculty, University of Lampung, Bandar Lampung, Indonesia
| | | | - Mudjiran
- Padang State University, Padang, Indonesia
| | - Masrul
- Medical Faculty, Andalas University, Padang, Indonesia
| | - Hardisman
- Medical Faculty, Andalas University, Padang, Indonesia
| | - Adi Heru Sutomo
- Community and Family Medicine, Medical Faculty, University of Gadjah Mada, Yogyakarta, Indonesia
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19
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Lee H, Vogel RI, LeRoy B, Zierhut HA. Adult adoptees and their use of direct-to-consumer genetic testing: Searching for family, searching for health. J Genet Couns 2020; 30:144-157. [PMID: 32602181 DOI: 10.1002/jgc4.1304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Abstract
Use of direct-to-consumer genetic testing (DTC-GT) is rapidly growing in the United States. Yet little is known about how specific populations like domestic and intercountry adoptees use DTC-GT. Adoptees often have little to no biological family history, which may affect how they use DTC-GT. This study aimed to examine adult adoptees' motivations to pursue DTC-GT, experiences completing a test, and reasons for not completing one. An online survey consisting of 41 closed-ended questions was distributed to domestic and intercountry adult adoptees in a snowball convenience method addressing seven areas: (a) demographics and adoption experience, (b) family health history, (c) familiarity with DTC-GT, (d) actual DTC-GT experience, (e) hypothetical DTC-GT experience, (f) health results, and (g) satisfaction with DTC-GT. Descriptive statistics were performed on participant demographics and adoption characteristics, and chi-squared and Fisher's exact tests compared demographics and adoption characteristics by familiarity with DTC-GT and completion of DTC-GT. A total of 117 adoptees met criteria and completed the survey. Adoptees were motivated to use DTC-GT to search for biological family (83.0%), verify race and ethnicity (72.3%), and find out where ancestors came from (66.0%). Most participants completed DTC-GT (80.3%); completion was significantly associated with searching for biological relatives (p < 0.01) and with older age (p = 0.05). For those who received health information (59.6%), 44.4% of participants reported talking with a health provider. Adoptees are using DTC-GT to search for biological relatives, confirm their ethnicity and ancestry, and gain information about their health. Genetic counselors and health professionals should be prepared to address DTC-GT with adoptees as nearly half discussed their results with providers; findings from this study provide insight into how this unique population uses DTC-GT, and the possibility of patient-centered, tailored care for adopted patients who do not have family health history.
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Affiliation(s)
- Heewon Lee
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA.,Cancer Risk Management Program, M Health Fairview, Minneapolis, MN, USA
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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20
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Stol DM, Hollander M, Damman OC, Nielen MMJ, Badenbroek IF, Schellevis FG, de Wit NJ. Mismatch between self-perceived and calculated cardiometabolic disease risk among participants in a prevention program for cardiometabolic disease: a cross-sectional study. BMC Public Health 2020; 20:740. [PMID: 32434574 PMCID: PMC7238643 DOI: 10.1186/s12889-020-08906-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background The rising prevalence of cardiometabolic diseases (CMD) calls for effective prevention programs. Self-assessment of CMD risk, for example through an online risk score (ORS), might induce risk reducing behavior. However, the concept of disease risk is often difficult for people to understand. Therefore, the study objective was to assess the impact of communicating an individualized CMD risk score through an ORS on perceived risk and to identify risk factors and demographic characteristics associated with risk perception among high-risk participants of a prevention program for CMD. Methods A cross-sectional analysis of baseline data from a randomized controlled trial conducted in a primary care setting. Seven thousand five hundred forty-seven individuals aged 45–70 years without recorded CMD, hypertension or hypercholesterolemia participated. The main outcome measures were: 1) differences in cognitive and affective risk perception between the intervention group - who used an ORS and received an individualized CMD risk score- and the control group who answered questions about CMD risk, but did not receive an individualized CMD risk score; 2) risk factors and demographic characteristics associated with risk perception. Results No differences were found in cognitive and affective risk perception between the intervention and control group and risk perception was on average low, even among high-risk participants. A positive family history for diabetes type 2 (β0.56, CI95% 0.39–0.73) and cardiovascular disease (β0.28, CI95% 0.13–0.43), BMI ≥25 (β0.27, CI95% 0.12–0.43), high waist circumference (β0.25, CI95% 0.02–0.48) and physical inactivity (β0.30, CI95% 0.16–0.45) were positively associated with cognitive CMD risk perception in high-risk participants. No other risk factors or demographic characteristics were associated with risk perception. Conclusions Communicating an individualized CMD risk score did not affect risk perception. A mismatch was found between calculated risk and self-perceived risk in high-risk participants. Family history and BMI seem to affect the level of CMD risk perception more than risk factors such as sex, age and smoking. A dialogue about personal CMD risk between patients and health care professionals might optimize the effect of the provided risk information. Trial registration Dutch trial Register number NTR4277, registered 26th Nov 2013.
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Affiliation(s)
- D M Stol
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.
| | - M Hollander
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands
| | - O C Damman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - M M J Nielen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - I F Badenbroek
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - F G Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands.,Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (location VUmc), Amsterdam, The Netherlands
| | - N J de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands
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21
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May T, Evans JP. Addressing perceived economic obstacles to genetic testing as a way to mitigate disparities in family health history for adoptees. HEALTH ECONOMICS, POLICY, AND LAW 2020; 15:277-287. [PMID: 30567613 DOI: 10.1017/s1744133118000488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this paper, we ask whether or not we can afford to realize the potential benefits of genetic testing as a screening tool for adoptees. Our method is to provide reasonable cost and savings estimates. We argue that the prospect of cost neutrality should be sufficient to explore the targeted screening for a population who will otherwise suffer an avoidable health disparity in access to inherited disease information. Our goal here is to establish that the investment needed to attain these benefits is not beyond our means.
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Affiliation(s)
- Thomas May
- Floyd and Judy Rogers Endowed Professor, Elson S. Floyd College of Medicine, Washington State University, Vancouver, WA, USA
- Ethics and Genomics Program, HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
| | - James P Evans
- Bryson Distinguished Professor of Genetics & Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
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22
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Rosenberg A, Coley N, Soulier A, Kulmala J, Soininen H, Andrieu S, Kivipelto M, Barbera M. Experiences of dementia and attitude towards prevention: a qualitative study among older adults participating in a prevention trial. BMC Geriatr 2020; 20:99. [PMID: 32164544 PMCID: PMC7068959 DOI: 10.1186/s12877-020-1493-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A better insight into older adults' understanding of and attitude towards cognitive disorders and their prevention, as well as expectations and reasons for participation in prevention trials, would help design, conduct, and implement effective preventive interventions. This qualitative study aimed at exploring the knowledge and perceptions of cognitive disorders and their prevention among participants in a prevention trial. METHODS Semi-structured interviews were conducted among the participants of a multinational randomised controlled trial testing the efficacy of a lifestyle-based eHealth intervention in preventing cardiovascular disease or cognitive decline in community dwellers aged 65+. Participants were probed on their reasons for participation in the trial and their views on general health, cardiovascular disease, ageing, and prevention. The subset of data focusing on cognitive disorders (15 interviewees; all in Finland) was considered for this study. Data were analysed using content analysis. RESULTS Participants' knowledge of the cause and risk factors of cognitive disorders and prevention was limited and superficial, and a need for up-to-date, reliable, and practical information and advice was expressed. Cognitive disorders evoked fear and concern, and feelings of hopelessness and misery were frequently expressed, indicating a stigma. Strong heredity of cognitive disorders was a commonly held belief, and opinions on the possibility of prevention were doubtful, particularly in relation to primary prevention. Family history and/or indirect experiences of cognitive disorders was a recurrent theme and it showed to be linked to both the knowledge of and feelings associated with cognitive disorders, as well as attitude towards prevention. Indirect experiences were linked to increased awareness and knowledge, but also uncertainty about risk factors and possibility of prevention. Distinct fear and concerns, particularly over one's own cognition/risk, and high motivation towards engaging in prevention and participating in a prevention trial were also identified in connection to this theme. CONCLUSIONS Family history and/or indirect experiences of cognitive disorders were linked to sensitivity and receptiveness to brain health and prevention potential. Our findings may be helpful in addressing older adults' expectations in future prevention trials to improve recruitment, maximise adherence, and facilitate the successful implementation of interventions.
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Affiliation(s)
- Anna Rosenberg
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Nicola Coley
- LEASP, UMR 1027, INSERM/Université Toulouse III Paul Sabatier, University of Toulouse, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Alexandra Soulier
- LEASP, UMR 1027, INSERM/Université Toulouse III Paul Sabatier, University of Toulouse, Toulouse, France
| | - Jenni Kulmala
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Neurocenter Finland, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Sandrine Andrieu
- LEASP, UMR 1027, INSERM/Université Toulouse III Paul Sabatier, University of Toulouse, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
| | - Mariagnese Barbera
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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Pokharel M, Elrick A, Canary HE, Clayton MF, Sukovic M, Champine M, Hong SJ, Kaphingst KA. Health communication roles in Latino, Pacific Islander, and Caucasian Families: A qualitative investigation. J Genet Couns 2019; 29:399-409. [PMID: 31605434 DOI: 10.1002/jgc4.1177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 11/06/2022]
Abstract
Family communication about health is critical for the dissemination of information that may improve health management of all family members. Communication about health issues, attitudes, and behaviors in families is associated with life expectancy as well as quality of life for family members. This study addresses family communication about health by examining individual roles for family health communication and factors related to these roles, among families of three different racial/ethnic groups: Caucasians, Latinos, and Pacific Islanders. Data were collected from 60 participants recruited as 30 family dyads, 10 from each group, through qualitative semistructured interviews. Interviews were conducted with each participant separately and then together in a dyadic interview. Two coders independently coded interview transcripts using NVivo 11. Results identified the family health communication roles of collector, disseminator, health educator, and researcher. We also identified several factors related to these roles using the lens of family systems theory-the presence of chronic conditions in the family, previous experience, medical education, and family hierarchy. Findings demonstrate many similarities and relatively few differences in the family health communication roles and the related factors among the families of different race/ethnicity. Conclusions highlight implications for future research and intervention development.
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Affiliation(s)
- Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, Texas
| | - Ashley Elrick
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Heather E Canary
- School of Communication, San Diego State University, San Diego, California
| | - Margaret F Clayton
- Huntsman Cancer Institute, Salt Lake City, Utah.,College of Nursing, University of Utah, Salt Lake City, Utah
| | - Masha Sukovic
- Department of Communication, University of Utah, Salt Lake City, Utah
| | | | - Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
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Chronic medical conditions and metabolic syndrome as risk factors for incidence of major depressive disorder: A longitudinal study based on 4.7 million adults in South Korea. J Affect Disord 2019; 257:486-494. [PMID: 31319340 DOI: 10.1016/j.jad.2019.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The assessment of comorbid physical illness and metabolic or cardiovascular risk factors as potential risk factors for onset of major depressive disorder (MDD) is crucial. We aimed to investigate potential risk factors for the development of MDD among individuals with chronic medical conditions and metabolic and behavioral risk factors using a large population-based retrospective cohort from the data of the National Health Insurance Service (NHIS) in South Korea. METHODS The population-based retrospective cohort included data from 2,370,815 adults (age ≥20 years) diagnosed with MDD between January 1, 2010, and December 31, 2016 and age- and gender-matched 2,370,815 healthy controls obtained from the claims data of the NHIS. The data of the regular health checkup provided by the NHIS were also included (age ≥40 years). Logistic regression analyses were performed to investigate the potential risk factors for the incidence of MDD. RESULTS Chronic medical conditions such as Parkinson's disease (odds ratio [OR] = 7.808, 95% confidence interval [CI] = 7.517-8.11), epilepsy (OR = 6.119, 95% CI = 6.019-6.22), multiple sclerosis (OR = 5.532, 95% CI = 4.976-6.151), Huntington's disease (OR = 5.387, 95% CI = 3.258-8.909), migraine (OR = 4.374, 95% CI = 4.341-4.408), stroke (OR = 4.074, 95% CI = 4.032-4.117), and cancer; metabolic syndrome (OR = 1.049, 95% CI = 1.041-1.057) and several of its components including central obesity, elevated fasting blood glucose and triglyceride levels, and reduced high-density lipoprotein level; and cigarette smoking, frequent alcohol consumption, and low physical activity are potential risk factors for the development of MDD. CONCLUSION Our results may support previous evidence on the association between physical conditions and the incidence of MDD as reported by individual population-based studies with modest sample sizes.
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25
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Drake I, Dias JA, Teleka S, Stocks T, Orho-Melander M. Lifestyle and cancer incidence and mortality risk depending on family history of cancer in two prospective cohorts. Int J Cancer 2019; 146:1198-1207. [PMID: 31077359 DOI: 10.1002/ijc.32397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/10/2019] [Accepted: 04/30/2019] [Indexed: 12/26/2022]
Abstract
The extent to which a favorable lifestyle may lower cancer risk in subjects with a family history of cancer is unknown. We conducted a prospective study in two Swedish cohorts, the Malmö Diet and Cancer Study (MDCS; n = 25,604) and the Malmö Preventive Project (MPP; n = 16,216). The association between a favorable lifestyle (based on nonsmoking, normal weight, absence of excessive drinking, regular physical activity and healthy diet) and cancer incidence and mortality risk was assessed using Cox regression stratified by family history of cancer (all types). A favorable lifestyle was associated with a 22% (95% confidence interval [CI]: 18-26%) and 40% (95% CI: 36-44%) lower risk of cancer incidence and mortality, respectively, compared to an unfavorable lifestyle. No significant effect modification by family history was observed but there was a null association between lifestyle and cancer incidence among subjects with two or more affected first-degree relatives. The observed relative risk estimates comparing an unfavorable with a favorable lifestyle corresponded to standardized 10-year cancer incidence rates of 11.2 vs. 9.5% in the MDCS, and 4.4 vs. 3.2% in the MPP, and a reduction in 20-year cancer mortality rate from 11.7% to 7.4% in the MDCS and 6.7% to 3.9% in the MPP. Improved adherence to cancer prevention recommendations may reduce cancer incidence and mortality risk in the general population, however, further studies are needed to assess the impact of lifestyle on cancer incidence among subjects with strong familial or polygenic risk for specific cancers.
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Affiliation(s)
- Isabel Drake
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Joana Alves Dias
- Nutritional Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Stanley Teleka
- Registry-based Epidemiology, Oncology and Pathology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Tanja Stocks
- Registry-based Epidemiology, Oncology and Pathology, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
| | - Marju Orho-Melander
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
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26
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Allen C, Escoffery C, Haardörfer R, McBride C. Factors Influencing Not Perceiving Family Health History Assessments as Important: Opportunities to Improve Dissemination of Evidence-Based Population Screening for Cancer. Public Health Genomics 2019; 21:144-153. [DOI: 10.1159/000499125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 02/25/2019] [Indexed: 11/19/2022] Open
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Developing community-based health education strategies with family history: Assessing the association between community resident family history and interest in health education. Soc Sci Med 2019; 271:112160. [PMID: 30862375 DOI: 10.1016/j.socscimed.2019.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 02/01/2019] [Accepted: 02/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Family history (FH) is an underutilized genetically informative tool that can influence disease prevention and treatment. It is unclear how FH fits into the development of community-based health education. This study examines the role that FH plays in perceived threat and health education related to mental and chronic physical conditions in the context of the health belief model. METHODS Data were collected from 1,048 adult participants aged 18-90 years. Approximately 76% of participants indicated African-American race/ethnicity and 35% had less than high school level education. Self-report data were collected on FH of four disorders: anxiety, depression, diabetes, and high blood pressure. Interest in receiving information regarding prevention as well as future testing efforts was assessed broadly. A series of logistic regressions examined the association between FH for each of the disorders and interest in receiving information on (1) prevention of diseases in general and (2) testing for diseases in general. These associations were also analyzed after accounting for the influence of perceived threat of conditions. RESULTS Interest in receiving general health education was significantly associated with FH of depression (OR = 2.72, 95% CI = 1.74-4.25), anxiety (OR = 2.26, 95% CI = 1.45-3.22), and high blood pressure (OR = 2.54, 95% CI = 1.05-6.12). After adjustment for perceived threat, the magnitude of these associations was reduced substantially. The associations between perceived threat and either interest in receiving information on disease testing or receiving general health education were strong and significant across all conditions (OR = 2.11-3.74). DISCUSSION These results provide evidence that perceived threat mediates the association between FH and engagement with health education. Currently available health education programs may benefit from considering the role of FH in an individual's motivation for participation in health education activities alongside other factors.
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28
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E Anderson E, Tejada S, B Warnecke R, Hoskins K. Views of Low-Income Women of Color at Increased Risk for Breast Cancer. Narrat Inq Bioeth 2018; 8:53-66. [PMID: 29657180 DOI: 10.1353/nib.2018.0023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Individual risk assessment (IRA) for breast cancer may increase adherence to risk-appropriate screening and prevention measures. However, knowledge gaps exist regarding how best to communicate IRA results and support women at increased risk in future health care decisions, in part because patients conceptualize and make meaning of risk differently from the medical community. Better understanding the views of low-income women of color identified as being at increased risk for breast cancer can inform efforts to conduct IRA in an ethical and respectful manner. We conducted in-depth interviews with 13 low-income African American and Latina women who receive care at a federally qualified health center (FQHC) and had recently learned of their increased risk for breast cancer. These interviews explored their experience of the IRA process, their interpretation of what being at increased risk means, and their reactions to provider recommendations. Eight key themes were identified. We conclude with recommendations for the implementation of IRA for breast cancer in underserved primary care settings.
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29
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Sá A, Peleteiro B. The effect of chronic disease family history on the adoption of healthier lifestyles. Int J Health Plann Manage 2018; 33:e906-e917. [PMID: 29968422 DOI: 10.1002/hpm.2561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 12/27/2022] Open
Abstract
AIM To determine the influence of family history (FH) and personal history (PH) of chronic disease (CD) in the adoption of healthy lifestyles. METHODS This cross-sectional study was based on the EPIPorto cohort (n = 1588). Participants were grouped taking into account FH and PH of CD, such as diabetes, myocardial infarction, stroke, asthma, and cancer, and if at least one of the first-degree relatives had died from the CD. Age-, sex-, and education-adjusted odds ratios and corresponding 95% confidence intervals were computed using multinomial logistic regression. RESULTS Subjects with PH and FH of CD were more likely to follow recommendations regarding salt intake but less likely regarding obesity measures. Overall, similar results were observed when repeating the analyses according to the type of CD, particularly in those with diabetes. CONCLUSIONS Recommendations towards healthier lifestyles are not followed by individuals with history of CD, at least in what concerns obesity measures. Our study suggests reducing obesity as a major target for interventions in these groups of individuals.
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Affiliation(s)
- Alexandre Sá
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal
| | - Bárbara Peleteiro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina Universidade do Porto, Porto, Portugal
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30
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Haug U, Riedel O, Cholmakow-Bodechtel C, Olsson L. First-degree relatives of cancer patients: a target group for primary prevention? A cross-sectional study. Br J Cancer 2018; 118:1255-1261. [PMID: 29559731 PMCID: PMC5943415 DOI: 10.1038/s41416-018-0057-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/05/2023] Open
Abstract
Background Persons with a first-degree relative (FDR) with cancer are at increased cancer risk. We investigated preventive behaviour, cancer risk perception and readiness to change an unhealthy lifestyle in persons with and without an FDR with cancer. Methods Using an online questionnaire, we conducted a cross-sectional study in Germany including persons (≥35 years) with an FDR with colorectal, lung, prostate, breast, stomach or cervical/uterine cancer (n = 621) and persons without cancer in FDRs (n = 303). Quota sampling ensured similar age and sex distributions in both groups. Results Unfavourable lifestyle factors were equally common in both groups. The proportion perceiving an increased cancer risk significantly differed (p < 0.0001) with 4% among respondents without cancer in FDRs and 18% (colorectal cancer) to 30% (stomach cancer) among cancer patients’ relatives. The proportion of smokers ready to quit smoking was significantly higher among those perceiving an increased vs. a lower cancer risk (64 vs. 46%, p = 0.04). There was a similar association for readiness to increase physical activity and consumption of fruits/vegetables and to reduce alcohol consumption. Conclusions Given the increased risk perception and motivation to change an unhealthy lifestyle, our study provides a strong rationale for research on the effectiveness of lifestyle interventions in cancer patients’ relatives.
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Affiliation(s)
- Ulrike Haug
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. .,Faculty of Human and Health Sciences, University of Bremen, Grazer Straße 2, 28359, Bremen, Germany.
| | - Oliver Riedel
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany
| | | | - Louise Olsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), 171 76, Stockholm, Sweden
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31
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Peterson-Burch FM. Family Matters: The Nurse's Role in Assessing Family Health History in Ocular Disease. INSIGHT (AMERICAN SOCIETY OF OPHTHALMIC REGISTERED NURSES) 2018; 43:23-25. [PMID: 30294194 PMCID: PMC6169806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Frances M Peterson-Burch
- Frances M. Peterson-Burch is a PhD student at the University of Pittsburgh School of Nursing. She can be reached at
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32
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Amuta AO, Mkuu R, Jacobs W, Barry AE. Number and Severity of Type 2 Diabetes among Family Members Are Associated with Nutrition and Physical Activity Behaviors. Front Public Health 2017; 5:157. [PMID: 28752087 PMCID: PMC5507971 DOI: 10.3389/fpubh.2017.00157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/19/2017] [Indexed: 01/30/2023] Open
Abstract
AIM A binary measurement of type 2 diabetes (T2D) has been found not to influence behaviors. We aimed to examine the influence of other measures of family history such as number of relatives, genetic closeness of relatives, and severity of T2D of family members on nutrition and physical activity behaviors among college students. METHODS Students across four colleges in Texas were sampled. Multiple linear regression models, controlling for covariates, were used to model results. Cross-sectional data were used. RESULTS More number of relatives with T2D was associated with vegetable consumption (β = 0.131, p = 0.007) and exercise (β = 0.129, p = 0.037). Having relatives with severe T2D was associated with vegetable consumption (β = 0.157, p = 0.002) and exercise (β = 106, p = 0.027). Closer genetic relationship with someone with T2D was associated with increased vegetable consumption (β = 0.107, p = 0.023) and exercise (β = 0.096, p = 0.047). CONCLUSION It is likely that the severe complications that may accompany the relatives T2D or having an immediate family member living with T2D may in fact motivate other family members without T2D to modify their attitudes, beliefs, and knowledge about T2D, thus encourage health-protective behaviors.
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Affiliation(s)
- Ann Oyare Amuta
- Health Studies, Texas Woman's University, Denton, TX, United States
| | - Rahma Mkuu
- Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Wura Jacobs
- Health Science, California State University Fullerton, Fullerton, CA, United States
| | - Adam E Barry
- Health & Kinesiology, Texas A&M University, College Station, TX, United States
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Amuta AO, Jacobs W, Barry AE. An Examination of Family, Healthcare Professionals, and Peer Advice on Physical Activity Behaviors among Adolescents at High Risk for Type 2 Diabetes. HEALTH COMMUNICATION 2017; 32:857-863. [PMID: 27435036 DOI: 10.1080/10410236.2016.1177907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Studies have shown that many college students do not meet the recommended daily physical activity (PA) levels, and about 22% of these students are overweight. Given that engaging in PA is a protective behavior against many chronic conditions, it is imperative to understand what sources of information/advice to engage in PA is most influential. Hence, the purpose of this study was to examine the relative impact of different sources of advice regarding exercise and PA on actual PA engagement among obese/overweight adolescents. Using data from 319 overweight/obese college students, multivariate regression analyses were conducted to examine which source of advice (from parents, peers, or healthcare provider) to engage in PA was associated with PA behavior among these adolescents. Influence of type 2 diabetes (T2D) family history on PA behavior was also examined. Moderate and vigorous PA behavior was more likely among obese/overweight adolescents who received advice to exercise or engage in PA from their peers (B = 200.85, β = 0.193, p = 0.001; B = 121.19, β = 0.145, p = 0.014). Overweight/obese adolescents with a T2D family history were more likely to walk compared with those without a T2D family history (χ2 = 12.97, p = 0.000). Findings suggest that although healthcare professionals advise obese/overweight adolescents, those who received advice regarding PA behavior from their peers were more likely to heed the advice and exercise/engage in PA. In essence, intervention efforts should focus on employing peer ambassadors to counsel other adolescents on the importance of PA.
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Affiliation(s)
- Ann O Amuta
- a Department of Health Studies , Texas Woman's University
| | - Wura Jacobs
- b Department of Health & Kinesiology , Texas A&M University
| | - Adam E Barry
- b Department of Health & Kinesiology , Texas A&M University
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34
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Llewellyn R, Cunningham W, Jaye C, Young J, Egan R, Radue P. 'Why worry about something you can't control?' Negotiated risk, longevity and health behaviours. Health (London) 2017; 21:259-277. [PMID: 28521650 DOI: 10.1177/1363459317695869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While we know about lay attitudes towards death and dying, we understand little about the ways people estimate their overall personal risk of life-limiting disease and/or death. This study contributes to the limited literature on lay longevity reckonings, with a particular focus on how these reckonings may influence health behaviours. Semi-structured interviews were held with 21 young older adults (54-65 years), addressing the core questions of 'What do you think you will die from, and how long do you expect to live?' Participants indicated their longevity estimation was guided by three key frameworks: family history, environment and lifestyle factors and lived experience. The reckoning process was also moderated by assumptions about loci of control and self-efficacy and the information available to participants. A tripartite model of death risk assessment is proposed, extending the idea of 'negotiated risk' beyond the scope of family history where it has received most attention. We argue that by drawing on the three risk-assessment frameworks, determining patients' predisposition for external/internal attributions of control and perceptions of self-efficacy, clinicians will be better equipped to understand - and thus guide - patients' reckonings of longevity and health behaviours that are influenced by it.
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Affiliation(s)
| | - Wayne Cunningham
- Royal College of Surgeons in Ireland - Medical University of Bahrain, Bahrain
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35
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Bowes A, Begley J, Kerr D. Lifestyle change reduces cardiometabolic risk factors and glucagon-like peptide-1 levels in obese first-degree relatives of people with diabetes. J Hum Nutr Diet 2017; 30:490-498. [DOI: 10.1111/jhn.12440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Bowes
- Bournemouth Diabetes and Endocrine Centre; Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust; Bournemouth UK
- Intermediate Dietetics Department; Dorset Healthcare University NHS Foundation Trust; Diabetes Centre; Poole UK
| | - J. Begley
- Bournemouth Diabetes and Endocrine Centre; Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust; Bournemouth UK
| | - D. Kerr
- Research and Innovation; William Sansum Diabetes Center; Santa Barbara CA USA
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36
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Wu RR, Myers RA, Hauser ER, Vorderstrasse A, Cho A, Ginsburg GS, Orlando LA. Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes. J Genet Couns 2017; 26:133-140. [PMID: 27296809 DOI: 10.1007/s10897-016-9988-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 06/05/2016] [Indexed: 02/03/2023]
Abstract
Family health history (FHH) in the context of risk assessment has been shown to positively impact risk perception and behavior change. The added value of genetic risk testing is less certain. The aim of this study was to determine the impact of Type 2 Diabetes (T2D) FHH and genetic risk counseling on behavior and its cognitive precursors. Subjects were non-diabetic patients randomized to counseling that included FHH +/- T2D genetic testing. Measurements included weight, BMI, fasting glucose at baseline and 12 months and behavioral and cognitive precursor (T2D risk perception and control over disease development) surveys at baseline, 3, and 12 months. 391 subjects enrolled of which 312 completed the study. Behavioral and clinical outcomes did not differ across FHH or genetic risk but cognitive precursors did. Higher FHH risk was associated with a stronger perceived T2D risk (pKendall < 0.001) and with a perception of "serious" risk (pKendall < 0.001). Genetic risk did not influence risk perception, but was correlated with an increase in perception of "serious" risk for moderate (pKendall = 0.04) and average FHH risk subjects (pKendall = 0.01), though not for the high FHH risk group. Perceived control over T2D risk was high and not affected by FHH or genetic risk. FHH appears to have a strong impact on cognitive precursors of behavior change, suggesting it could be leveraged to enhance risk counseling, particularly when lifestyle change is desirable. Genetic risk was able to alter perceptions about the seriousness of T2D risk in those with moderate and average FHH risk, suggesting that FHH could be used to selectively identify individuals who may benefit from genetic risk testing.
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Affiliation(s)
- R Ryanne Wu
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA. .,Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA.
| | - Rachel A Myers
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA
| | - Elizabeth R Hauser
- Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA.,Molecular Physiology Institute, Duke University, Durham, NC, USA.,Cooperative Studies Program Epidemiology Center, VAMC, Durham, Durham, NC, USA
| | - Allison Vorderstrasse
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA.,School of Nursing, Duke University, Durham, NC, USA
| | - Alex Cho
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA.,Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA
| | - Geoffrey S Ginsburg
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA.,Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA.,Department of Pathology, Duke University, Durham, NC, USA
| | - Lori A Orlando
- Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA.,Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA
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37
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Carroll JC, Campbell-Scherer D, Permaul JA, Myers J, Manca DP, Meaney C, Moineddin R, Grunfeld E. Assessing family history of chronic disease in primary care: Prevalence, documentation, and appropriate screening. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e58-e67. [PMID: 28115461 PMCID: PMC5257240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess the proportion of primary care patients who report a family history (FH) of type 2 diabetes, coronary artery disease, breast cancer, or colorectal cancer (CRC); assess concordance of FH information derived from the electronic medical record (EMR) compared with patient-completed health questionnaires; and assess whether appropriate screening was informed by risk based solely on FH. DESIGN Data from the BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) trial were used. Patients were mailed questionnaires. Baseline FH and screening data were obtained for enrolled patients from the EMR and health questionnaires. SETTING Ontario and Alberta. PARTICIPANTS Randomly selected patients from 8 family practices. MAIN OUTCOME MEASURES Agreement on FH between the EMR and questionnaire was determined; logistic regression was used to assess significant predictors of screening. RESULTS In total, 775 of 789 (98%) patients completed the health questionnaire. The mean age of participants was 52.5 years and 72% were female. A minimum of 12% of patients (range 12% to 36%) had a reported FH of 1 of 4 chronic diseases. Among patients with positive FH, the following proportions of patients had that FH recorded in the EMR compared with the questionnaire: diabetes, 24% in the EMR versus 36% on the questionnaire, κ = 0.466; coronary artery disease, 35% in the EMR versus 22% on the questionnaire, κ = 0.225; breast cancer, 21% in the EMR versus 22% on the questionnaire, κ = 0.241; and CRC, 12% in the EMR versus 14% on the questionnaire, κ = 0.510. There was moderate agreement for diabetes and CRC. The presence of FH was a significant predictor of CRC screening (odds ratio 1.9, 95% CI 1.1 to 3.1). CONCLUSION A moderate prevalence of FH was found for 4 conditions for which screening recommendations vary with risk based on FH. Having patients self-complete an FH was thought to be feasible; however, questions about FH accuracy and completeness from both self-report and EMR remain. Work is needed to determine how to facilitate the adoption of FH tools into practice as well as strategies linking familial risk to appropriate screening.Trial registration number ISRCTN07170460 (ISRCTN Registry).
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Affiliation(s)
- June C Carroll
- Professor and Sydney G. Frankfort Chair in the Department of Family and Community Medicine of the Sinai Health System at the University of Toronto in Ontario.
| | - Denise Campbell-Scherer
- Associate Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Joanne A Permaul
- Research associate in the Ray D. Wolfe Department of Family Medicine in the Sinai Health System
| | - Jesse Myers
- Second-year family medicine resident at Women's College Hospital at the University of Toronto
| | - Donna P Manca
- Director of Research in the Department of Family Medicine Research Program at the University of Alberta
| | - Christopher Meaney
- Biostatistician in the Department of Family and Community Medicine at the University of Toronto
| | - Rahim Moineddin
- Biostatistician in the Department of Family and Community Medicine at the University of Toronto
| | - Eva Grunfeld
- Giblon Professor and Vice Chair of Research in the Department of Family and Community Medicine at the University of Toronto and Director of Knowledge Translation Research in the Health Services Research Program at the Ontario Institute for Cancer Research
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Vijayan T, Zheng P, Nguyen C, Brown AM, Chen YW, Peters MG. Survey of Asian patients with hepatitis B infection: limited knowledge of transmission and screening of family members. J Immigr Minor Health 2016; 17:112-7. [PMID: 23913129 DOI: 10.1007/s10903-013-9883-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Asian American families are disproportionately affected by Hepatitis B (HBV) infection. We aimed to assess the extent of screening family members of Asian patients with known HBV infection as well as patients' knowledge of HBV disease. A cross-sectional survey of established Asian patients with HBV-infection was performed at a university liver clinic. Outcome measures included the percentage of family members whose HBV serostatus was unknown and the percentage of patients who were able to correctly identify modes of transmission. A total of 803 US-based family members were identified by 58 patients. Patients did not know the HBV serostatus of 50% of their family members and 28% of their immediate family members. Fifty percent of participants did not know how they had acquired HBV or stated unlikely transmission modes. Though nationwide vaccination campaigns target this underrepresented population, screening family members of Asian patients with HBV remains a challenge.
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Affiliation(s)
- Tara Vijayan
- Division of Infectious Diseases, University of California, San Francisco, 513 Parnassus Ave, Room S-380, San Francisco, CA, 94143-0654, USA,
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Vornanen M, Konttinen H, Kääriäinen H, Männistö S, Salomaa V, Perola M, Haukkala A. Family history and perceived risk of diabetes, cardiovascular disease, cancer, and depression. Prev Med 2016; 90:177-83. [PMID: 27353304 DOI: 10.1016/j.ypmed.2016.06.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/02/2016] [Accepted: 06/22/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Family history is a useful and inexpensive tool to assess risks of multifactorial diseases. Family history enables individualized disease prevention, but its effects on perceived risks of various diseases need to be understood in more detail. We examined how family history relates to perceived risk of diabetes mellitus, cardiovascular disease (CVD), cancer, and depression, and whether these associations are independent of or moderated by sociodemographic factors, health behavior/weight status (smoking, alcohol consumption, physical activity, BMI [kg/m(2)]), or depressive symptoms. METHODS Participants were Finnish 25-74-year-olds (N=6258) from a population-based FINRISK 2007 study. Perceived absolute lifetime risks (Brewer et al., 2004; Becker, 1974; Weinstein and Nicolich, 1993; Guttmacher et al., 2004; Yoon et al., 2002) and first-degree family history of CVD, diabetes, cancer and depression, and health behaviors were self-reported. Weight and height were measured in a health examination. RESULTS Family history was most prevalent for cancer (36.7%), least for depression (19.6%). Perceived risk mean was highest for CVD (2.8), lowest for depression (2.0). Association between family history and perceived risk was strongest for diabetes (β=0.34, P<0.001), weakest for depression (β=0.19, P<0.001). Adjusting for sociodemographics, health behavior, and depressive symptoms did not change these associations. The association between family history and perceived risk tended to be stronger among younger than among older adults, but similar regardless of health behaviors or depressive symptoms. DISCUSSION Association between family history and perceived risk varies across diseases. People's current understandings on heritability need to be acknowledged in risk communication practices. Future research should seek to identify effective strategies to combine familial and genetic risk communication in disease prevention.
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Affiliation(s)
- Marleena Vornanen
- Department of Social Research, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 Helsinki, Finland.
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 Helsinki, Finland.
| | - Helena Kääriäinen
- National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.
| | - Satu Männistö
- National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.
| | - Veikko Salomaa
- National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.
| | - Markus Perola
- National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00271 Helsinki, Finland.
| | - Ari Haukkala
- Department of Social Research, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 Helsinki, Finland.
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Intergenerational transmission of dietary behaviours: A qualitative study of Anglo-Australian, Chinese-Australian and Italian-Australian three-generation families. Appetite 2016; 103:309-317. [DOI: 10.1016/j.appet.2016.04.036] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 01/29/2023]
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Hoyt R, Linnville S, Thaler S, Moore J. Digital Family History Data Mining with Neural Networks: A Pilot Study. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2016; 13:1c. [PMID: 26903781 PMCID: PMC4739442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Following the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, electronic health records were widely adopted by eligible physicians and hospitals in the United States. Stage 2 meaningful use menu objectives include a digital family history but no stipulation as to how that information should be used. A variety of data mining techniques now exist for these data, which include artificial neural networks (ANNs) for supervised or unsupervised machine learning. In this pilot study, we applied an ANN-based simulation to a previously reported digital family history to mine the database for trends. A graphical user interface was created to display the input of multiple conditions in the parents and output as the likelihood of diabetes, hypertension, and coronary artery disease in male and female offspring. The results of this pilot study show promise in using ANNs to data mine digital family histories for clinical and research purposes.
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Affiliation(s)
- Robert Hoyt
- Health Informatics Program at the College of Science, Engineering and Health at the University of West Florida in Pensacola, FL
| | - Steven Linnville
- Robert E. Mitchell Center for Prisoner of War Studies in Pensacola, FL
| | | | - Jeffrey Moore
- Robert E. Mitchell Center for Prisoner of War Studies in Pensacola, FL
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Rubin G, Berendsen A, Crawford SM, Dommett R, Earle C, Emery J, Fahey T, Grassi L, Grunfeld E, Gupta S, Hamilton W, Hiom S, Hunter D, Lyratzopoulos G, Macleod U, Mason R, Mitchell G, Neal RD, Peake M, Roland M, Seifert B, Sisler J, Sussman J, Taplin S, Vedsted P, Voruganti T, Walter F, Wardle J, Watson E, Weller D, Wender R, Whelan J, Whitlock J, Wilkinson C, de Wit N, Zimmermann C. The expanding role of primary care in cancer control. Lancet Oncol 2015; 16:1231-72. [PMID: 26431866 DOI: 10.1016/s1470-2045(15)00205-3] [Citation(s) in RCA: 355] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/25/2015] [Accepted: 07/27/2015] [Indexed: 12/21/2022]
Abstract
The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise—from epidemiologists, psychologists, policy makers, and cancer specialists—has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care—its continuous, coordinated, and comprehensive care for individuals and families—are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.
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Affiliation(s)
- Greg Rubin
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
| | - Annette Berendsen
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | | | - Rachel Dommett
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Craig Earle
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Jon Emery
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Tom Fahey
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Eva Grunfeld
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Sumit Gupta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - David Hunter
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK
| | | | - Una Macleod
- Hull-York Medical School, University of Hull, Hull, UK
| | - Robert Mason
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Geoffrey Mitchell
- Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Richard D Neal
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | | | - Martin Roland
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Bohumil Seifert
- Department of General Practice, Charles University, Prague, Czech Republic
| | - Jeff Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Stephen Taplin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Peter Vedsted
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Teja Voruganti
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Fiona Walter
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eila Watson
- Department of Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - David Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Jeremy Whelan
- Research Department of Oncology, University College London, London, UK
| | - James Whitlock
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Clare Wilkinson
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | - Niek de Wit
- Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands
| | - Camilla Zimmermann
- Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Syurina EV, Gerritsen AMJM, Hens K, Feron FJM. “What about FH of my child?” parents’ opinion on family history collection in preventive primary pediatric care. Per Med 2015; 12:327-337. [DOI: 10.2217/pme.15.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Family history (FH) in Preventive Primary Pediatric Care is to identify children at risk for complex diseases and provide personal preventive strategies. This study was to assess parents’ opinion on FH collection. Methods: Semi-structured interviews were conducted. Among issues addressed were: former experiences with FH, knowledge about FH, family definition and sharing information about FH. Results: The importance of FH for participants depended on their knowledge, perceived family health status and former experiences. After insight into FH, parents shift to believing it to be important, but certain barriers exist in reporting FH. Conclusion: Parents suggest that the importance of FH should be more emphasized and more trusting relationship with Preventive Primary Pediatric Care should be invested in.
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Affiliation(s)
- Elena V Syurina
- Department of Social Medicine, School for Public Health & Primary Care (CAPHRI), Faculty of Health, Medicine & Life Sciences, Maastricht University, The Netherlands
| | - Anne-Marie JM Gerritsen
- Department of Social Medicine, School for Public Health & Primary Care (CAPHRI), Faculty of Health, Medicine & Life Sciences, Maastricht University, The Netherlands
| | - Kristien Hens
- Centre for Society & the Life Sciences (CSG), Nijmegen, The Netherlands
| | - Frans JM Feron
- Department of Social Medicine, School for Public Health & Primary Care (CAPHRI), Faculty of Health, Medicine & Life Sciences, Maastricht University, The Netherlands
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Wijdenes M, Henneman L, Dondorp WJ, Cornel MC, Timmermans DRM. Users evaluate a detailed familial risk questionnaire as valuable and no more time consuming than a simple enquiry in a web-based diabetes risk assessment tool. Public Health 2015; 130:87-90. [PMID: 26187586 DOI: 10.1016/j.puhe.2015.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 06/03/2015] [Accepted: 06/05/2015] [Indexed: 11/24/2022]
Affiliation(s)
- M Wijdenes
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - L Henneman
- Department of Clinical Genetics, Section Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - W J Dondorp
- Department of Health, Ethics and Society, Research Institutes CAPHRI and GROW, Maastricht University, Maastricht, The Netherlands
| | - M C Cornel
- Department of Clinical Genetics, Section Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - D R M Timmermans
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Amuta AO, Barry AE. Influence of Family History of Cancer on Engagement in Protective Health Behaviors. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2015.1023478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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May T, Strong KA, Khoury MJ, Evans JP. Can targeted genetic testing offer useful health information to adoptees? Genet Med 2015; 17:533-5. [PMID: 25905442 DOI: 10.1038/gim.2015.58] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 01/25/2023] Open
Affiliation(s)
- Thomas May
- 1] Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin, USA [2] Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
| | - Kimberly A Strong
- Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Muin J Khoury
- Office of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James P Evans
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Chen ES, Carter EW, Winden TJ, Sarkar IN, Wang Y, Melton GB. Multi-source development of an integrated model for family health history. J Am Med Inform Assoc 2015; 22:e67-80. [PMID: 25336591 PMCID: PMC5901119 DOI: 10.1136/amiajnl-2014-003092] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/20/2014] [Accepted: 09/04/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To integrate data elements from multiple sources for informing comprehensive and standardized collection of family health history (FHH). MATERIALS AND METHODS Three types of sources were analyzed to identify data elements associated with the collection of FHH. First, clinical notes from multiple resources were annotated for FHH information. Second, questions and responses for family members in patient-facing FHH tools were examined. Lastly, elements defined in FHH-related specifications were extracted for several standards development and related organizations. Data elements identified from the notes, tools, and specifications were subsequently combined and compared. RESULTS In total, 891 notes from three resources, eight tools, and seven specifications associated with four organizations were analyzed. The resulting Integrated FHH Model consisted of 44 data elements for describing source of information, family members, observations, and general statements about family history. Of these elements, 16 were common to all three source types, 17 were common to two, and 11 were unique. Intra-source comparisons also revealed common and unique elements across the different notes, tools, and specifications. DISCUSSION Through examination of multiple sources, a representative and complementary set of FHH data elements was identified. Further work is needed to create formal representations of the Integrated FHH Model, standardize values associated with each element, and inform context-specific implementations. CONCLUSIONS There has been increased emphasis on the importance of FHH for supporting personalized medicine, biomedical research, and population health. Multi-source development of an integrated model could contribute to improving the standardized collection and use of FHH information in disparate systems.
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Affiliation(s)
- Elizabeth S Chen
- Center for Clinical and Translational Science—Biomedical Informatics Unit, University of Vermont, Burlington, Vermont, USA
- Department of Medicine—Division of General Internal Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Computer Science, University of Vermont, Burlington, Vermont, USA
| | - Elizabeth W Carter
- Center for Clinical and Translational Science—Biomedical Informatics Unit, University of Vermont, Burlington, Vermont, USA
| | - Tamara J Winden
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Applied Research, Allina Health, Minneapolis, Minnesota, USA
| | - Indra Neil Sarkar
- Center for Clinical and Translational Science—Biomedical Informatics Unit, University of Vermont, Burlington, Vermont, USA
- Department of Computer Science, University of Vermont, Burlington, Vermont, USA
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, Vermont, USA
| | - Yan Wang
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Genevieve B Melton
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Parrott R. Communicating about family health history: heredity, culture, iatrogenesis and the public good. Br J Soc Med 2015; 69:3-5. [DOI: 10.1136/jech-2014-203874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Hovick SR, Yamasaki JS, Burton-Chase AM, Peterson SK. Patterns of family health history communication among older African American adults. JOURNAL OF HEALTH COMMUNICATION 2015; 20:80-7. [PMID: 25174859 DOI: 10.1080/10810730.2014.908984] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This qualitative study examined patterns of communication regarding family health history among older African American adults. The authors conducted 5 focus groups and 6 semi-structured interviews with African Americans aged 60 years and older (N = 28). The authors identified 4 distinct patterns of family health history communication: noncommunication, open communication, selective communication (communication restricted to certain people or topics), and one-way communication (communication not reciprocated by younger family members). In general, participants favored open family health history communication, often resulting from desires to change patterns of noncommunication in previous generations regarding personal and family health history. Some participants indicated that they were selective about what and with whom they shared health information in order to protect their privacy and not worry others. Others described family health history communication as one-way or unreciprocated by younger family members who appeared uninterested or unwilling to share personal and family health information. The communication patterns that the authors identified are consistent with communication privacy management theory and with findings from studies focused on genetic testing results for hereditary conditions, suggesting that individuals are consistent in their communication of health and genetic risk information. Findings may guide the development of health message strategies for African Americans to increase family health history communication.
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Ashida S, Schafer EJ. Family health information sharing among older adults: reaching more family members. J Community Genet 2015; 6:17-27. [PMID: 25074679 PMCID: PMC4286562 DOI: 10.1007/s12687-014-0197-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 07/16/2014] [Indexed: 11/29/2022] Open
Abstract
Although family health history (FHH) information has tremendous potential in the prevention of common complex diseases such as heart disease and cancer, lack of knowledge about one's own FHH among the public hinders its utility. Older individuals often desire to contribute to the well-being of younger generations and also play critical roles in disseminating this information. This study evaluated psychosocial factors associated with the extent of FHH communication within families. Older adults (N = 110) were interviewed at three senior centers in an urban community. Multivariate Poisson regression analysis showed that respondents who received FHH from a parent reported 41 % more family members with whom they shared FHH (b = 0.34, p < 0.001) controlling for the family network size. Furthermore, one unit increase in the number of family members with whom respondents exchange reciprocal emotional support (b = 0.04, p < 0.01), perceived familiarity with own FHH (b = 0.14, p = 0.01), and self-efficacy to share FHH (b = 0.18, p = 0.02) were associated with 4, 15, and 20 % increases in the number of family members with whom respondents shared FHH, respectively. Future efforts may inform older adults about their important role in modeling FHH communication behavior to encourage information sharing in future generations while providing information about how to collect and disseminate FHH to increase their familiarity and ability to share FHH within the family.
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Affiliation(s)
- Sato Ashida
- Department of Community and Behavioral Health, Aging Mind and Brain Initiative, University of Iowa College of Public Health, 145 N. Riverside Drive, N422 CPHB, Iowa City, IA, 52242, USA,
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