Evaluation of the family health history project among urban American Indians and Alaska Natives in the Pacific Northwest

Background: American Indians and Alaska Natives (AI/AN) suffer a disproportionate burden of preventable illness. Family history is an important tool for disease prevention and can serve as a basis for improving healthcare and encouraging healthy lifestyle choices. While AI/AN have used storytelling for generations to convey history and culture, many individuals are unaware of the value of this information in the healthcare setting. Method: This project adapted a national family health history tool to develop a Native-specific tool. A family was counted as enrolled when three or more members agreed to participate. Families lived in urban areas across Washington and Oregon and were recruited through existing partnerships at health organizations and community centers. A baseline survey was administered to assess knowledge of family history and communication about disease risk. Families were provided the tool and contacted 2-3 months later for a follow-up survey to assess relevance and use. Results: A total of 25 families (75 individuals) completed the study. Preliminary data show 45% reported the tool to be very or extremely useful. Families were 40% more likely to actively collect family history if they had a recognized family health leader. While 81 % of the cohort reported using the tool between 1-5 times, 76% did not create a family health portrait to share with their provider. Conclusion: While this project demonstrates that a community-centered approach to a national project is feasible, preliminary results indicate that barriers persist in communication of family health history to providers for urban AI/AN families.