230542 Utilizing Family Health History to Assess Objective Risk for Chronic Disease among African Americans: Building a Culturally Tailored, Community-Based Intervention

Tuesday, November 9, 2010 : 1:06 PM - 1:24 PM

Mary A. Garza, PhD, MPH , Behavioral and Community Health, University of Maryland for Health Equity School of Public Health, University of Maryland College Park, College Park, MD
Donna Almario Doebler, MPH, MS , Behavioral & Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
Sarah E. Woody , Department of Human Genetics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
James Butler III, DrPH, MEd , Department of Behavioral and Community Health Sciences & Research Center of Excellence on Minority Health Disparities, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
Craig S. Fryer, DrPH, MPH , Department of Behavioral and Community Health Sciences & Research Center of Excellence on Minority Health Disparities, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
Kevin H. Kim, PhD , Department of Psychology in Education, University of Pittsburgh, School of Education, Pittsburgh, PA
Robin E. Grubs, PhD , Department of Human Genetics, University of Pittsburgh, Graduate school of Public Health, Pittsburgh, PA
Elizabeth Gettig, MS , Department of Human Genetics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
Sandra C. Quinn, PhD , Department of Behavioral and Community Health Sciences & Research Center of Excellence on Minority Health Disparities, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
Stephen B. Thomas, PhD , Department of Behavioral and Community Health Sciences & Research Center of Excellence on Minority Health Disparities, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Background: African Americans (AA) experience a disproportionate burden of morbidity and mortality from preventable chronic diseases. Family health history (FHH) is a critical risk factor for type 2 diabetes (DIAB), cardiovascular disease (CVD), and hypertension (HTN). According to an NIH, "family history has an important role in the practice of medicine and may motivate positive lifestyle changes, enhance individual empowerment, and influence clinical interventions." However, no consensus exists on how FHH information is best obtained from racial/ethnic minority populations. Limited studies exist that examine the use of FHH to influence AA risk perceptions. This study examined the influence of a community-based FHH intervention on AA risk perceptions for DIAB, CVD, and HTN. Methods: The intervention used a pre/post design with one follow-up session. Participants completed a pre-survey followed by a FHH interview, immediately followed by a post-survey. Survey collected data on socio-demographics, behavioral risk factors, trust in research, and risk perception. Participants were contacted 30 days later for follow-up. Data analysis 1) summarized distribution of participants' objective risk (average, moderate, or high), based on Scheuner's objective risk stratification, 2) compared accuracy of risk perception pre- and post-FHH using marginal homogeneity tests, and 3) examined predictors of accuracy of risk perception post-FHH using multinomial logistic regression. Results: 799 AA completed the intervention. Majority were female (84%), ≥51 years of age (58%), and 25% had an annual income of ≤ $20,000. A majority of individuals (52%) reported being diagnosed with either DIAB (19%), CVD (9%), or HTN (45%). A higher percentage of individuals were classified as having high risk for DIAB (47%), CVD (41%), and HTN (72%). Preliminary results demonstrate accuracy was significantly different pre- and post-family health history (p<0.05). In addition, predictors of accuracy post-FHH included age, income, education, perceived risk pre- and post-FHH, and objective risk (p<0.05). Conclusions: The family health history is a promising public health tool that can be culturally tailored to meet the needs of minority populations. Participants identified as "high risk" would benefit greatly from targeted prevention strategies. This intervention has the potential to motivate positive lifestyle changes, thus decreasing racial and ethnic health disparities.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs

Learning Objectives:
By the end of the session, each participant will be able to: 1) Discuss the role of family health history in assessing chronic disease risk perception among African Americans; 2) Describe three factors associated with increasing chronic disease risk perception in African American populations.

Keywords: Health Disparities, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting health disparities research for the past 15 years plus I am a co-investigator on this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.