Chinese Americans' perceived barriers to discussing family history with U.S. health care providers

Background and purpose: Major national agencies, such as the NIH, CDC, and U.S. Surgeon General, have initiated a series of events to urge the lay public to discuss family history with their health care providers. However, to the best of our knowledge, there are no data regarding how Chinese Americans communicate family history with health care providers. To reduce genomics-related health disparities, it is important to identify barriers that influence Chinese Americans to communicate their family history with health care providers. Methods: Forty-nine participants from major Chinese American communities in a Southeastern metropolitan city were recruited for in-depth qualitative interviews regarding their perceived barriers to discuss family history with their doctors. Results: The majority of participating Chinese Americans (83.7%) had never or seldom discussed family history with their doctors. Their perceived barriers were as follows: 1) lack of inquiry from the U.S. doctors, 2) self-claim that their family and themselves are healthy, 3) lack of motivation, 4) the claim that the practice of the U.S. health care system is unfriendly to patients, 5) language barriers, 6) lack of knowledge regarding their own family history information, and 7) sharing family history with others conflicting with Chinese culture. Discussion: Findings suggest that most Chinese Americans in our study fail to engage in open discussion with their health care providers about their family history. Health professionals should develop culturally sensitive family history communication initiatives and genomic services to address Chinese Americans' perceived barriers in this aspect.