Effect of Family Context on African American Women's Use of Family Health History Tools

Background: Few U.S. adults collect and record family health history (FHH) information, which is critical for tailoring disease prevention and screening recommendations. Most FHH research has involved primarily White participants; research is needed on improving collection of FHH information among African Americans. In this study, we examined family context and other possible predictors of using FHH tools among African American women. Methods: Using a mixed-methods approach, we interviewed 32 African American women, half of whom had a previous cancer diagnosis. An in-person interview focused on family context, family communication about health, and reactions to a FHH tool. Participants chose one of two FHH tools to take home. A follow-up call three weeks later assessed whether participants had used the tool to collect FHH information. Results: All participants thought knowing FHH was “very” or “somewhat” important. Although 56% had collected some FHH information previously, only 28% had recorded it. Women were most likely to talk about health with female family members. Participants also reported that distant relationships with family members (often on the paternal side) and generational differences in sharing health information could be barriers to collecting FHH. Participants highlighted sharing information with future generations as a use for a written FHH. At follow-up, 60% reported using their selected FHH tool. Discussion: Findings highlighted family communication issues that could affect collecting FHH information. Efforts to promote health and wellness across the lifespan and across generations by improving FHH collection among African Americans must take into account familial and cultural contexts.