Health promotion through family health history at federally-funded health centers

BACKGROUND: Risk assessment based on family health history (FHH) allows providers to personalize and prioritize health messages, shifts the focus of healthcare from treatment to prevention, and can empower individuals and families to be stewards of their own health. However, FHH is inconsistently collected in healthcare settings. To address this, six federally-funded health centers across the U.S. are customizing the Does It Run in the Family? patient education toolkit for diverse populations to improve FHH awareness and discussion among health center providers, staff, and patients. METHODS: 73 staff and providers (including nurses, medical assistants, health educators, physicians) were trained on FHH and genetics. The evaluation uses pre/post surveys and consumer and provider interviews to assess knowledge, comfort with genetics information, and trends in FHH practice in the clinic. RESULTS: Comparison of pre/post training survey data show that self-reported understanding in how to initiate discussions with patients about FHH improved (from 60% to 92% reporting “understanding well”) as did confidence in discussing FHH risk factors with patients (from 70% to 94% reporting feeling “confident”). During interviews, providers and staff noted the potential of this project to improve the quality and consistency of practice across providers, enhance relationships at the center, and contribute to moving the center toward a medical home model. CONCLUSION: A patient FHH toolkit and provider training on FHH can empower patients and providers to collect more comprehensive FHH and work collaboratively toward a preventive, rather than reactive, healthcare practice.