Kaphingst K A, Lachance C R, Gepp A, D'Anna L Hoyt, Rios-Ellis B
National Human Genome Research Institute, Bethesda, MD, USA.
Public Health Genomics. 2011;14(4-5):211-21. doi: 10.1159/000272456. Epub 2009 Dec 29.
Family health history (FHH) is a tool used to inform individuals about inherited disease risk. Due to their disproportionate morbidity and mortality from some common chronic diseases, U.S. Latinos are an important audience for FHH information. This study examined the effects of a culturally-tailored intervention led by lay health advisors (LHAs) in delivering information about FHH on participants' intentions, self-efficacy, and conceptual knowledge.
474 Spanish-speaking Latino participants were enrolled in the study. Individuals in the intervention group participated in a single group educational session using discussion and interactive activities to build skills for discussing FHH with one's family members and doctor, while individuals in the comparison group had a brochure read aloud to them. Pre- and post-test questionnaires were verbally administered.
Primary dependent variables were intentions and self-efficacy to discuss FHH with family members and doctors; these increased in both groups. Multivariate analyses demonstrated that the intervention led to a significantly greater increase in self-efficacy to discuss FHH with family members (p = 0.03). LHA participants were also more than twice as likely (OR = 2.6, 95% CI = 1.3-5.0) to correctly understand the purpose of a FHH and found FHH information more useful (p < 0.0001).
A communication intervention delivered by LHAs shows promise as an effective means of educating underserved Spanish-speaking Latinos about the importance of FHH for disease prevention. Such community-based approaches can help to close knowledge and skills gaps about FHH and increase confidence in using this information to improve the health of those most at risk.
家族健康史（FHH）是一种用于告知个人遗传疾病风险的工具。由于美国拉丁裔在一些常见慢性病方面的发病率和死亡率不成比例，他们是FHH信息的重要受众群体。本研究考察了由非专业健康顾问（LHA）主导的文化定制干预措施在提供FHH信息方面对参与者的意愿、自我效能感和概念性知识的影响。
474名讲西班牙语的拉丁裔参与者被纳入研究。干预组的个体参加了一次小组教育课程，通过讨论和互动活动来培养与家人及医生讨论FHH的技能，而对照组的个体则听人朗读了一本宣传册。通过口头方式进行前后测问卷调查。
主要因变量是与家人及医生讨论FHH的意愿和自我效能感；两组均有所提高。多变量分析表明，干预措施使与家人讨论FHH的自我效能感显著提高（p = 0.03）。LHA参与者正确理解FHH目的的可能性也高出两倍多（OR = 2.6，95% CI = 1.3 - 5.0），并认为FHH信息更有用（p < 0.0001）。
由LHA实施的沟通干预措施有望成为一种有效的手段，用以教育服务不足的讲西班牙语的拉丁裔了解FHH对疾病预防的重要性。这种基于社区的方法有助于缩小关于FHH的知识和技能差距，并增强利用这些信息改善高危人群健康状况的信心。
