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医疗服务不足人群对家族健康史的感知熟悉度及重要性。

Perceived familiarity with and importance of family health history among a medically underserved population.

作者信息

Ashida Sato, Goodman Melody S, Stafford Jewel, Lachance Christina, Kaphingst Kimberly A

机构信息

Social and Behavioral Sciences, University of Memphis School of Public Health, 201 Robison Hall, Memphis, TN, 38152, USA,

出版信息

J Community Genet. 2012 Oct;3(4):285-95. doi: 10.1007/s12687-012-0097-x. Epub 2012 May 9.

Abstract

Inadequate knowledge of family health history (FHH) continues to be a major obstacle limiting its usefulness in public health and clinical practice; strategies to facilitate FHH dissemination are needed. Data (N = 1,334) were obtained through waiting-room surveys completed by a diverse sample of patients attending three community health centers. Perceptions about the importance of genetic information (β = 0.13, p < 0.001; β = 0.11, p < 0.001) and higher genetic self-efficacy (β = 0.14, p < 0.001; β = 0.23, p < 0.001) were significantly associated with higher levels of perceived familiarity with and importance of FHH, respectively. Furthermore, beliefs about genetic causation of illnesses (β = 0.12, p < 0.001) and a wider reach of health communication within one's family (β = 0.15, p < 0.001) were associated with higher levels of perceived familiarity with one's FHH. Participants in the oldest group (>50 years) reported higher familiarity than those in the youngest (18-25 years). Those with higher familiarity were significantly less likely to answer "don't know" when reporting diabetes and heart disease diagnoses among immediate (OR = 0.35 and OR = 0.29, respectively) and extended (OR = 0.50 and OR = 0.46, respectively) family members. Having a wider health communication reach within a family may be beneficial in increasing familiarity with FHH; however, the reported levels of communication reach were limited among most participants. Women, older-generation family members, and those who believe in the importance of genetics in health or feel confident about using genetic information may be particularly important as targets of public health interventions to facilitate FHH dissemination within families.

摘要

对家族健康史(FHH)的了解不足仍然是限制其在公共卫生和临床实践中发挥作用的主要障碍;因此需要采取促进FHH传播的策略。通过对在三个社区卫生中心就诊的不同患者样本进行候诊室调查,获得了数据(N = 1334)。对遗传信息重要性的认知(β = 0.13,p < 0.001;β = 0.11,p < 0.001)以及更高的遗传自我效能感(β = 0.14,p < 0.001;β = 0.23,p < 0.001)分别与对FHH更高的感知熟悉度和重要性显著相关。此外,对疾病遗传病因的信念(β = 0.12,p < 0.001)以及在家庭中更广泛的健康交流范围(β = 0.15,p < 0.001)与对个人FHH更高的感知熟悉度相关。年龄最大组(>50岁)的参与者报告的熟悉度高于最年轻组(18 - 25岁)的参与者。在报告直系亲属(分别为OR = 0.35和OR = 0.29)和旁系亲属(分别为OR = 0.50和OR = 0.46)中的糖尿病和心脏病诊断时,熟悉度较高的人回答“不知道”的可能性显著较低。在家庭中有更广泛的健康交流范围可能有助于提高对FHH的熟悉度;然而,大多数参与者报告的交流范围水平有限。女性、年长一代的家庭成员以及那些认为遗传学在健康中很重要或对使用遗传信息有信心的人,作为促进FHH在家庭中传播的公共卫生干预目标可能尤为重要。

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