Koehly Laura M, Morris Bronwyn A, Skapinsky Kaley, Goergen Andrea, Ludden Amanda
Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Building 31, Rm B1B54, Bethesda, MD, 20892-2073, USA.
BMC Public Health. 2015 Nov 13;15:1120. doi: 10.1186/s12889-015-2483-x.
Common diseases such as heart disease, diabetes, and cancer are etiologically complex with multiple risk factors (e.g., environment, genetic, lifestyle). These risk factors tend to cluster in families, making families an important social context for intervention and lifestyle-focused disease prevention. The Families Sharing Health Assessment and Risk Evaluation (SHARE) workbook was designed as an educational tool outlining family health history based risk of heart disease, type 2 diabetes, breast cancer, and colorectal cancer. The current paper describes the steps taken to develop and evaluate the workbook employing a user-centered design approach.
The workbook was developed in four steps, culminating in an evaluation focusing on understanding and usability of the tool. The evaluation was based on two Phases of data collected from a sample of mothers of young children in the Washington, D.C., area. A baseline assessment and follow-up approximately two weeks after receipt of the workbook were conducted, as well as focus groups with participants. The design of the workbook was refined in response to participant feedback from the first evaluation Phase and subsequently re-evaluated with a new sample.
After incorporating user-based feedback and revising the workbook, Phase 2 evaluation results indicated that understanding of the workbook components improved for all sections (from 6.26 to 6.81 on a 7-point scale). In addition, 100% of users were able to use the algorithm to assess their disease risk and over 60% used the algorithm to assess family members' disease risk. At follow-up, confidence to increase fruit, vegetable and fiber intake improved significantly, as well.
The Families SHARE workbook was developed and evaluated resulting in a family health history tool that is both understandable and usable by key stakeholders. This educational tool will be used in intervention studies assessing the effectiveness of family genomics health educators who use the Families SHARE workbook to disseminate family risk information and encourage risk reducing behaviors.
ClinicalTrials.gov, NCT01498276 . Registered 21 December 2011.
诸如心脏病、糖尿病和癌症等常见疾病病因复杂,存在多种风险因素(如环境、遗传、生活方式)。这些风险因素往往在家庭中聚集,使家庭成为干预和以生活方式为重点的疾病预防的重要社会背景。“家庭共享健康评估与风险评估”(SHARE)工作手册被设计为一种教育工具,概述基于家族病史的心脏病、2型糖尿病、乳腺癌和结直肠癌风险。本文描述了采用以用户为中心的设计方法开发和评估该工作手册所采取的步骤。
该工作手册分四个步骤开发,最终进行了一项侧重于工具的理解性和可用性的评估。该评估基于从华盛顿特区地区幼儿母亲样本中收集的两个阶段的数据。在收到工作手册后进行了基线评估和大约两周后的随访,以及与参与者的焦点小组讨论。根据第一阶段评估中参与者的反馈对工作手册的设计进行了改进,随后用新样本进行了重新评估。
纳入基于用户的反馈并修订工作手册后,第二阶段评估结果表明,所有部分对工作手册内容的理解均有提高(在7分制量表上从6.26提高到6.81)。此外,100%的用户能够使用该算法评估自身疾病风险,超过60%的用户使用该算法评估家庭成员的疾病风险。在随访时,增加水果、蔬菜和纤维摄入量的信心也显著提高。
开发并评估了“家庭共享健康评估与风险评估”工作手册,形成了一种关键利益相关者既能理解又能使用的家族病史工具。该教育工具将用于干预研究,评估使用“家庭共享健康评估与风险评估”工作手册传播家族风险信息并鼓励降低风险行为的家庭基因组健康教育工作者的有效性。
ClinicalTrials.gov,NCT01498276。2011年12月21日注册。