Goergen Andrea F, Ashida Sato, Skapinsky Kaley, de Heer Hendrik D, Wilkinson Anna V, Koehly Laura M
Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Md., USA.
Public Health Genomics. 2016;19(2):93-101. doi: 10.1159/000443473. Epub 2016 Feb 9.
This study investigated diabetes and heart disease family health history (FHH) knowledge and changes after providing personalized disease risk feedback.
A total of 497 adults from 162 families of Mexican origin were randomized by household to conditions based on feedback recipient and content. Each provided personal and relatives' diabetes and heart disease diagnoses and received feedback materials following baseline assessment. Multivariate models were fitted to identify factors associated with the rate of 'don't know' FHH responses.
At baseline, US nativity was associated with a higher 'don't know' response rate (p = 0.002). Though confounded by country of birth, younger age showed a trend toward higher 'don't know' response rates. Overall, average 'don't know' response rates dropped from 20 to 15% following receipt of feedback (p < 0.001). An intervention effect was noted, as 'don't know' response rates decreased more in households where one family member (vs. all) received supplementary risk assessments (without behavioral recommendations; p = 0.011).
Limited FHH knowledge was noted among those born in the US and younger participants, representing a key population to reach with intervention efforts. The intervention effect suggests that 'less is more', indicating the potential for too much information to limit health education program effectiveness.
本研究调查了糖尿病和心脏病家族健康史(FHH)知识以及提供个性化疾病风险反馈后的变化。
来自162个墨西哥裔家庭的497名成年人按家庭随机分组,根据反馈接受者和内容分为不同条件组。每组在基线评估后提供个人及亲属的糖尿病和心脏病诊断信息,并接收反馈材料。采用多变量模型确定与“不知道”FHH回答率相关的因素。
在基线时,在美国出生与较高的“不知道”回答率相关(p = 0.002)。尽管受出生国家的影响,但年龄较小者显示出“不知道”回答率较高的趋势。总体而言,收到反馈后,平均“不知道”回答率从20%降至15%(p < 0.001)。注意到一种干预效果,即当一名家庭成员(而非所有成员)接受补充风险评估(无行为建议)时,“不知道”回答率在家庭中下降得更多(p = 0.011)。
在美国出生的人和年轻参与者的FHH知识有限,这是干预工作的关键目标人群。干预效果表明“少即是多”,这意味着过多信息可能会限制健康教育项目的效果。