Allen Caitlin G, Duquette Debra, Guan Yue, McBride Colleen M
Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30308, USA.
Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL, 60611, USA.
J Community Genet. 2020 Apr;11(2):147-159. doi: 10.1007/s12687-019-00424-9. Epub 2019 Jul 2.
Uptake of community-facing family health history (FHH) tools to identify those at highest risk of disease and target prevention efforts has been consistently low. This review uses the diffusion of innovations (DOI) as a framework to organize the FHH evidence base and identify potential strategies to improve uptake of community-facing FHH tools. Methods for this literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We completed systematic searches in PubMed, Embase, and Web of Science databases for studies from 2009 to 2017 and hand searched bibliographies of relevant literature to identify additional articles. We abstracted and synthesized results, which were then organized by the DOI including the innovation-decision making process and characteristics of the innovation likely to influence diffusion (e.g., compatibility, relative advantage, complexity, trialability, observa/bility). Of the 290 unique articles identified, 65 were eligible for full-text review after title and abstract screening; a total of 27 were included in the final abstraction. Eleven unique tools were identified. The most commonly used tool was the Surgeon General's My Family Health Portrait (n =9/27). Only six studies directly evaluated participant perceptions shown to be associated with tool uptake. Studies tended to focus on improving compatibility by customizing tools to the target population's needs and use of educational interventions. Results from this review suggest the need to evaluate strategies to increase the pace of uptake of community-facing FHH tools. These include pragmatic trials that compare different approaches to engage and evaluate participant perceptions of the relative advantage and complexity of tools. Ancillary support strategies may include collaborations with community networks to facilitate use and implementation study designs for rigorous evaluation.
用于识别疾病风险最高人群并针对预防工作的面向社区的家庭健康史（FHH）工具的使用率一直很低。本综述以创新扩散（DOI）为框架，整理FHH的证据基础，并确定提高面向社区的FHH工具使用率的潜在策略。本文献综述的方法遵循系统评价和Meta分析的首选报告项目指南。我们在PubMed、Embase和Web of Science数据库中对2009年至2017年的研究进行了系统检索，并人工检索了相关文献的参考文献以识别其他文章。我们提取并综合了结果，然后按照DOI进行组织，包括创新决策过程以及可能影响扩散的创新特征（例如，兼容性、相对优势、复杂性、可试验性、可观察性）。在识别出的290篇独特文章中，65篇在标题和摘要筛选后符合全文审查条件；最终提取共纳入27篇。识别出11种独特工具。最常用的工具是美国卫生局局长的《我的家庭健康画像》（n = 9/27）。只有六项研究直接评估了与工具使用相关的参与者认知。研究倾向于通过根据目标人群的需求定制工具和使用教育干预措施来提高兼容性。本综述结果表明，需要评估提高面向社区的FHH工具使用速度的策略。这些策略包括比较不同方法以吸引并评估参与者对工具相对优势和复杂性的认知的实用试验。辅助支持策略可能包括与社区网络合作以促进使用，并采用实施研究设计进行严格评估。
