University of Iowa College of Nursing, Iowa City, Iowa.
Cleveland Clinic, Cleveland, Ohio.
Health Expect. 2020 Feb;23(1):169-181. doi: 10.1111/hex.12986. Epub 2019 Oct 23.
A positive family history of type 2 diabetes (T2D) has been associated with risk awareness and risk-reducing behaviours among the unaffected relatives. Yet, little is known about how people with a positive family history for diabetes develop and manage their personal sense of risk.
To characterize two key concepts, salience and vulnerability, within the familial risk perception (FRP) model among unaffected individuals, at increased familial risk for T2D.
We conducted a mixed method study. Descriptions of salience and vulnerability were collected through semi-structured interviews. Participant's perception of self-reported risk factors (family history, age, race/ethnicity, medical history, weight and exercise) was measured using the Perceived Risk Factors for T2D Tool and was compared to a clinical evaluation of the same risk factors.
We identified two components of salience: (a) concern for developing T2D and (b) risk awareness triggers, and two features of vulnerability: (a) statement of risk and (b) risk assessment devices. Although few participants (26%) were concordant between their perceived and clinical overall T2D risk, concordance for individual risk factors was higher, ranging from 42% (medical history) to 90% (family history).
Both familial and non-familial events lead people to contemplate their T2D risk, even among people who have a positive family history. Participants often downplayed their overall risk and underestimated their overall risk compared to a clinical risk assessment of the same self-reported risk factors. Clinicians could leverage key components of the FRP process as way to engage patients in risk reduction strategies earlier.
2 型糖尿病（T2D）的阳性家族史与未受影响的亲属的风险意识和降低风险行为有关。然而，人们对具有糖尿病阳性家族史的人如何发展和管理个人风险知之甚少。
在 T2D 家族风险感知（FRP）模型中，描述在家族风险增加的情况下，两个关键概念（凸显度和脆弱性）在未受影响个体中的特征。
我们进行了一项混合方法研究。通过半结构化访谈收集凸显度和脆弱性的描述。使用 T2D 感知风险因素工具测量参与者对自我报告的风险因素（家族史、年龄、种族/民族、医疗史、体重和运动）的感知，并用相同风险因素的临床评估进行比较。
我们确定了凸显度的两个组成部分：（a）对 T2D 发展的担忧和（b）风险意识触发因素，以及脆弱性的两个特征：（a）风险陈述和（b）风险评估装置。尽管很少有参与者（26%）在他们感知的和临床的整体 T2D 风险之间一致，但个别风险因素的一致性更高，从 42%（医疗史）到 90%（家族史）不等。
无论是家族性还是非家族性事件，都会促使人们思考自己的 T2D 风险，即使是那些有阳性家族史的人也是如此。与对相同自我报告风险因素的临床风险评估相比，参与者往往低估了自己的整体风险。临床医生可以利用 FRP 过程的关键组成部分，更早地让患者参与降低风险策略。
