Hood Sula M, Golembiewski Elizabeth H, Sow Hadyatoullaye, Benbow Kyle, Prather Jeremy, Robison Lisa D, Martin-Hagler Elisabeth
Indiana University Richard M. Fairbanks School of Public Health, Department of Social and Behavioral Sciences, Indianapolis, IN.
Indiana University Richard M. Fairbanks School of Public Health, Department of Health Policy and Management, Indianapolis, IN.
J Soc Struct. 2019 Jan;20(3):96-118. doi: 10.21307/joss-2019-008. Epub 2019 Jul 31.
Family health history is a strong risk factor for many chronic diseases. Ethnic minorities have been found to have a low awareness of their family health history (FHH), which may pose a contributing factor to health disparities.
The purpose of this mixed-methods social network analysis study was to identify structural and contextual patterns in African American adults' FHH knowledge based on interpersonal communication exchanges with their family members.
African American adults completed individually administered family network interviews. Participants' 3-generation family pedigree served as a visual aid to guide their interview. Our primary outcome of interest for this analysis was whether a family member was reported as someone who talks to the participant about their own (i.e., the family member's) health, which we refer to as a "personal health informant." To contextualize quantitative findings, participants were asked to describe they learned about the health history of the relatives they identified during their interview.
Participants (n=37) reported an average family network size of 29.4 relatives (SD = 15.5; Range = 10-67). Each participant, on average, named 17% of their familial network as personal health informants. Multivariate regression results showed that participants were more likely to name an alter as a personal health informant if the alter was female (OR = 2.14, p = 0.0519), from the maternal side of the participant's family (OR = 1.12, p = 0.0006), had one or more chronic health conditions (OR = 2.41, p = 0.0041), was someone who has discussions with the participant about the participant's health (OR = 16.28, p < 0.0001), was a source of family health information (OR = 3.46, p = 0.0072), and was someone whose health the participant helps to monitor or track (OR = 5.93, p = 0.0002). Complementary qualitative findings indicate that FHH knowledge is facilitated by open, direct communication among relatives. Personal health informants were described as disclosing information for the purposes of informing others for preventive purposes and for gaining social support. Participants also learned about FHH via other methods, including direct observation, during caretaking, and following a relative's death.
Communication and disclosure practices is an important determinant of African Americans' FHH knowledge. More culturally and contextually meaningful public health efforts are needed to promote family health history sharing, especially regarding paternal family health history, siblings, and extended relatives.
家族健康史是许多慢性病的重要风险因素。研究发现，少数族裔对其家族健康史（FHH）的认知度较低，这可能是导致健康差距的一个因素。
这项混合方法的社会网络分析研究旨在基于非裔美国成年人与其家庭成员的人际交流，确定他们FHH知识中的结构和背景模式。
非裔美国成年人分别完成了家庭网络访谈。参与者的三代家族谱系用作视觉辅助工具，以指导访谈。我们此次分析的主要关注结果是，是否有家庭成员被报告为会与参与者谈论其自身（即该家庭成员）健康状况的人，我们将其称为“个人健康信息提供者”。为了将定量结果置于具体情境中，我们要求参与者描述他们是如何了解在访谈中提及的亲属的健康史的。
参与者（n = 37）报告的家庭网络平均规模为29.4名亲属（标准差 = 15.5；范围 = 10 - 67）。平均而言，每位参与者将其家族网络中17%的人命名为个人健康信息提供者。多变量回归结果显示，如果该人是女性（比值比 = 2.14，p = 0.0519）、来自参与者家族的母系一方（比值比 = 1.12，p = 0.0006）、患有一种或多种慢性健康状况（比值比 = 2.41，p = 0.0041）、会与参与者谈论参与者自身健康状况（比值比 = 16.28，p < 0.0001）、是家庭健康信息的来源（比值比 = 3.46，p = 0.0072），以及是参与者会帮助监测或跟踪其健康状况的人（比值比 = 5.93，p = 0.0002），那么参与者更有可能将其命名为个人健康信息提供者。补充性的定性研究结果表明，亲属之间开放、直接的沟通有助于FHH知识的传播。个人健康信息提供者被描述为出于预防目的告知他人信息并获得社会支持而披露信息。参与者还通过其他方式了解FHH，包括直接观察、在照顾期间以及在亲属去世后。
沟通和披露行为是非裔美国人FHH知识的重要决定因素。需要开展更具文化和情境意义的公共卫生工作，以促进家族健康史的分享，特别是关于父系家族健康史、兄弟姐妹和远亲的信息。
