Faculty Publications
Familial Risk for Common Diseases in Primary Care The Family Healthware (TM) Impact Trial
Familial Risk for Common Diseases in Primary Care The Family Healthware (TM) Impact Trial
Am J Prev Med. 2009;36(6):506-14.
Abstract Context: Family history is a risk factor for many common chronic diseases, yet it remains underutilized in primary care practice. Background: Family Healthware (TM) is a self-administered, web-based tool that assesses familial risk for CHD; stroke; diabetes; and colorectal, breast, and ovarian cancer, and provides a personalized prevention plan based on familial risk. The Family Healthware Impact Trial evaluated the tool. Design: In this cluster RCT, participants completed baseline and 6-month follow-up surveys. The intervention group used Family Healthware directly after the baseline survey. Controls used the tool after completing the follow-up survey. Setting/participants: Patients aged 35-65 years with no known diagnosis of these six diseases were enrolled from 41 primary care practices. Main outcome measures: The prevalence of family-history-based risk for coronary heart disease (CHD); stroke; diabetes; and colorectal, breast, and ovarian cancer was determined in a primary care population. Results: From 2005 to 2007, 3786 participants enrolled. Data analysis was undertaken from September 2007 to March 2008. Participants had a mean age of 50.6 years and were primarily white (91%) women (70%). Of the 3585 participants who completed the risk assessment tool, 82% had a strong or moderate familial risk for at least one of the diseases: CHD (strong=33%, moderate=26%); stroke (strong=15%, moderate=34%); diabetes (strong=11%, moderate=26%); colorectal cancer (strong=3%, moderate=11%); breast cancer (strong=10%, moderate=12%); and ovarian cancer (strong=4%, moderate=6%). Women had a significantly (p<0.04) higher familial risk than men for all diseases except colorectal and ovarian cancer. Overweight participants were significantly (p <= 0.02) more likely to have a strong family history for CHD, stroke, and diabetes. Older participants were significantly (p <= 0.02) more likely to report a strong family history for CHD and stroke as well as colorectal and breast cancer. Conclusions: This self-administered, online tool delineated a substantial burden of family-history-based risk for these chronic diseases in an adult, primary care population. Trial registration: NCT00164658. (Am J Prev Med 2009;36(6):506-514) (C) 2009 American journal of Preventive Medicine