EXPLORING THE INFLUENCE OF FAMILY HEALTH HISTORIES ON RISK PERCEPTIONAMONG AFRICAN AMERICANS: A QUANTITATIVE ANALYSIS

PURPOSE: The Center for Minority Health (CMH) in the University of Pittsburgh's Graduate School of Public Health established The Healthy Black Family Project, a program designed to increase awareness of the contribution of family health history to the development of chronic diseases. We assessed the impact of a family health history session on African American's risk perceptions for the development of chronic diseases, which result from interactions between genes and the environment. The public health significance of this study was to delineate how participants' perceived risks for developing chronic diseases (i.e., cancer, cardiovascular disease, etc.) would shape risk-reducing behavior modifications and utilization of preventive services.METHODS: Participants (n=175) completed interviews to create a family health history (or pedigree), a schematic representation of health history information in a family. Of these individuals, a total of 125 participants completed surveys that assessed their perceptions of risk for nine chronic diseases. For the purpose of this study, statistical analysis was limited to colorectal cancer (CRC) and cardiovascular disease (CVD). Assessments of risk perception before and following the family health history sessions were calculated to assess changes in accuracy of risk.RESULTS: Overall, participants appeared to understand the contribution of general risk factors (i.e., smoking) to disease development. However, participants were less knowledgeable about risk related to family health history. Of the 125 participants, sixty-nine percent (n=86) and eighty-five percent (n=107) overestimated the lifetime risks to develop colon cancer for women and men in the general population, respectively. Similar trends were observed for heart disease. More participants were accurate about their risk perceptions for colon cancer than for heart disease in both the pre- and post-family health history session. Among the participants whose perceptions changed, inaccurate perceptions for colon cancer and heart disease prior to the family health history interview were significantly more likely to become accurate for colon cancer (p=0.028) and heart disease (p=0.005).CONCLUSIONS: The family health history is an effective tool in identifying at-risk individuals and promoting accurate risk perceptions. Encouraging the use of family health history and providing accurate risk perceptions can lead to healthy behavior modifications that may decrease racial and ethnic health disparities