Context
Family history is a risk factor for many common chronic diseases, yet it remains underutilized
in primary care practice.
Background
Family Healthware™ 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.
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© 2009 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
