Factors Influencing Not Perceiving Family Health History Assessments as Important: Opportunities to Improve Dissemination of Evidence-Based Population Screening for Cancer

Abstract

Introduction: Public willingness to collect personal family health history (FHH) assessments is integral to implement population screening to identify those at high cancer risk who could benefit most from lifesaving interventions. Yet, surprisingly little consideration has been given to factors associated with the public’s perceived importance of FHH in the context of cancer. Methods: Using data from the 2013 Health Information National Trends survey, we assessed the association of intrapersonal (e.g., cancer worry), sociodemographic (e.g., education), and interpersonal-level factors (e.g., family trust) associated with not perceiving FHH assessment to be very important for personal health. Associations were tested with bivariate analyses and hierarchical logistic regression. Results: Of the 3,007 respondents, 32.7% reported perceiving FHH as not very important to their health. Whites (p < 0.001), males (p = 0.003), and those born in the United States (p = 0.004) were most likely to perceive FHH as not very important. Those who were least worried about cancer and perceived that cancer risk could not be lowered also viewed FHH as not very important (p = 0.002, p = 0.018, respectively). In hierarchical regression analyses, the association of low cancer worry remained significant after accounting for sociodemographic and interpersonal factors. The addition of sociodemographic factors modestly improved the model; the addition of interpersonal factors did not improve the model. Conclusions: A sizable proportion of the public does not perceive FHH to be very important, may be hard to reach, and impede implementation of population screening guidelines for inherited cancers. Campaigns to increase the perceived value of FHH assessment may need to be tailored to demographic subgroups, emphasize cancer prevention, and encourage family communication.

Gender differences in self‐reported family history of cancer: A review and secondary data analysis

“…30 A recent study also using data from the HINTS 4 Cycle 3 (2013) iteration indicated that those (altogether about one-third) participants who believed that family health history was not important for their health were significantly more likely to be male (57%) than female (43%). 31 Traditional masculinity norms which expect men to be independent and emotionally controlled and regard psychological or medical help-seeking as "weak" or "unmanly" were identified as factors associated with poor communication with health professionals. They also explained delays in medical help-seeking in men in general 32 as well as men's help-seeking for cancer symptoms.…”

“…In line with these findings are the results from the US Health Styles Survey which reported that men are less likely (23%) compared with women (36%) to actively collect health information on their relatives’ health family history 30 . A recent study also using data from the HINTS 4 Cycle 3 (2013) iteration indicated that those (altogether about one‐third) participants who believed that family health history was not important for their health were significantly more likely to be male (57%) than female (43%) 31 …”

Exploring the Role of Community Health Workers in Improving the Collection of Family Health History: A Pilot Study

“…We also asked CHWs in our sample to complete a FHH tool as a means to inform their views about the feasibility of integrating these assessments in their routine practices (Allen, Escoffery, et al, 2018; McWalter & Gaviglio, 2015). CHWs noted that the collection of FHH information would improve their own relationship and work with clients.…”

“…Traditionally, FHH information is collected by health professionals as part of medical visits; however, given the challenges of collecting FHH information in these settings (e.g., limited time, patients having incomplete knowledge of health histories,), a wide range of tools and initiatives have been developed and promoted to facilitate FHH collection outside clinical settings (American Medical Association, 2018; Bates, 2005; Rich et al, 2004; Valdez et al, 2010; Williams et al, 2011). While individuals often recognize the importance of FHH, less than one third of the population has collected personal FHH; FHH knowledge is also notably lower among minorities and those with limited literacy (Allen, Escoffery, et al, 2018).…”

Understanding the Process of Family Cancer History Collection and Health Information Seeking

“…The collection of family cancer history (FCH) is an effective and inexpensive way to capture information that can guide stratified cancer risk assessment, target screening, and prevention efforts; activate individuals and their family members for screening and/or genetic counseling and testing; and motivate positive behavior change (Ashida et al, 2012; Claassen et al, 2010; deHeer et al, 2017; Koehly et al, 2018; McBride et al, 2013; Ochs-Balcom et al, 2015; Qureshi & Kai, 2008; Rebbeck et al, 2018; Valdez et al, 2010; Yoon et al, 2002). While family health history is widely acknowledged as useful for guiding clinical and public health practice, as few as one third of individuals know their family health information and only 3% have ever used a tool to collect this information (C.G. Allen et al, in press).…”