The Context of Collecting Family Health History: Examining Definitions of Family and Family Communication about Health among African American Women

Abstract

Public health initiatives encourage the public to discuss and record family health history (FHH) information, which can inform prevention and screening for a variety of conditions. Most research on FHH discussion and collection, however, has involved predominantly White participants and has not considered lay definitions of family or family communication patterns about health. This qualitative study of 32 African American women, 16 with a history of cancer, analyzed participants’ definitions of family, family communication about health, and collection of FHH information. “Family” was defined by biological relatedness, social ties, interactions, and proximity. Several participants noted using different definitions of family for different purposes (e.g. biomedical vs. social). Health discussions took place between and within generations and were influenced by structural relationships (e.g. sister) and characteristics of family members (e.g. trustworthiness). Participants described managing tensions between sharing health information and protecting privacy, especially related to generational differences in sharing information, fear of familial conflict or gossip, and denial (sometimes described as refusal to “own” or “claim” a disease). Few participants reported that anyone in their family kept formal FHH records. Results suggest FHH initiatives should address family tensions and communication patterns that affect discussion and collection of FHH information.

Developing Shared Appraisals of Diabetes Risk Through Family Health History Feedback: The Case of Mexican-Heritage Families

“…Consistent with the literature [28][29][30], our results highlight the importance of relational factors in health communication and disease prevention. Dyads with at least one female actor are more likely to communicate about risk.…”

“…In turn, interaction and information exchange in dyads can translate into shared appraisals of disease risk when they actively engage in collecting and updating their family health history. At the same time, distant and conflictual dyadic relationships can create barriers and delays in effective risk communication [30]. Prior research evaluating intervention programs on the basis of family health history has reported a number of changes associated with the provision of tailored risk feedback, including modified risk perceptions [31][32][33], more engagement in healthy behaviors [34][35][36], and increase in self-reported health communication [37,38].…”

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

“…Notions of the definition of family can also differ by race/ethnicity. For example, compared to whites, African Americans consider family to extend beyond biological ties to kinship [53]. This mismatch in definition of family as affectional rather than biological may influence perceptions of who is necessary to include in FHH assessment [50-52, 54].…”

Utilizing Genomics through Family Health History with the Theory of Planned Behavior: Prediction of Type 2 Diabetes Risk Factors and Preventive Behavior in an African American Population in Florida

“…African Americans tend to remain silent when it comes to discussing certain family matters, particularly those that involve health [9,10]. Sometimes people are aware of their family medical history but still do not heed the risk factors or warnings.…”