title: More good than harm: a randomised controlled trial of the effect of education about familial risk of diabetes on psychological outcomes.
abstract: BACKGROUND
  Offspring of people with type 2 diabetes underestimate their risk of developing the disease and know little about primary prevention. However, education about risk might cause psychological harm.
  
  
  OBJECTIVE
  To examine cognitive and psychological effects of education about personal risk.
  
  
  METHODS
  Patients with type 2 diabetes were recruited from randomly selected general practices. One of their adult offspring was randomly selected and randomly allocated into one of three groups: 1. Group 1: given an initial interview, education, and a final interview; 2. Group 2: given an initial and final interview; and 3. Group 3: given one interview only. Psychological outcomes were assessed using Hospital Anxiety and Depression Scale (HAD) and Positive Well-Being Scale (PWB) scores.
  
  
  RESULTS
  Sixty-nine per cent (105/152) of eligible offspring participated. Ninety-one per cent (96/152) completed the study. Comparing first and final interviews, in Group 1, significantly fewer responders at final interview (after education) thought that their risk of developing diabetes was 'low' (65% versus 41%, P = 0.027), while in Group 2, there was no significant change in risk perception (P = 0.13). Significantly fewer people in the educated group (Group 1, final interview) than in the control group (Group 3) thought their risk of developing diabetes was 'low' (41% versus 77%, P = 0.002). Risk education did not affect total HAD scores or PWB scores significantly.
  
  
  CONCLUSIONS
  Educating offspring of people with type 2 diabetes in this way about their risk of diabetes and possible preventive strategies increases their perception of personal risk but does not cause psychological harm.
authors.affiliation: Department of Primary Health Care and General Practice, Imperial College School of Medicine, London.
authors.forename: M
authors.initials: M
authors.lastname: Pierce
authors.forename: D
authors.initials: D
authors.lastname: Ridout
authors.forename: D
authors.initials: D
authors.lastname: Harding
authors.forename: H
authors.initials: H
authors.lastname: Keen
authors.forename: C
authors.initials: C
authors.lastname: Bradley
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics / Q000523:psychology*; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D018709:Statistics, Nonparametric