title: Utah's Family High Risk Program: bridging the gap between genomics and public health.
abstract: BACKGROUND
  Family history is a simple yet powerful genomic tool that can identify individuals and entire populations at risk for diseases such as heart disease, cancer, and diabetes. Despite its use for predicting disease, family history has traditionally been underused in the public health setting.
  
  
  BACKGROUND
  A program for identifying families at risk for a variety of chronic diseases was implemented in Utah. Utah has population characteristics that are unique among the United States. Although the land area is large, most residents live within a relatively small geographic area. The religion of 70% of the residents encourages the recording of detailed family histories, and many families have access to records dating back to the 1800s.
  
  
  METHODS
  From 1983 through 1999, the Utah Department of Health, local health departments, school districts, the University of Utah, and the Baylor College of Medicine implemented and conducted the Family High Risk Program, which identified families at risk for chronic diseases using the Health Family Tree Questionnaire in Utah high schools.
  
  
  CONCLUSIONS
  The collection of family history is a cost-effective method for identifying and intervening with high-risk populations. More than 80% of eligible families consented to fully participate in the program. A total of 80,611 usable trees were collected. Of the 151,188 Utah families who participated, 8546 families identified as high-risk for disease(s) were offered follow-up interventions.
  
  
  CONCLUSIONS
  The program was revolutionary in design and demonstrated that family history can bridge the gap between genetic advances and public health practice.
authors.affiliation: Utah Department of Health Chronic Disease Genomics Program, PO Box 142106, Salt Lake City, UT, 84114-2106, USA. jennyjohnson@utah.gov
authors.forename: Jenny
authors.initials: J
authors.lastname: Johnson
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Giles
authors.forename: Ladene
authors.initials: L
authors.lastname: Larsen
authors.forename: Joan
authors.initials: J
authors.lastname: Ware
authors.forename: Ted
authors.initials: T
authors.lastname: Adams
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hunt
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D005190:Family; D023281:Genomics; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D008487:Medical History Taking; D011634:Public Health; D018570:Risk Assessment; D014589:Utah