Familial risk for common diseases in primary care: the Family Healthware Impact Trial.
BACKGROUND
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.


METHODS
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.


METHODS
Patients aged 35-65 years with no known diagnosis of these six diseases were enrolled from 41 primary care practices.


METHODS
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<or=0.02) more likely to have a strong family history for CHD, stroke, and diabetes. Older participants were significantly (p<or=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.


BACKGROUND
NCT00164658.
O'Neill
Suzanne M
SM
Center for Medical Genetics, NorthShore University HealthSystem (formerly Evanston Northwestern Healthcare), Evanston, Illinois, USA. s-oneill@northwestern.edu
Rubinstein
Wendy S
WS
Wang
Catharine
C
Yoon
Paula W
PW
Acheson
Louise S
LS
Rothrock
Nan
N
Starzyk
Erin J
EJ
Beaumont
Jennifer L
JL
Galliher
James M
JM
Ruffin
Mack T
MT
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000235:genetics*; D003327:Coronary Disease / Q000235:genetics*; D048909:Diabetes Complications / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics*; D015995:Prevalence; D011320:Primary Health Care; D012306:Risk; D020521:Stroke / Q000235:genetics*