title: Using a family systems approach to investigate cancer risk communication within melanoma families.
abstract: OBJECTIVE
  The family provides an important communication nexus for information and support exchange about family cancer history, and adoption of family-wide cancer risk reduction strategies. The goals of this study were to (1) use the family systems theory to identify characteristics of this sample of families at increased risk of developing melanoma and (2) to relate familial characteristics to the frequency and style of familial risk communication.
  
  
  METHODS
  Participants were first-degree relatives (n=313) of melanoma patients, recruited into a family web-based intervention study. We used multivariable logistic regression models to analyze the association between family functioning and family communication.
  
  
  RESULTS
  Most participants were female (60%), with an average age of 51 years. Fifty percent of participants reported that they spoke to their relatives about melanoma risk and people were more likely to speak to their female family members. Familial adaptation, cohesion, coping, and health beliefs were strongly associated with an open style of risk communication within families. None were associated with a blocked style of risk communication. Only cohesion and adaptation were associated with the amount of risk communication that occurred within families.
  
  
  CONCLUSIONS
  Overall, individuals who came from families that were more highly cohesive, adaptable, and shared strong beliefs about melanoma risk were more likely to communicate openly about melanoma. The fact that this association was not consistent across blocked communication and communication frequency highlights the multifaceted nature of this process. Future research should focus on the interplay between different facets of communication.
authors.affiliation: Robert Wood Johnson Health and Society Scholars Program, University of California at San Francisco, San Francisco, CA 94118, USA. HarrisJN@chc.ucsf.edu
authors.forename: Julie N
authors.initials: JN
authors.lastname: Harris
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hay
authors.forename: Alan
authors.initials: A
authors.lastname: Kuniyuki
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Asgari
authors.forename: Nancy
authors.initials: N
authors.lastname: Press
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005190:Family / Q000523:psychology*; D005191:Family Characteristics; D005195:Family Relations; D005260:Female; D020022:Genetic Predisposition to Disease; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000517:prevention & control / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D012878:Skin Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000523:psychology; D012959:Socioeconomic Factors