title: Veterans' experience in using the online Surgeon General's family health history tool.
abstract: AIM: To assess veterans' experience and satisfaction in using the Surgeon General's (SG) online family health history (FHH) tool, and determine the perceived facilitators and barriers to using the online SG-FHH tool.  MATERIALS #ENTITYSTARTX00026; METHODS: A mixed-method using both qualitative and quantitative approaches was employed in this study. A total of 35 veterans at the VA Medical Center in San Antonio, Texas, USA were invited to enter their FHH information using the online SG-FHH tool, complete the study's satisfaction survey and participate in a short semi-structured interview. The goal of the semi-structured interviews was to assess participants perceived facilitators and barriers to using the online SG-FHH tool. All participants were also provided with a printed copy of their pedigree, which was generated by the SG-FHH tool and were encouraged to share it with their relatives and providers.  RESULTS: The majority of participants (91%) said that they had access to a computer with internet capability and 77% reported that they knew how to use a computer. More than two-thirds of the participants felt that items on the SG-FHH tool were easy to read and felt that FHH categories were relevant to their family's health. Approximately 94% of participants viewed the SG-FHH tool as useful, and the majority of participants (97%) indicated that they were likely to recommend the tool to others. Content analysis of the semi-structured interviews highlighted several barriers to veterans' use of the SG-FHH tool and their FHH information. These included: lack of patients' knowledge regarding their relatives' FHH, and privacy and confidentiality concerns.  CONCLUSION: This study provides information on the performance and functionality of an inexpensive and widely accessible method for FHH collection. Furthermore, our findings highlight several opportunities and challenges facing the utilization of FHH information as a clinical and genomic tool at the Veterans Health Administration (VHA). The results suggest that strategies that improve veterans' knowledge regarding the importance of their FHH information and that address their concerns about privacy and confidentiality may enhance the successful implementation of FHH information into VHA clinical practice.  IMPLICATIONS: identifying a locally accepted method for FHH collection and documentation which can be conducted outside of the patient visit will reduce time burdens for providers and patients and allow for a focus on other important topics during clinic visits. Improvement in familial risk screening and assessment will enable the VHA to be prepared for personalized medicine and focus their resources on promoting critically important health behaviors for populations with the highest risk of developing chronic diseases and their complications.
authors.affiliation: Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX78229, USA.
authors.forename: Nedal
authors.initials: N
authors.lastname: Arar
authors.forename: Joann
authors.initials: J
authors.lastname: Seo
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Abboud
authors.forename: Michael
authors.initials: M
authors.lastname: Parchman
authors.forename: Polly
authors.initials: P
authors.lastname: Noel
references.citation: MMWR Morb Mortal Wkly Rep. 2004 Nov 12;53(44):1044-7
references.pmid: 15538320
references.citation: Genet Med. 2005 May-Jun;7(5):311-6
references.pmid: 15915082
references.citation: Genet Med. 2006 Dec;8(12):752-9
references.pmid: 17172938
references.citation: J Genet Couns. 2010 Feb;19(1):84-96
references.pmid: 19856089
references.citation: Ann Fam Med. 2005 Sep-Oct;3(5):405-14
references.pmid: 16189056
references.citation: Genet Med. 2000 Jul-Aug;2(4):214-21
references.pmid: 11252705
references.citation: Ann Epidemiol. 2005 Oct;15(9):712-9
references.pmid: 16157258
references.citation: Community Genet. 2007;10(1):10-8
references.pmid: 17167245
references.citation: Comput Inform Nurs. 2008 Sep-Oct;26(5):258-64
references.pmid: 18769180
references.citation: Am J Pharmacogenomics. 2003;3(6):405-18
references.pmid: 14672522
references.citation: Annu Rev Public Health. 2010;31:69-87 1 p following 87
references.pmid: 20070206
references.citation: Am J Med Genet. 1997 Aug 22;71(3):315-24
references.pmid: 9268102
references.citation: Genet Med. 2008 Dec;10(12):895-902
references.pmid: 19092442
references.citation: J Am Med Inform Assoc. 2007 Nov-Dec;14(6):798-806
references.pmid: 17712090
references.citation: Am J Prev Med. 2003 Feb;24(2):128-35
references.pmid: 12568818
references.citation: N Engl J Med. 2004 Nov 25;351(22):2333-6
references.pmid: 15564550
references.citation: Public Health Genomics. 2010;13(2):63-71
references.pmid: 19439917
references.citation: Per Med. 2010 Sep;7(5):485-494
references.pmid: 29776243
references.citation: JAMA. 2008 Mar 19;299(11):1320-34
references.pmid: 18349093
references.citation: Genet Med. 2010 Apr;12(4):212-8
references.pmid: 20216073
references.citation: Curr Protoc Hum Genet. 2010 Jul;Chapter 9:Unit 9.21
references.pmid: 20582917
references.citation: Telemed J E Health. 2010 Jun;16(5):595-602
references.pmid: 20575727
references.citation: J Fam Pract. 2002 Oct;51(10):856
references.pmid: 12836643
references.citation: J Gen Intern Med. 2004 Mar;19(3):273-80
references.pmid: 15009784
references.citation: Community Genet. 2004;7(1):33-43
references.pmid: 15475669
references.citation: J Am Med Inform Assoc. 2008 Nov-Dec;15(6):723-8
references.pmid: 18755994
references.citation: Genet Med. 2010 Jun;12(6):370-5
references.pmid: 20479646
references.citation: Prev Chronic Dis. 2009 Jan;6(1):A33
references.pmid: 19080039
references.citation: Eur J Hum Genet. 2008 Aug;16(8):873-4
references.pmid: 18560443
references.citation: Public Health Genomics. 2010;13(7-8):431-9
references.pmid: 20829581