title: Improving learning about familial risks using a multicomponent approach: the GRACE program.
abstract: To enhance learning (knowledge, attitudes and practices) about the importance of family health history (FHH) information and familial risks.
  
  
  
  A pre-post design with one group was employed in this study. Five learning sessions were conducted with a community-based sample (n = 75) recruited from five counties in Texas, USA. Each learning session included: a short online video; enactive instructions on how to use the online Surgeon General FHH tool; and a presentation on how to assess familial risks. Participants completed the pre-post knowledge, attitudes and practices questionnaires and the study's satisfaction survey, and participated in a short focus group interview.
  
  
  
  Participants' average age was 48.1 ± 13.3 years. Over half of the participants (79%) were female, and 55% described themselves as non-Hispanic White. Our findings showed significant changes (p < 0.05) in participants' specific knowledge about factors that affect their familial risks. Similarly, significant changes (p < 0.05) in participants' attitudes toward familial risks assessment for common disease complications and confidence in controlling these risks have been documented. Participants' reported a high level of satisfaction in using online FHH tools, yet no significant change (p > 0.05) was detected in their reported practices regarding sharing FHH information with their providers or relatives. Focus group interviews revealed that participants were uncertain about providers' or relatives' reactions to sharing FHH information.
  
  
  
  Using different learning styles may have a significant impact on improving knowledge and attitudes about familial risks.
authors.affiliation: Department of Medicine, University of Texas Health Science Center at San Antonio, South Texas Veterans Health Care System, San Antonio, TX, CP-210-827 5597, USA ; South Texas Veterans Health Care System/Audie L Murphy Memorial Veterans Hospital, San Antonio, TX, USA.
authors.forename: Nedal
authors.initials: N
authors.lastname: Arar
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Delgado
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Abboud
keywords: familial risks assessment; family health history tool; genomics; learning; online Surgeon General