Protocol for a randomized controlled trial testing the impact of feedback on familial risk of chronic diseases on family-level intentions to participate in preventive lifestyle behaviors.
Common disease risk clusters in families due to shared genetics, exposure to environmental risk factors, and because many health behaviours are established and maintained in family environments. This randomised controlled trial will test whether the provision of a family health history (FHH) risk assessment tool increases intentions and engagement in health behaviors. Message distribution and collective behavior change within family networks will be mapped using social network analysis. The relative intervention impact will be compared between families from different ethnic backgrounds.



One hundred and fifty mothers (50 Anglo-Australian, 50 Italian-Australian, 50 Vietnamese-Australian) will be recruited, with four or more other family members across three generations, including a child (aged 10-18 years). Each family is randomly assigned to intervention or control. At baseline and 6-month follow-up, all participants complete surveys to assess dietary and physical activity intentions and behaviors, attitudes towards food, and perceived disease risk. Intervention families receive a visual pedigree detailing their FHH of diabetes, heart disease, breast and bowel cancer, a health education workbook to ascertain members' disease risk (i.e. average or above average risk), and screening and primary prevention recommendations. After completion of follow-up assessments, controls will receive their pedigree and workbook. The primary hypothesis is that attitudes and lifestyle behaviors will improve more within families exposed to FHH feedback, although the extent of this improvement may vary between families from different ethnic backgrounds. Additionally, the extent of improvement in the treatment group will be moderated by the level of family disease risk, with above-average risk leading to greater improvement. A secondary aim will explore different family members' roles in message distribution and collective responses to risk using social network approaches and to compare network functioning between families with different ethnic backgrounds.



Results will guide future health promotion programs aimed at improving lifestyle factors. This research will assess whether FHH can motivate families to adopt family-level strategies to support health promoting behaviors. Secondary analyses aim to identify change agents within the family who are particularly effective in shifting normative behaviors.



Australian New Zealand Clinical Trials Registry ACTRN12613001033730 . Retrospectively registered: 17 September, 2013.
Flinders Centre for Innovation in Cancer, Flinders University of South Australia & Cancer Council South Australia, Adelaide, Australia.
Carlene J
CJ
Wilson
Institute for Health Promotion & Disease Prevention Research, University of Southern California, Los Angeles, USA.
Kayla
K
de la Haye
School of Health Sciences, Flinders University of South Australia, Adelaide, Australia.
John
J
Coveney
Flinders Centre for Innovation in Cancer, Flinders University of South Australia & Cancer Council South Australia, Adelaide, Australia.
Donna L
DL
Hughes
School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia.
Amanda
A
Hutchinson
South Australian Health and Medical Research Institute, Adelaide, Australia.
Caroline
C
Miller
School of Health Sciences, Flinders University of South Australia, Adelaide, Australia.
Ivanka
I
Prichard
School of Health Sciences, Flinders University of South Australia, Adelaide, Australia.
Paul
P
Ward
Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, USA. koehlyl@mail.nih.gov.
Laura M
LM
Koehly
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D002648:Child; D002908:Chronic Disease / Q000517:prevention & control* / Q000523:psychology; D002985:Clinical Protocols; D004032:Diet / Q000523:psychology; D015444:Exercise; D005190:Family / Q000523:psychology*; D005260:Female; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D000070497:Healthy Lifestyle; D006801:Humans; D033182:Intention; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D009042:Motivation; D010375:Pedigree; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
Culture; Eating behavior; Family health history; Health behavior; Intergeneration transmission; Randomised clinical trials