The distribution of family history risk for disease in primary care practices Free

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Background: Family Healthware™ created by the Centers for Disease Control and Prevention, is a self-administered, web-based tool that assesses familial risk for 6 diseases coronary heart disease (CHD), stroke (CVA), diabetes (DM), and colorectal (CRC), breast (BC), and ovarian (OC) cancers and provides a "prevention plan" with personalized recommendations for lifestyle changes and screening. The tool systematically collects and records family history information for the aforementioned diseases as well as an individual's behavioral risk factors, nutrition, physical activity and current screening practices. The objective of this data presentation is to describe the distribution of family history risk classification for each disease in primary care
 >practices.
 >Methods: The Family Healthware Impact Trial (FHITr), a cluster-randomized clinical trial in primary care practices evaluates the clinical utility of the tool in 3785 healthy participants. FHITr randomized all practices to intervention or control arms. After randomization, all participants completed a baseline survey, and intervention arm participants completed Family Healthware™. All participants completed a 6-month follow-up survey to evaluate change, and control arm participants subsequently complete the tool. This presentation is of only the baseline data of family history.
 >Results: Of the 3785 participants enrolled, 2363 were allocated to the intervention arm, and their data is presented here. Participants had a mean age=50.6 years (range 35-65) and were primarily Caucasian (90%) and female (71%) with a mean BMI of 27 (SD=6). Overall, 82% have a strong (S) or moderate (M) family-history based risk for at least one of these diseases: CHD (S=33%, M=26%), CVA (S=14%, M=34%), DM (S=11%, M=28%), CRC (S=2%, M=11%), BC (S=10%, M=14%), OC (S=4%, M=6%). Screening compliance according to standard population recommendations varied across tests: cholesterol (95%), blood pressure (92%), colorectal cancer screening (78%), mammograms (73%).
 >Conclusions: Our findings suggest a substantial burden of family-history based risk in the adult primary care population. Implementing the automated online risk assessment tool as a standard part of practice may easily and economically identify subpopulations that would benefit most from targeted prevention strategies.