Acting Surgeon General Encourages Americans to Know Health History

Acting Surgeon General Steven K. Galson, M.D., M.P.H., encourages everyone to identify and make a record of health problems that seem to run in the family. The Office of the Surgeon General has an updated Web tool to help create that health history.

"Talking about and sharing your own family health history is something you can do right now in order to gain an understanding of your health and the health of family members," says Galson. "It's a starting point for taking fuller charge of your own health future.

"Tracing the illnesses your grandparents, parents, and additional blood relatives have suffered from can help your health care provider predict diseases and disorders from which you could be at risk," Galson said.

Families can use the Web-based tool "My Family Health Portrait." This tool provides consumers with a free and easily-to-use way to assemble their family health information. Launched in 2004 in partnership with several other agencies of the U.S. Department of Health and Human Services, the Surgeon General's Family History Initiative encourages all American families to learn more about their family health history.

Thanksgiving Day is Family Health History Day

“Knowing your family health history is an important way to understand your risk factors and the preventive steps you can take to keep you and your family healthy,” stated DPH Commissioner J. Robert Galvin, M.D., M.P.H., M.B.A.

The goal of the Family Health Initiative is to provide an accessible method for easily obtaining an accurate family health history and, importantly, to use that information in health promotion and disease prevention. Such information is important because, although it is estimated that in a few years sophisticated genetic testing and other related advances will dramatically change how health care is practiced, genetic information can already be used today to improve health.

HHS Launches New Family Health History Initiative

U.S. Surgeon General Richard H. Carmona declared Thanksgiving Day, when American families traditionally gather to celebrate and give thanks, to be the first annual National Family History Day. Americans are encouraged to use their family gatherings as a time to collect important family health history information that can benefit all family members.

To help gather family history information, HHS released a new, free computer program that organizes important health information into a printout that can be taken to a health care professional to help determine whether a patient is at higher risk for disease. The printout can also be placed in a patient's medical record. The new computerized tool, called "My Family Health Portrait,"

The Agency for Healthcare Research and Quality (AHRQ) operates a national database of medical practice guidelines, developed by independent medical and professional organizations, that can help individuals and their health care professionals to customize prevention programs. Family health history is one of the criteria for many of the practice guidelines, which frequently recommend specific medical testing to detect an illness early. The guidelines can be found at the National Guideline Clearinghouse. AHRQ is part of the U.S. Department of Health and Human Services.

The "My Family Health Portrait" software can be downloaded from the Internet and installed on computers using the Windows operating system with the .NET framework installed.
All personal information entered into the program is maintained on the user's computer only; no information is available to the federal government or any other agency. The software will be available in both English and Spanish.

In addition to the software tool, a print version of "My Family Health Portrait" will be available in English and Spanish ( this is so exciting, we will also have this in Spanish!!) through the Federal Citizen Information Center and at consolidated health centers nationwide. Consolidated health centers provide care to patients regardless of their ability to pay. HHS' Health Resources and Services Administration funds the national network of more than 3,600 community health centers, migrant health centers, health care for the homeless centers, and public housing primary care centers.

Self Reported Impact of FHH Modules:

“We need more education about good habits and life style--try, try, try, no quit!”

“I went to the doctor and he said I am fat. Now I exercise and eat more vegetables.”

“People is motivated by activities and we can learn much better.”

In this pilot study we learned the following:

1. FHH is viewed as a risk factor for chronic disease among Utah Hispanics.
2. FHH creates communication that builds family support for maintaining positive lifestyle changes.
   
3. Changes survey format to meet cultural needs were needed.
   
4. Misconceptions exist about heredity among Hispanics. We had to reinforce that disease, allergies, and conditions have a genetic component.
5. Genetic variance exists among family members:

· Perception of risk vary

· Variety of incentives needed!

The impact of our pilot study was determined through a pretest and a posttest survey administered to both groups. The survey was a 32-item paper and pencil questionnaire that assessed beliefs regarding the contribution of family history to the development of common chronic diseases in our participants were included. Our results are summarized in the table below.

Percent Change in FHH Attitudes, Knowledge and Behavior

ATTITUDE/BEHAVIOR	Percent Change
Felt motivated to make changes after participating	64%
Felt motivated to learn more	68%
Reported having talked to a family member about their FHH	64%
Reported changing their diet	55%
Reported visiting a medical professional	23%

Hispanic ESL class participants were self-selected and each class assigned as comparison (n=50) and experimental groups (n=50). Only the experimental group received instruction on the following FHH modules:

• Family Traits Trivia -This FHH teaching module encourages participants to observe the shared traits of family members, as well as the combination of traits that makes them unique.

• Pick the Risk: The Polygenic Pedigree Challenge -- Participants are challenged to track and record the passage of colored candies (representing genes) through generations of a family using a pedigree.

• Risk Continuum - A whole-class kinesthetic demonstration of what it means to be in a "risk group" for developing heart disease based on family history/genetics.

The Genetic Science Learning Center at the University of Utah has developed many FHH teaching modules originally designed for high school students. Elsie Lopez and I have adapted these module for the adult Hispanic population in Utah. We carried out an FHH pilot study intervention in the community last year. The purpose of this study was to determine the extent to which FHH education had an impact on attitudes and health care seeking behaviors regarding chronic disease risk and FHH collection among participants.