DNP 810 Topic 3 Discussion Question One
DNP 810 Topic 3 Discussion Question One
A multi-generational family health history can facilitate your management of a patient’s disease. What model would you use to create a multi-generational family health history for a patient? Explain. Support your rationale with a minimum of two scholarly sources.
Family health history (FHH) represents the combined effects of genetic, environmental, and social factors that contribute to disease risk.1 Consequently, FHH is a strong predictor of disease, and is an important clinical tool for identifying those at increased risk of common, complex conditions.2,3 Knowledge of FHH has important implications for health care delivery, including screening and
lifestyle recommendations targeted to early detection and disease prevention.4,5 Indeed, research suggests that, for heart disease and diabetes, an individual with just one affected FDR or two affected SDRs is considered to be at increased risk for developing these diseases.3,6–9
Consequently, FHH knowledge is highly relevant to the assessment of diabetes and heart disease risk. Identifying those at increased risk for these chronic conditions enables health professionals to recommend appropriate preventive actions, which if applied by the patient, have the potential to prevent disease onset.10 But, in order for this personalization in health care to be effective, patients must have accurate FHH information; thus, not knowing one’s FHH can have serious consequences for understanding and assessing chronic disease risk and identification of appropriate preventive strategies. Unfortunately, FHH knowledge is limited in the United States, as active collection of FHH information from family members is generally infrequent and incomplete.
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The need for effective programs aimed at improving FHH knowledge is particularly relevant for immigrant and minority families, who more often experience language and communication barriers between family members as well as with health care providers; less access to or engagement in the medical system; and lack of medical and health knowledge regarding the role of family health history as a risk factor for many diseases.13–19 Mexican Americans, for instance, comprising almost 10% of the U.S. population, are almost twice as likely as non-Hispanic whites to develop diabetes. Further, diabetes is a known risk factor for heart disease, which is one of the leading causes of death in the United States.20–22 Thus, it is critical to identify effective approaches for improving FHH knowledge in this at-risk group.
In addition to engaging this often understudied population, the current report also improves upon the limited literature investigating factors associated with individual’s knowledge of their FHH. In contrast to the traditional clinical visit recruitment, a community-based recruitment approach was used, which allowed access to a more diverse set of participants who may not have been actively engaged in the health care system.23 Moreover, a more sensitive measure of FHH knowledge was used based on the gold standard – a detailed three-generation FHH assessment.24 This is distinct from the global assessments of perceived familiarity with FHH used in previous research.25
Despite the documented widespread lack of FHH knowledge and the importance of FHH information for assessing disease risk and tailoring of preventive strategies, very little research has examined ways to improve FHH knowledge, particularly among underserved minority populations at increased risk. Therefore, the current study aimed to assess FHH-based knowledge and evaluate improvement in knowledge following an intervention among a largely immigrant minority sample of Mexican origin families. Specifically, the study aimed to assess: 1) the demographic and health care-related characteristics associated with limited FHH knowledge for diabetes and heart disease at baseline assessment, 2) the demographic and health care-related characteristics associated with change in FHH knowledge at follow-up assessment, and 3) whether a family-based intervention providing FHH-based risk feedback can improve FHH knowledge.
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