Multiple-informant family health history and behavioral assessment: consistent perceptions across family members?

Authors

• J Lin
• CS Marcum
• M Myers
• LM Koehly

Abstract

Family health histories (FHH) are widely used in research and clinical practice to assess complex disease risk. Despite being a family-centric phenomenon, FHH may be perceived by family members in distinct ways, which in turn results in different risk assessment for each individual even when the underlying patterns of disease and (un)healthful behaviors are the same. We take a multiple-informant approach and examine inter-rater consistency in FHH report across family members in a sample of 45 families in the greater Cincinnati area. Informants reported on not only their own information, but also on information about their family members, with regards to age, diagnoses of heart disease, diabetes, high blood pressure and high cholesterol and health behaviors, including smoking status, excessive alcohol use, diet, weight status and exercise. We found that family members provided fairly consistent report of heart disease (64% consistent) and diabetes (61% consistent) diagnoses. When considering non-traditional FHH assessments of biomarkers and lifestyle factors, family members were consistent in reports of smoking (56% consistent) and excessive alcohol use (64% consistent). However, a lower degree of consistency was observed for hypertension and high cholesterol (44% and 46% consistent, respectively), as well as for diet, physical activity, and weight status (42%-46% consistent). Our findings provide insights on the uneven distribution of FHH knowledge within families, highlighting that FHH should be considered as a cognitive process rather than a set of facts. In practice, it may be beneficial to link FHH records across family members to improve risk assessment.

Scientific Focus Area: Social and Behavioral Sciences

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