Third-Degree Family Health History and Perception of Disease Risk

Third-Degree Family Health History and Perception of Disease Risk by Liana F. Romero Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University May 2015 Abstract Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant’s perception of disease risk. Twohundred seventy-three participants were recruited from health care facilities and from the general population using convenience sampling. Bivariate and multivariate tests were applied to analyze the obtained data. Binary regression indicated a statistically significant association between the presence of heart disease, stroke, breast cancer, ovarian/cervical cancer, prostate cancer, colon cancer, and diabetes, and the perception of risk for the particular disease as noted in the FHH. A familial history of stroke appeared to be the strongest predictor of perception of disease risk. Moreover, increasing age, particularly within the age range of 40 to 57, was associated with increasing levels of perception ofChronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant’s perception of disease risk. Twohundred seventy-three participants were recruited from health care facilities and from the general population using convenience sampling. Bivariate and multivariate tests were applied to analyze the obtained data. Binary regression indicated a statistically significant association between the presence of heart disease, stroke, breast cancer, ovarian/cervical cancer, prostate cancer, colon cancer, and diabetes, and the perception of risk for the particular disease as noted in the FHH. A familial history of stroke appeared to be the strongest predictor of perception of disease risk. Moreover, increasing age, particularly within the age range of 40 to 57, was associated with increasing levels of perception of disease risk for heart disease, stroke, and prostate cancer. Individuals from the general population significantly indicated higher-than-average risk for colon cancer compared to those from health care facilities. Social change implication of this study may be the widespread implementation of a familial health history questionnaire that leads to an impactful, higher degree of disease risk awareness, prompting preventive action on the part of the individual, and leading to improved individual and population health. Third-Degree Family Health History and Perception of Disease Risk by Liana F. Romero Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Epidemiology Walden University May 2015 Dedication During the 5 years of my doctoral journey, so many people have touched my life and given me the motivation to move forward. Thank you to my parents and step-parents, my Miami family, friends Melanie Erickson and Judy Stellini as well as other family, friends, and co-workers for all their support and encouragement. Much gratitude to my cousin Liza Roig for all of her help, and a special thank you to Mike Farrell for his humorous enthusiasm during the final stages. To my husband, Oscar, and our children Kevin, Michael, Angela, and Monica, thank you for your infinite patience, but more important for always believing in me and inspiring me to find the resilience to follow my destiny and make my dreams come true. Acknowledgments I would like to acknowledge Dr. Vasileios Margaritis, my committee chair, who has been invaluable in his guidance and supportive beyond words; I could not have asked for a better chair. I would also like to thank my committee members, Dr. Aaron Mendelsohn and Dr. Talmage Holmes for their guidance, and Dr. Tammy Root and Dr. Nancy Rae for their support and assistance. I am eternally grateful to Angela Carroll, N. P. and Judy Stellini, N. P. for their unwavering cooperation.