Abstract PO-239: Improving family cancer history collection among African American families: A mixed-methods assessment of qualities of a family health history collection tool
Authors: Allen Caitlin G. , Escoffery Cam , An Weihua , Brody Gene , Hood Clarissa , McBride Colleen M. 
Published: December 2020

Abstract
Importance: Family cancer history (FCH) is a critical cancer risk factor. Gathering this information using a FCH collection tool is considered the front-line method for assessing cancer risk. High-quality FCH collection tools are essential to recording health information and allowing providers to tailor prevention and early detection. Unfortunately, most FCH tools do not consider end-users’ perspectives resulting in fewer than 3% of the population having ever used a tool to record health information. African American (AA) families are among the least likely to use a FCH tool to complete health history. Objective: To evaluate AA perceptions of FCH tools using the diffusion of innovations (DOI) constructs and assess whether these tool characteristics influence subjective (belief about how well they completed the tool) or objective (percent of tool complete) FCH completeness. Methods: 52 AA individuals used a publically available FCH collection tool (ItRunsInMyFamily) to complete their family history of cancer. Individuals answered survey questions (10 point scale) and were interviewed about their experience using the tool based on the DOI innovation constructs. Basic descriptive and bivariate analyses were conducted for the quantitative results using SAS 9.4 and qualitative results were analyzed using MaxQDA. Results: We found overall positive experiences for individuals who used the FCH tools (means: complexity=8.8, compatibility=8.8, observability=7.9, trialability=8.9, and relative advantages=8.0). Lower levels of perceived complexity of the tool was associated with higher levels of subjective FCH completeness (B=0.06, p=0.004). There were no associations between DOI tool characteristics and objective FCH completeness. Qualitative findings suggested that interviewees felt the tool was easy to understand and use; however, the tool did not account for unique family dynamics (e.g., step siblings) or extended kin beyond three generations. Many reported using the networking feature of the tool to invite their family members to complete relevant information, but few reported that their family members ever engaged with the tool. Conclusion and Relevance: AA individuals who were part of this study had positive perceptions about FCH tool characteristics. Of the DOI constructs assessed, only complexity was associated with how well individuals perceived they completed their FCH (not how well they actually completed their FCH). Reducing tool complexity could help improve overall impressions of the tool and self-efficacy about ability to complete FCH. Improving the networking capabilities of the tool and providing education to family members who are invited to contribute health information may improve engagement of family members in completing relevant aspects of the FCH tools and improve completeness of FCH.
Better tailoring of tools for AA families could reduce known disparities in FCH tool use and enhance opportunities for risk-stratified screening and early cancer detection among AAs.
Citation Format: Caitlin G. Allen, Cam Escoffery, Weihua An, Gene Brody, Clarissa Hood, Colleen M. McBride. Improving family cancer history collection among African American families: A mixed-methods assessment of qualities of a family health history collection tool [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-239.