Cynthia Penaflor and Dr. Michael Barnes, Health Science

Family health history (FHH) is recognized as an important risk factor for chronic disease. Researchers have demonstrated that individuals who have family members with a particular chronic disease are at greater risk of developing the disease themselves compared to the general population. The extent to which people view FHH as a risk factor has implications for whether or not FHH data is collected by individuals and utilized for disease prevention. While research has recently been conducted among Caucasian audiences throughout Utah, little is known about the impact of FHH on immigrants or others who lack community connections to traditional health resources. This study was the first attempt among Hispanic immigrants that aimed to assess (1) how FHH is viewed as a risk factor for chronic disease and (2) to determine the impact of a FHH learning module on the importance of FHH in changing attitudes and behaviors among participants.

Participants in the study were students in English as Second language (ESL) classes taught by Teresa Tavares, Executive Director of Centro Hispano, in Provo, Utah. The Alpine School District ESL Program served as our comparison group. Classes in the intervention and comparison group were made up of approximately 40 intermediate/advanced. We taught the FHH teaching modules developed by the Genetic Science Learning Center at the University of Utah as the intervention. This module was originally designed for high school students. Our intervention involved the teaching of the following modules:

• Family Traits Trivia – An activity that encourages participants to observe the shared traits of family members, as well as the combination of traits that makes them unique.
• Generations of Traits — A hands-on activity where participants track and record the passage of colored “pom-pom traits” through three generations of gingerbread people. In doing so, participants learn that siblings may or may not inherit the same combination of traits.
• 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.

We developed, adapted, and administered a 32-item paper and pencil questionnaire to assess individual perception regarding the contribution of family history to the development of common chronic diseases. To determine the impact of the FHH intervention, the posttest was provided to both groups following the last lifestyle module. Expert panelists have confirmed the validity of the tool and have assisted in item revisions to aid in clarity and simplicity. Subjects were self-selected and consent for participation was obtained through a cover letter attached to the survey instrument. We coded our data collected from the pre-test and post-test surveys to an electronic spreadsheet program. After data entry was completed, descriptive statistics were calculated. Parametric statistics was also calculated to determine significant differences between study variables. To do this we used statistical analysis of covariance (ANCOVA). This analysis helped us compare the experimental and control groups by accounting for variation on important variables (7). Statistical assistance was provided by the BYU Center for Statistical Consultation.

Our hypothesis was that the FHH intervention would make a change in our participants’ attitudes and behaviors. Change in their perception in our qualitative data was satisfactory but our quantitative data was not statistically significant because of small sampling. This pilot study demonstrated that although the educational modules were effective and were adapted to the literacy level of the Hispanic ESL students, the number of educational modules used should be reduced to the two most interactive ones such as the Family Traits Trivia and Risk Continuum modules. These modules presented FHH concepts that were novel, attractive, and easily remembered by the Hispanic study participants, with the strongest potential for promoting long-lasting health behavior change. A second phase of the study is needed and should be carried out on a bigger scale involving a larger number of students and intervention should be reduced to the two most interactive ones such as the Family Traits Trivia and Risk Continuum modules.

Results from this study could impact the type of health messages and educational methods directed among Hispanics in Utah. In addition, the findings could serve as a basis for improving not only the communication between Hispanic patients and health care professionals but also the delivery of health services. By completing and providing health care providers with relevant and sufficient family health information, early screening, diagnoses, and treatment could be provided before adverse changes brought about by disease become irreversible. Other family members who share the same risks for chronic disease, such as spouses and children, could be encouraged to adopt healthy habits and lifestyle.