Familial Cancer

, Volume 13, Issue 2, pp 325–332 | Cite as

Providing patient education: impact on quantity and quality of family health history collection

  • Chris A. BeadlesEmail author
  • R. Ryanne Wu
  • Tiffany Himmel
  • Adam H. Buchanan
  • Karen P. Powell
  • Elizabeth Hauser
  • Vincent C. Henrich
  • Geoffrey S. Ginsburg
  • Lori A. Orlando
Original Article


Background: Family health history (FHH) is an underutilized tool in primary care to identify and risk-stratify individuals with increased cancer risk. Objective: Evaluate the influence of patient education on quantity and quality of FHH entered into a primary care-based software program, and impact on the program’s cancer risk management recommendations. Design: Two primary care practices within a larger type II hybrid implementation-effectiveness controlled clinical trial. Participants: English speaking non-adopted patients with a well visit appointment December 2012–March 2013. Interventions: One to two weeks prior to their well visit appointment, participants entered their FHH into the program. Participants were then provided educational materials describing key FHH components. They were instructed to use the interval to collect additional FHH information. Patients then returned for their scheduled appointment, and updated their FHH with any new information. Main Measures: Percentage per pedigree of relatives meeting individual quality criteria. Changes made after patient education and changes to recommendations for surveillance, chemoprevention or genetic counseling referral. Key Results: Post patient education, pedigrees exhibited a greater percentage (per pedigree) of: deceased relatives with age at death (84 vs. 81 % p = 0.02), deceased relatives with cause of death (91 vs. 87 % p = 0.02), relatives with a named health condition (45 vs. 42 % p = 0.002), and a greater percentage of relatives with high quality records (91 vs. 89 % p = 0.02). Of 43 participants with pedigree changes that could trigger changes in risk stratified prevention recommendations, 12 participants (28 %) received such changes. Conclusions: Patient education improves FHH collection and subsequent risk stratification utilized in providing actionable evidence-based care recommendations for cancer risk management.


Family history Patient education Risk assessment Clinical decision support 



The authors received funds from Department of Defense.

Conflict of interest


Supplementary material

10689_2014_9701_MOESM1_ESM.pdf (196 kb)
Why family health history and risk assessment is important for your care (PDF 195 kb)
10689_2014_9701_MOESM2_ESM.pdf (4.9 mb)
How to talk to your relatives about family health history and what information to collect (PDF 5006 kb)
10689_2014_9701_MOESM3_ESM.pdf (95 kb)
A worksheet for collecting your family health history (PDF 95 kb)


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Copyright information

© Springer Science+Business Media Dordrecht (outside the USA) 2014

Authors and Affiliations

  • Chris A. Beadles
    • 1
    • 2
    Email author
  • R. Ryanne Wu
    • 1
    • 2
    • 3
  • Tiffany Himmel
    • 2
  • Adam H. Buchanan
    • 4
  • Karen P. Powell
    • 5
  • Elizabeth Hauser
    • 6
    • 7
  • Vincent C. Henrich
    • 5
  • Geoffrey S. Ginsburg
    • 2
  • Lori A. Orlando
    • 2
    • 3
  1. 1.Health Services Research and Development, Durham VA Medical CenterDepartment of Veteran Affairs Medical CenterDurhamUSA
  2. 2.Duke Center for Personalized and Precision Medicine, and Institute of Genome Science and PolicyDuke University Health SystemDurhamUSA
  3. 3.Duke Department of Internal MedicineDuke University Health SystemDurhamUSA
  4. 4.Duke Cancer InstituteDuke University Health SystemDurhamUSA
  5. 5.Center for Biotechnology, Genomics and Health ResearchUNCGGreensboroUSA
  6. 6.CSP Epidemiology CenterDepartment of Veteran Affairs Medical CenterDurhamUSA
  7. 7.Center for Human GeneticsDuke UniversityDurhamUSA

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