Abstract
Introduction: Public willingness to collect personal family health history (FHH) assessments is integral to implement population screening to identify those at high cancer risk who could benefit most from lifesaving interventions. Yet, surprisingly little consideration has been given to factors associated with the public’s perceived importance of FHH in the context of cancer. Methods: Using data from the 2013 Health Information National Trends survey, we assessed the association of intrapersonal (e.g., cancer worry), sociodemographic (e.g., education), and interpersonal-level factors (e.g., family trust) associated with not perceiving FHH assessment to be very important for personal health. Associations were tested with bivariate analyses and hierarchical logistic regression. Results: Of the 3,007 respondents, 32.7% reported perceiving FHH as not very important to their health. Whites (p < 0.001), males (p = 0.003), and those born in the United States (p = 0.004) were most likely to perceive FHH as not very important. Those who were least worried about cancer and perceived that cancer risk could not be lowered also viewed FHH as not very important (p = 0.002, p = 0.018, respectively). In hierarchical regression analyses, the association of low cancer worry remained significant after accounting for sociodemographic and interpersonal factors. The addition of sociodemographic factors modestly improved the model; the addition of interpersonal factors did not improve the model. Conclusions: A sizable proportion of the public does not perceive FHH to be very important, may be hard to reach, and impede implementation of population screening guidelines for inherited cancers. Campaigns to increase the perceived value of FHH assessment may need to be tailored to demographic subgroups, emphasize cancer prevention, and encourage family communication.
References
1.
The EGAPP initiative
: lessons learned. Genetics in medicine : official journal of the American College of Medical Genetics. 2014
;16(3):217-224.2.
Teutsch
SM
, Bradley
LA
, Palomaki
GE
, Haddow
JE
, Piper
M
, Calonge
N
, et al.; EGAPP Working Group
. The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Initiative: methods of the EGAPP Working Group
. Genet Med
. 2009
Jan
;11
(1
):3
–14
.
[PubMed]
1098-36003.
Rich
EC
, Burke
W
, Heaton
CJ
, Haga
S
, Pinsky
L
, Short
MP
, et al. Reconsidering the family history in primary care
. J Gen Intern Med
. 2004
Mar
;19
(3
):273
–80
.
[PubMed]
0884-87344.
United States Preventive Task Force
. Breast Cancer
. Screening
. 2016
.0925-61645.
United States Preventive Task Force. Cervical Cancer: Screening
2018
; https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening26.
United States preventive Task Force. Colorectal Cancer: Screening.
2016
; https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening2?ds=1&s=colorectal7.
Benson
AB
3rd, Venook
AP
, Al-Hawary
MM
, Cederquist
L
, Chen
YJ
, Ciombor
KK
, et al. NCCN Guidelines Insights: Colon Cancer, Version 2.2018
. J Natl Compr Canc Netw
. 2018
Apr
;16
(4
):359
–69
.
[PubMed]
1540-14058.
Daly
MB
, Pilarski
R
, Berry
M
, Buys
SS
, Farmer
M
, Friedman
S
, et al. NCCN Guidelines Insights: Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 2.2017
. J Natl Compr Canc Netw
. 2017
Jan
;15
(1
):9
–20
.
[PubMed]
1540-14059.
American College of Obstetricians and Gynecologists
ACOG Committee on Practice Bulletins—Gynecology
ACOG Committee on Genetics
Society of Gynecologic Oncologists
. ACOG Practice Bulletin No. 103: hereditary breast and ovarian cancer syndrome
. Obstet Gynecol
. 2009
Apr
;113
(4
):957
–66
.
[PubMed]
0029-784410.
Ashida
S
, Goodman
MS
, Stafford
J
, Lachance
C
, Kaphingst
KA
. Perceived familiarity with and importance of family health history among a medically underserved population
. J Community Genet
. 2012
Oct
;3
(4
):285
–95
.
[PubMed]
1868-310X11.
Valdez
R
, Yoon
PW
, Qureshi
N
, Green
RF
, Khoury
MJ
. Family history in public health practice: a genomic tool for disease prevention and health promotion
. Annu Rev Public Health
. 2010
;31
(1
):69
–87
.
[PubMed]
0163-752512.
Khoury
MJ
, Davis
R
, Gwinn
M
, Lindegren
ML
, Yoon
P
. Do we need genomic research for the prevention of common diseases with environmental causes?
Am J Epidemiol
. 2005
May
;161
(9
):799
–805
.
[PubMed]
0002-926213.
Pyeritz
RE
. The family history: the first genetic test, and still useful after all those years?
Genetics in medicine : official journal of the American College of Medical Genetics. 2012
;14(1):3-9. 14.
Yoon
PW
, Scheuner
MT
, Khoury
MJ
. Research priorities for evaluating family history in the prevention of common chronic diseases
. Am J Prev Med
. 2003
Feb
;24
(2
):128
–35
.
[PubMed]
0749-379715.
American Medical Association
. Family Medical History in Disease Prevention.
2018
.16.
Thompson
T
, Seo
J
, Griffith
J
, Baxter
M
, James
A
, Kaphingst
KA
. “You don’t have to keep everything on paper”: african American women’s use of family health history tools
. J Community Genet
. 2013
Apr
;4
(2
):251
–61
.
[PubMed]
1868-310X17.
Ashida
S
, Kaphingst
KA
, Goodman
M
, Schafer
EJ
. Family health history communication networks of older adults: importance of social relationships and disease perceptions.
Health education & behavior : the official publication of the Society for Public Health Education. 2013
;40(5):612-619. 18.
Schroy
PC
3rd, Barrison
AF
, Ling
BS
, Wilson
S
, Geller
AC
. Family history and colorectal cancer screening: a survey of physician knowledge and practice patterns
. Am J Gastroenterol
. 2002
Apr
;97
(4
):1031
–6
.
[PubMed]
0002-927019.
Acton
RT
, Burst
NM
, Casebeer
L
, Ferguson
SM
, Greene
P
, Laird
BL
, et al. Knowledge, attitudes, and behaviors of Alabama’s primary care physicians regarding cancer genetics
. Acad Med
. 2000
Aug
;75
(8
):850
–2
.
[PubMed]
1040-244620.
Grover
S
, Stoffel
EM
, Bussone
L
, Tschoegl
E
, Syngal
S
. Physician assessment of family cancer history and referral for genetic evaluation in colorectal cancer patients.
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2004
;2(9):813-819. 21.
Sweet
KM
, Bradley
TL
, Westman
JA
. Identification and referral of families at high risk for cancer susceptibility
. J Clin Oncol
. 2002
Jan
;20
(2
):528
–37
.
[PubMed]
0732-183X22.
National Instututes of Health
. National Institutes of Health State-of-the-Science Conference Statement Family History and Improving Health. National Institutes of Health;2009
.23.
Kanetzke
EE
, Lynch
J
, Prows
CA
, Siegel
RM
, Myers
MF
. Perceived utility of parent-generated family health history as a health promotion tool in pediatric practice
. Clin Pediatr (Phila)
. 2011
Aug
;50
(8
):720
–8
.
[PubMed]
0009-922824.
Williams
JL
, Collingridge
DS
, Williams
MS
. Primary care physicians’ experience with family history: an exploratory qualitative study
. Genet Med
. 2011
Jan
;13
(1
):21
–5
.
[PubMed]
1098-360025.
Guttmacher
AE
, Collins
FS
, Carmona
RH
. The family history—more important than ever
. N Engl J Med
. 2004
Nov
;351
(22
):2333
–6
.
[PubMed]
0028-479326.
Wang
C
, Bowen
DJ
, Kardia
SL
. Research and practice opportunities at the intersection of health education, health behavior, and genomics.
Health education & behavior : the official publication of the Society for Public Health Education. 2005
;32(5):686-701. 27.
Welch
BM
, Dere
W
, Schiffman
JD
. Family health history: the case for better tools
. JAMA
. 2015
May
;313
(17
):1711
–2
.
[PubMed]
0098-748428.
Welch
BM
, O’Connell
N
, Schiffman
JD
. 10 years later: assessing the impact of public health efforts on the collection of family health history
. Am J Med Genet A
. 2015
Sep
;167A
(9
):2026
–33
.
[PubMed]
1552-482529.
Office of the Surgeon General
. The Surgeon General's Family Health History Initiative.
2016
.30.
Yoon
PW
, Scheuner
MT
, Peterson-Oehlke
KL
, Gwinn
M
, Faucett
A
, Khoury
MJ
. Can family history be used as a tool for public health and preventive medicine?
Genetics in medicine : official journal of the American College of Medical Genetics. 2002
;4(4):304-310. 31.
Qureshi
N
, Kai
J
. Informing patients of familial diabetes mellitus risk: how do they respond? A cross-sectional survey
. BMC Health Serv Res
. 2008
Feb
;8
(1
):37
.
[PubMed]
1472-696332.
Claassen
L
, Henneman
L
, Janssens
AC
, Wijdenes-Pijl
M
, Qureshi
N
, Walter
FM
, et al. Using family history information to promote healthy lifestyles and prevent diseases; a discussion of the evidence
. BMC Public Health
. 2010
May
;10
(1
):248
.
[PubMed]
1471-245834.
Glanz
K
, Rimer
BK
, Viswanath
K
. Health Behavior and Health Education: Theory, Research, and Practice
. San Francisco
: Jossey-Bass
; 2008
.35.
Bandura
A
. Health promotion from the perspective of social cognitive theory
. Psychol Health
. 2007
;13
(4
):623
–49
. 0887-044636.
Institute of Medicine Committee on H
. Behavior: Research P, Policy. The National Academies Collection: Reports funded by National Institutes of Health. In: Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington (DC): National Academies Press (US) National Academy of Sciences.; 2001
.37.
Janz
NK
, Becker
MH
. The Health Belief Model: a decade later
. Health Educ Q
. 1984
;11
(1
):1
–47
.
[PubMed]
0195-840238.
Prochaska
JO
, DiClemente
CC
. Stages and processes of self-change of smoking: toward an integrative model of change
. J Consult Clin Psychol
. 1983
Jun
;51
(3
):390
–5
.
[PubMed]
0022-006X39.
Prochaska
JO
. Decision making in the transtheoretical model of behavior change
. Med Decis Making
. 2008
Nov-Dec
;28
(6
):845
–9
.
[PubMed]
0272-989X40.
Prochaska
JO
, Velicer
WF
. The transtheoretical model of health behavior change
. Am J Health Promot
. 1997
Sep-Oct
;12
(1
):38
–48
.
[PubMed]
0890-117141.
Hovick
SR
. Understanding family health information seeking: a test of the theory of motivated information management
. J Health Commun
. 2014
;19
(1
):6
–23
.
[PubMed]
1081-073042.
Hovick
SR
, Yamasaki
JS
, Burton-Chase
AM
, Peterson
SK
. Patterns of family health history communication among older African American adults
. J Health Commun
. 2015
;20
(1
):80
–7
.
[PubMed]
1081-073043.
McLeroy
KR
, Bibeau
D
, Steckler
A
, Glanz
K
. An ecological perspective on health promotion programs
. Health Educ Q
. 1988
;15
(4
):351
–77
.
[PubMed]
0195-840244.
Smedley
BD
, Syme
SL
; Committee on Capitalizing on Social Science and Behavioral Research to Improve the Public’s Health
. Promoting health: intervention strategies from social and behavioral research
. Am J Health Promot
. 2001
Jan-Feb
;15
(3
):149
–66
.
[PubMed]
0890-117145.
Julian-Reynier
C
, Eisinger
F
, Chabal
F
, Lasset
C
, Noguès
C
, Stoppa-Lyonnet
D
, et al. Disclosure to the family of breast/ovarian cancer genetic test results: patient’s willingness and associated factors
. Am J Med Genet
. 2000
Sep
;94
(1
):13
–8
.
[PubMed]
0148-729946.
Claes
E
, Evers-Kiebooms
G
, Boogaerts
A
, Decruyenaere
M
, Denayer
L
, Legius
E
. Communication with close and distant relatives in the context of genetic testing for hereditary breast and ovarian cancer in cancer patients
. Am J Med Genet A
. 2003
Jan
;116A
(1
):11
–9
.
[PubMed]
1552-482547.
Nycum
G
, Avard
D
, Knoppers
BM
. Factors influencing intrafamilial communication of hereditary breast and ovarian cancer genetic information
. Eur J Hum Genet
. 2009
Jul
;17
(7
):872
–80
.
[PubMed]
1018-481348.
Goergen
AF
, Ashida
S
, Skapinsky
K
, de Heer
HD
, Wilkinson
AV
, Koehly
LM
. What You Don’t Know: Improving Family Health History Knowledge among Multigenerational Families of Mexican Origin
. Public Health Genomics
. 2016
;19
(2
):93
–101
.
[PubMed]
1662-424649.
Koehly
LM
, Ashida
S
, Goergen
AF
, Skapinsky
KF
, Hadley
DW
, Wilkinson
AV
. Willingness of Mexican-American adults to share family health history with healthcare providers
. Am J Prev Med
. 2011
Jun
;40
(6
):633
–6
.
[PubMed]
0749-379750.
Lindenmeyer
A
, Griffiths
F
, Hodson
J
. ‘The family is part of the treatment really’: a qualitative exploration of collective health narratives in families
. Health (London)
. 2011
Jul
;15
(4
):401
–15
.
[PubMed]
1461-719651.
Geelen
E
, Van Hoyweghen
I
, Horstman
K
. Making genetics not so important: family work in dealing with familial hypertrophic cardiomyopathy
. Soc Sci Med
. 2011
Jun
;72
(11
):1752
–9
.
[PubMed]
0277-953652.
Koehly
LM
, Peters
JA
, Kenen
R
, Hoskins
LM
, Ersig
AL
, Kuhn
NR
, et al. Characteristics of health information gatherers, disseminators, and blockers within families at risk of hereditary cancer: implications for family health communication interventions
. Am J Public Health
. 2009
Dec
;99
(12
):2203
–9
.
[PubMed]
0090-003653.
Thompson
T
, Seo
J
, Griffith
J
, Baxter
M
, James
A
, Kaphingst
KA
. The context of collecting family health history: examining definitions of family and family communication about health among African American women
. J Health Commun
. 2015
Apr
;20
(4
):416
–23
.
[PubMed]
1081-073054.
Acheson
LS
, Wiesner
GL
, Zyzanski
SJ
, Goodwin
MA
, Stange
KC
. Family history-taking in community family practice: implications for genetic screening.
Genetics in medicine : official journal of the American College of Medical Genetics. 2000
;2(3):180-185. 55.
Cohen
M
. Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer
. Psychooncology
. 2006
Oct
;15
(10
):873
–83
.
[PubMed]
1057-924956.
Nelson
HD
, Pappas
M
, Zakher
B
, Mitchell
JP
, Okinaka-Hu
L
, Fu
R
. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation
. Ann Intern Med
. 2014
Feb
;160
(4
):255
–66
.
[PubMed]
0003-481957.
Lostao
L
, Joiner
TE
, Pettit
JW
, Chorot
P
, Sandín
B
. Health beliefs and illness attitudes as predictors of breast cancer screening attendance
. Eur J Public Health
. 2001
Sep
;11
(3
):274
–9
.
[PubMed]
1101-126258.
Zhang
LR
, Chiarelli
AM
, Glendon
G
, Mirea
L
, Knight
JA
, Andrulis
IL
, et al. Worry is good for breast cancer screening: a study of female relatives from the ontario site of the breast cancer family registry
. J Cancer Epidemiol
. 2012
;2012
:545062
.
[PubMed]
1687-855859.
Amuta
AO
, Mkuu
RS
, Jacobs
W
, Ejembi
AZ
. Influence of Cancer Worry on Four Cancer Related Health Protective Behaviors among a Nationally Representative Sample: Implications for Health Promotion Efforts
. J Cancer Educ
. 2018
Oct
;33
(5
):1002
–10
.
[PubMed]
0885-819560.
Kelly
KM
, Schoenberg
N
, Wilson
TD
, Atkins
E
, Dickinson
S
, Paskett
E
. Cervical cancer worry and screening among appalachian women
. J Prim Prev
. 2015
Apr
;36
(2
):79
–92
.
[PubMed]
0278-095X61.
Moser
RP
, McCaul
K
, Peters
E
, Nelson
W
, Marcus
SE
. Associations of perceived risk and worry with cancer health-protective actions: data from the Health Information National Trends Survey (HINTS)
. J Health Psychol
. 2007
Jan
;12
(1
):53
–65
.
[PubMed]
1359-105362.
Persoskie
A
, Ferrer
RA
, Klein
WM
. Association of cancer worry and perceived risk with doctor avoidance: an analysis of information avoidance in a nationally representative US sample
. J Behav Med
. 2014
Oct
;37
(5
):977
–87
.
[PubMed]
0160-771563.
Emanuel
AS
, Kiviniemi
MT
, Howell
JL
, Hay
JL
, Waters
EA
, Orom
H
, et al. Avoiding cancer risk information
. Soc Sci Med
. 2015
Dec
;147
:113
–20
.
[PubMed]
0277-953664.
Maddux
JE
, Sherer
M
, Rogers
RW
. Self-efficacy expectancy and outcome expectancy: their relationship and their effects on behavioral intentions
. Cognit Ther Res
. 1982
;6
(2
):207
–11
. 0147-591665.
Acheson
LS
, Wang
C
, Zyzanski
SJ
, et al. Family history and perceptions about risk and prevention for chronic diseases in primary care: a report from the family healthware impact trial.
Genetics in medicine : official journal of the American College of Medical Genetics. 2010
;12(4):212-218. 66.
Peters
JA
, Kenen
R
, Hoskins
LM
, Koehly
LM
, Graubard
B
, Loud
JT
, et al. Unpacking the blockers: understanding perceptions and social constraints of health communication in hereditary breast ovarian cancer (HBOC) susceptibility families
. J Genet Couns
. 2011
Oct
;20
(5
):450
–64
.
[PubMed]
1059-770067.
68.
Vatcheva
KP
, Lee
M
, McCormick
JB
, Rahbar
MH
. Multicollinearity in Regression Analyses Conducted in Epidemiologic Studies
. Epidemiology (Sunnyvale)
. 2016
Apr
;6
(2
):227
.
[PubMed]
2161-116569.
Wong
GY
, Mason
WM
. The Hierarchical Logistic Regression Model for Multilevel Analysis
. J Am Stat Assoc
. 1985
;80
(391
):513
–24
. 0162-145970.
Smith
RA
, Manassaram-Baptiste
D
, Brooks
D
, Doroshenk
M
, Fedewa
S
, Saslow
D
, et al. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening
. CA Cancer J Clin
. 2015
Jan-Feb
;65
(1
):30
–54
.
[PubMed]
0007-923571.
Centers for Disease Control and Prevention
. Tier 1 Genomics Applications and their Importance to Public Health. 2014
; https://www.cdc.gov/genomics/implementation/toolkit/tier1.htm72.
Smith
ML
, Beaudoin
CE
, Sosa
ET
, Pulczinski
JC
, Ory
MG
, McKyer
EL
. Motivations, Barriers, and Behaviors Related to Obtaining and Discussing Family Health History: A Sex-Based Comparison Among Young Adults
. Front Public Health
. 2015
Nov
;3
:249
.
[PubMed]
2296-256573.
Hughes Halbert
C
, Welch
B
, Lynch
C
, Magwood
G
, Rice
L
, Jefferson
M
, et al. Social determinants of family health history collection
. J Community Genet
. 2016
Jan
;7
(1
):57
–64
.
[PubMed]
1868-310X74.
Niederdeppe
J
, Levy
AG
. Fatalistic beliefs about cancer prevention and three prevention behaviors
. Cancer Epidemiol Biomarkers Prev
. 2007
May
;16
(5
):998
–1003
.
[PubMed]
1055-996575.
Mayo
RM
, Ureda
JR
, Parker
VG
. Importance of fatalism in understanding mammography screening in rural elderly women
. J Women Aging
. 2001
;13
(1
):57
–72
.
[PubMed]
0895-284176.
Chavez
LR
, Hubbell
FA
, Mishra
SI
, Valdez
RB
. The influence of fatalism on self-reported use of Papanicolaou smears
. Am J Prev Med
. 1997
Nov-Dec
;13
(6
):418
–24
.
[PubMed]
0749-379777.
Pérez-Stable
EJ
, Sabogal
F
, Otero-Sabogal
R
, Hiatt
RA
, McPhee
SJ
. Misconceptions about cancer among Latinos and Anglos
. JAMA
. 1992
Dec
;268
(22
):3219
–23
.
[PubMed]
0098-748478.
Corona
R
, Rodríguez
V
, Quillin
J
, Gyure
M
, Bodurtha
J
. Talking (or not) about family health history in families of Latino young adults
. Health Educ Behav
. 2013
Oct
;40
(5
):571
–80
.
[PubMed]
1090-198179.
Hay
JL
, Buckley
TR
, Ostroff
JS
. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature
. Psychooncology
. 2005
Jul
;14
(7
):517
–34
.
[PubMed]
1057-924980.
Vrinten
C
, Waller
J
, von Wagner
C
, Wardle
J
. Cancer fear: facilitator and deterrent to participation in colorectal cancer screening
. Cancer Epidemiol Biomarkers Prev
. 2015
Feb
;24
(2
):400
–5
.
[PubMed]
1055-996581.
Cameron
LD
, Reeve
J
. Risk perceptions, worry, and attitudes about genetic testing for breast cancer susceptibility
. Psychol Health
. 2006
;21
(2
):211
–30
.
[PubMed]
0887-044682.
So
J
. A further extension of the Extended Parallel Process Model (E-EPPM): implications of cognitive appraisal theory of emotion and dispositional coping style
. Health Commun
. 2013
;28
(1
):72
–83
.
[PubMed]
1041-023683.
Wallace
JP
, Baugh
C
, Cornett
S
, Hood
B
, Prows
CA
, Ryan
N
, et al. A family history demonstration project among women in an urban Appalachian community
. Prog Community Health Partnersh
. 2009
;3
(2
):155
–63
.
[PubMed]
1557-054184.
Katapodi
MC
, Dodd
MJ
, Lee
KA
, Facione
NC
. Underestimation of breast cancer risk: influence on screening behavior
. Oncol Nurs Forum
. 2009
May
;36
(3
):306
–14
.
[PubMed]
0190-535X85.
Kelly
KM
, Ferketich
AK
, Sturm
AC
, Porter
K
, Sweet
K
, Kemp
K
, et al. Cancer risk and risk communication in urban, lower-income neighborhoods
. Prev Med
. 2009
Apr
;48
(4
):392
–6
.
[PubMed]
0091-743586.
DiLorenzo
TA
, Schnur
J
, Montgomery
GH
, Erblich
J
, Winkel
G
, Bovbjerg
DH
. A model of disease-specific worry in heritable disease: the influence of family history, perceived risk and worry about other illnesses
. J Behav Med
. 2006
Feb
;29
(1
):37
–49
.
[PubMed]
0160-771587.
Lin
J
, Marcum
CS
, Myers
MF
, Koehly
LM
. Put the Family Back in Family Health History: A Multiple-Informant Approach
. Am J Prev Med
. 2017
May
;52
(5
):640
–4
.
[PubMed]
0749-379788.
Giordimaina
AM
, Sheldon
JP
, Kiedrowski
LA
, Jayaratne
TE
. Searching for the Kinkeepers: Historian Gender, Age, and Type 2 Diabetes Family History
. Health Educ Behav
. 2015
Dec
;42
(6
):736
–41
.
[PubMed]
1090-198189.
McBride
CM
, Bowen
D
, Brody
LC
, Condit
CM
, Croyle
RT
, Gwinn
M
, et al. Future health applications of genomics: priorities for communication, behavioral, and social sciences research
. Am J Prev Med
. 2010
May
;38
(5
):556
–65
.
[PubMed]
0749-379790.
Heckathorn
DD
. Respondent Driven Sampling: A New Approach to the Study of Hidden Populations
. Soc Probl
. 1997
;44
(2
):174
–99
. 0037-779191.
Valente
TW
, Pitts
SR
. An Appraisal of Social Network Theory and Analysis as Applied to Public Health: challenges and Opportunities
. Annu Rev Public Health
. 2017
Mar
;38
(1
):103
–18
.
[PubMed]
0163-752592.
Lewis
MA
, McBride
CM
, Pollak
KI
, Puleo
E
, Butterfield
RM
, Emmons
KM
. Understanding health behavior change among couples: an interdependence and communal coping approach
. Soc Sci Med
. 2006
Mar
;62
(6
):1369
–80
.
[PubMed]
0277-953693.
Manswell Butty
JA
, Richardson
F
, Mouton
CP
, Royal
CD
, Green
RD
, Munroe
KA
. Evaluation findings from genetics and family health history community-based workshops for African Americans
. J Community Genet
. 2012
Jan
;3
(1
):1
–12
.
[PubMed]
1868-310X© 2019 S. Karger AG, Basel
2019
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
