Family Healthware™ is a Web-based research tool that can be used to assess a person’s familial risk for six diseases (coronary heart disease, stroke, diabetes, and colorectal, breast, and ovarian cancer). It provides users in research studies with a “prevention plan” containing personalized recommendations for lifestyle changes and screening. For each person, the tool collects data about the following:
- Health behaviors (e.g., smoking and exercise).
- Screening tests (e.g., blood cholesterol and mammography).
- Health history among his or her first- and second-degree relatives.
One set of algorithms in the software analyzes users’ family health history data and assesses their familial risk for each of the six diseases. A second set of algorithms uses the data on familial risk, health behaviors, and screening results to generate personalized prevention messages. Family Healthware™ was developed by a multi-disciplinary team with expertise in clinical genetics, behavioral science, health communication, preventive medicine, and epidemiology, with support from a major commercial communications firm and a software development company.
Research and Evaluation
Evaluation of Family Healthware™ is being conducted to determine if personalized prevention messages tailored to familial risk will motivate people at risk to change lifestyle behaviors or seek additional medical advice or screening. Three academic research centers at the University of Michigan School of Medicine, Evanston Northwestern Healthcare Research Institute, and Case Western Reserve University School of Medicine, using a network of primary care practices, have evaluated this tool. The study began enrolling patients in December 2005, and data collection was completed by the fall of 2007. As a result of this research, a series of papers are being published in peer-reviewed journals and presented at various workshops and meetings. A list of these publications is provided below.
To help fill gaps in our understanding of the role that family health history plays in disease occurrence and prevention, CDC researchers are also analyzing data from past and ongoing population-based studies of chronic diseases, including the National Health and Nutrition Examination Survey and the National Health Interview Survey.
- Wang C, Sen A, Plegue M, Ruffin MT 4th, O'Neill SM, Rubinstein WS, Acheson LS; Family Healthware™ Impact Trial (FHITr) Group; Family Healthware Impact Trial FHITr Group. Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr). Prev Med. 2015 Apr 19. pii: S0091-7435(15)00113-9.
- Wang C, Sen A, Ruffin MT 4th, Nease DE Jr, Gramling R, Acheson LS, O'Neill SM, Rubinstein WS; Family Healthware™ Impact Trial (FHITr) Group. Family history assessment: impact on disease risk perceptions. Am J Prev Med. 2012 Oct;43(4):392-8.
- Dorman JS, Valdez R, Liu T, Wang C, Rubinstein WS, O'Neill SM, Acheson LS, Ruffin MT 4th, Khoury MJ. Health beliefs among individuals at increased familial risk for type 2 diabetes: Implications for prevention. Diabetes Res Clin Pract. 2012 Jan 16.
- Ruffin MT, Nease DE. Using Patient Monetary Incentives and Electronically Derived Patient Lists to Recruit Patients to a Clinical Trial. JABFM 2011; 24(5): 569-574.
- Rubinstein, W.S., O’Neill, S.M., Acheson, L.S., Ruffin, M.T., IV, Wang, C., & Beaumont, J., for the Family HealthwareTM Impact Trial (FHITr) Group. Clinical Utility of family history for cancer screening and referral in primary care. Genet Med 2011 Nov;13(11):956-65.
- Ruffin, M.T., Nease, D.E., Jr., Pace, W.D., Sen, A., Wang, C., Acheson, L.S., Rubinstein, W., O’Neill, S.M., & Gramling, R., for the Family HealthwareTM Impact Trial (FHITr) Group. Effect of preventive messages tailored to family history on health behaviors: the Family HealthwareTM Impact Trial. Ann Fam Med. 2011; 9, 3-11.
- Rubinstein, W.S., O’Neill, S.M., Rothrock, N., Starzjk, E.J., Beaumont, J.L., Acheson, L.S., Wang, C., Gramling, R., Galliher, J.M., & Ruffin, M.T., IV. Components of family history associated with women’s disease perceptions for cancer: A report from the Family HealthwareTM Impact Trial (FHITr). Genet Med. 2011; 13(1): 52-62.
- Acheson LS, Wang C, Zyzanski SJ, Lynn A, Ruffin MT 4th, Gramling R, Rubinstein WS, O'Neill SM, Nease DE Jr; Family Healthware Impact Trial (FHITr) Group. Family history and perceptions about risk and prevention for chronic diseases in primary care: a report from the family healthware impact trial. Genet Med. 2010; 12(4):212-8.
- O'Neill SM, Rubinstein WS, Wang C, Yoon PW, Acheson LS, Rothrock N, Starzyk EJ, Beaumont JL, Galliher JM, Ruffin MT 4th. Family Healthware Impact Trial group. Familial risk for common diseases in primary care: the Family Healthware Impact Trial. Am J Prev Med. 2009; 36(6):506-14.
- Wang C, O'Neill SM, Rothrock N, Gramling R, Sen A, Acheson LS, Rubinstein WS, Nease DE Jr, Ruffin MT 4th. Family Healthware Impact Trial (FHITr) group. Comparison of risk perceptions and beliefs across common chronic diseases. Prev Med. 2009; 48(2):197-202.
- Yoon PW, Scheuner MT, Jorgensen C, Khoury MJ. Developing Family Healthware, a family history screening tool to prevent common chronic diseases. Prev Chronic Dis. 2009 Jan;6(1):A33.