All things considered, my risk for diabetes is medium: A risk personalization process of familial risk for type 2 diabetes.


Journal

Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926

Informations de publication

Date de publication:
02 2020
Historique:
received: 05 04 2019
revised: 28 08 2019
accepted: 27 09 2019
pubmed: 28 10 2019
medline: 23 4 2021
entrez: 25 10 2019
Statut: ppublish

Résumé

A positive family history of type 2 diabetes (T2D) has been associated with risk awareness and risk-reducing behaviours among the unaffected relatives. Yet, little is known about how people with a positive family history for diabetes develop and manage their personal sense of risk. To characterize two key concepts, salience and vulnerability, within the familial risk perception (FRP) model among unaffected individuals, at increased familial risk for T2D. We conducted a mixed method study. Descriptions of salience and vulnerability were collected through semi-structured interviews. Participant's perception of self-reported risk factors (family history, age, race/ethnicity, medical history, weight and exercise) was measured using the Perceived Risk Factors for T2D Tool and was compared to a clinical evaluation of the same risk factors. We identified two components of salience: (a) concern for developing T2D and (b) risk awareness triggers, and two features of vulnerability: (a) statement of risk and (b) risk assessment devices. Although few participants (26%) were concordant between their perceived and clinical overall T2D risk, concordance for individual risk factors was higher, ranging from 42% (medical history) to 90% (family history). Both familial and non-familial events lead people to contemplate their T2D risk, even among people who have a positive family history. Participants often downplayed their overall risk and underestimated their overall risk compared to a clinical risk assessment of the same self-reported risk factors. Clinicians could leverage key components of the FRP process as way to engage patients in risk reduction strategies earlier.

Sections du résumé

BACKGROUND
A positive family history of type 2 diabetes (T2D) has been associated with risk awareness and risk-reducing behaviours among the unaffected relatives. Yet, little is known about how people with a positive family history for diabetes develop and manage their personal sense of risk.
OBJECTIVE
To characterize two key concepts, salience and vulnerability, within the familial risk perception (FRP) model among unaffected individuals, at increased familial risk for T2D.
DESIGN
We conducted a mixed method study. Descriptions of salience and vulnerability were collected through semi-structured interviews. Participant's perception of self-reported risk factors (family history, age, race/ethnicity, medical history, weight and exercise) was measured using the Perceived Risk Factors for T2D Tool and was compared to a clinical evaluation of the same risk factors.
RESULTS
We identified two components of salience: (a) concern for developing T2D and (b) risk awareness triggers, and two features of vulnerability: (a) statement of risk and (b) risk assessment devices. Although few participants (26%) were concordant between their perceived and clinical overall T2D risk, concordance for individual risk factors was higher, ranging from 42% (medical history) to 90% (family history).
DISCUSSION AND CONCLUSION
Both familial and non-familial events lead people to contemplate their T2D risk, even among people who have a positive family history. Participants often downplayed their overall risk and underestimated their overall risk compared to a clinical risk assessment of the same self-reported risk factors. Clinicians could leverage key components of the FRP process as way to engage patients in risk reduction strategies earlier.

Identifiants

pubmed: 31646744
doi: 10.1111/hex.12986
pmc: PMC6978869
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

169-181

Subventions

Organisme : NINR NIH HHS
ID : T32NR009759
Pays : United States
Organisme : NINR NIH HHS
ID : 5F31NR014758
Pays : United States
Organisme : NIH/National Institute of Nursing Research
ID : K23 NR012972-01
Pays : International

Informations de copyright

© 2019 The Authors Health Expectations published by John Wiley & Sons Ltd.

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Auteurs

Sandra Daack-Hirsch (S)

University of Iowa College of Nursing, Iowa City, Iowa.

Lisa L Shah (LL)

University of Iowa College of Nursing, Iowa City, Iowa.

Kaitlyn Jones (K)

University of Iowa College of Nursing, Iowa City, Iowa.

Brenda Rocha (B)

University of Iowa College of Nursing, Iowa City, Iowa.

Megan Doerr (M)

Cleveland Clinic, Cleveland, Ohio.

Emily Gabitzsch (E)

Cleveland Clinic, Cleveland, Ohio.

Thad Meese (T)

Cleveland Clinic, Cleveland, Ohio.

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