ArticleBMC health services research2022
Implementation-effectiveness trial of systematic family health history based risk assessment and impact on clinical disease prevention and surveillance activities.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01956773 (Family Health History in Diverse Care Settings), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Family Health History in Diverse Care Settings
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Genetically guided precision medicine clinical decision support tools: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Streamlining Inherited Cancer Identification via an EMR-Integrated Risk Assessment Platform: A Nonrandomized Clinical Trial.JAMA network open · 2026Trial
- Cost-effectiveness of primary care-based risk assessment and hereditary cancer genetic testing.BMC primary care · 2025Trial
- Breaking barriers to completing genetic testing for inherited breast cancer among at-risk Black women using a community-based participatory research approach.HGG advances · 2026Article
- Barriers and facilitators of cancer genetic risk screening at community-based organizations serving Latinas.Journal of community genetics · 2025Article
- Family history and cancer risk study (FOREST): A clinical trial assessing electronic patient-directed family history input for identifying patients at risk of hereditary cancer.Contemporary clinical trials · 2025Article
- Validation of a guidelines-based digital tool to assess the need for germline cancer genetic testing.Hereditary cancer in clinical practice · 2024Article
- Efficacy of Community Health Worker-Delivered Family Health History-Based Breast Cancer Education and Services Among Chinese Americans.Journal of cancer education : the official journal of the American Association for Cancer Education · 2024Article
- Feasibility of an electronic patient-facing cancer family history tool in medically underserved populations.Genetics in medicine open · 2024Article
- Advances in Clinical Decision Support Systems: Contributions from the 2022 Literature.Yearbook of medical informatics · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundSystematically assessing disease risk can improve population health by identifying those eligible for enhanced prevention/screening strategies. This study aims to determine the clinical impact of a systematic risk assessment in diverse primary care populations.
methodsHybrid implementation-effectiveness trial of a family health history-based health risk assessment (HRA) tied to risk-based guideline recommendations enrolling from 2014-2017 with 12 months of post-intervention survey data and 24 months of electronic medical record (EMR) data capture.
setting19 primary care clinics at four geographically and culturally diverse U.S. healthcare systems.
participantsany English or Spanish-speaking adult with an upcoming appointment at an enrolling clinic.
methodsA personal and family health history based HRA with integrated guideline-based clinical decision support (CDS) was completed by each participant prior to their appointment. Risk reports were provided to patients and providers to discuss at their clinical encounter. OUTCOMES: provider and patient discussion and provider uptake (i.e. ordering) and patient uptake (i.e. recommendation completion) of CDS recommendations. MEASURES: patient and provider surveys and EMR data.
resultsOne thousand eight hundred twenty nine participants (mean age 56.2 [SD13.9], 69.6% female) completed the HRA and had EMR data available for analysis. 762 (41.6%) received a recommendation (29.7% for genetic counseling (GC); 15.2% for enhanced breast/colon cancer screening). Those with recommendations frequently discussed disease risk with their provider (8.7%-38.2% varied by recommendation, p-values ≤ 0.004). In the GC subgroup, provider discussions increased referrals to counseling (44.4% with vs. 5.9% without, P < 0.001). Recommendation uptake was highest for colon cancer screening (provider = 67.9%; patient = 86.8%) and lowest for breast cancer chemoprevention (0%).
conclusionsSystematic health risk assessment revealed that almost half the population were at increased disease risk based on guidelines. Risk identification resulted in shared discussions between participants and providers but variable clinical action uptake depending upon the recommendation. Understanding the barriers and facilitators to uptake by both patients and providers will be essential for optimizing HRA tools and achieving their promise of improving population health.
trial registrationClinicaltrials.gov number NCT01956773 , registered 10/8/2013.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.