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The Utah Department of Health Family High Risk Program

The Utah Department of Health has over 20 years of experience using family history to identify and target high risk populations. Perhaps the best known example of a family history intervention is the Family High Risk Program. This program identified families at risk from a variety of diseases that could be prevented, delayed, or treated with early interventions.

"Utah's Family High Risk Program: bridging the gap between genomics and public health" now available from the CDC Preventing Chronic Disease online journal.

Health Family Tree tool - online and secure tool to collect and analyze your family health history. Users will receive a free personalized report detailing what their family health history means for them and their family! Developed by the University of Utah Cardiovascular Genetics Research Clinic and the Genomics Program.

Family High Risk Program report pdf - This report describes the program in detail, provides 10 year evaluation data, and provides examples of materials used in the program. Also included in the report are recommendations for public health agencies to use in designing new family history interventions.

Background

  • Implemented from 1983-1999 in 10th grade high school health education classes

  • Health Family Tree tool was used to collect three generations of family medical history from students - Click here to view the Health Family Tree tool

  • Identified risk for heart disease, stroke, breast and colon cancer, diabetes, asthma, hypertension, high blood cholesterol, and Alzheimer's disease

  • Identified lifestyle behaviors that may increase disease risk such as smoking status, alcohol use, weight, and routine exercise patterns

  • Researchers analyzed the Health Family Trees and a computer report was sent to consenting families describing any risk they had for a particular disease

  • Local health department public health nurses provided "high risk" families with follow up interventions

  • Interventions included in-home visits, medical screenings, referral to health care providers, and education on behavior modifications

  • Evaluations from a 10 year span showed health behavior changes occurred in both high and average risk families

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Partners of the Family High Risk Program

  • Utah Department of Health

  • University of Utah Cardiovascular Genetics Research Program

  • Baylor College of Medicine

  • Local health departments

  • Local school districts

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Three consent options were given to families

  • Option 1 - full participation in program. Health Family Tree was analyzed, report sent to families, high risk families received interventions, and names and contact information kept at the University of Utah.

  • Option 2 - partial participation in program. Health Family Tree was analyzed but no report was sent to families, high risk families received no interventions, and names and contact information kept at the University of Utah.

  • Option 3 - non participation in program. Students completed alternate assignments.

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Family High Risk Program statistics

  • Cost for each participating student was less than $10 (doesn't include interventions for high risk families)

  • Cost for each high risk family was $27 (includes interventions)

  • 80,611 useable Health Family Trees collected

  • 151,188 Utah families participated

  • 8,456 families identified as high risk

  • 90% of high risk families received interventions

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"The new frontier opened by genomics offers public health an opportunity to apply new knowledge in the effort to prevent and treat diseases that currently threaten the public's health."

J Law Med Ethics
2002; 30: 173-176