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Family History:
Practical Considerations for Pediatric Primary Care Clinicians
Reasons to collect
family history information
- Family history is
a traditional tool for diagnosing and identifying risk for
genetic disorders. It is also being used more commonly to assess
risk for complex common conditions for which the genetic cause
is unknown, such as heart disease and diabetes.
- Family history
can inform decisions about screening, patient education, and
other preventive health measures.
- It helps
physicians build rapport with patients and their families,
understand relationships within families, and identify shared
environments and behaviors that might put a patient at higher
risk for disease.
- It can also help
identify inheritance patterns and correct mistaken beliefs—for
instance, that a disease affects only one gender or skips a
generation.
- Family history is
an essential part of a complete physical exam visit for a child.
Strategies for
collecting family histories
- Use frequent
well-child exams to complete and update family history
information. (If a patient comes in for all recommended
well-child exams, the clinician will see the patient 10 times in
the first 2 years of life.)
- Several tools can
help with collecting family histories. Choose the ones that work
best, and introduce families to those tools during their first
visit
- Add family
history links to the office or clinic website. Ask parents to
gather information before they come for an office visit.
Information collected at home can help guide the visit.
- Provide handouts
with resources for collecting family medical history. Print fact
sheets from the Web.
- Post reminders or
create slogans for clinicians and families, such as “5 minutes
for family history” or “Don’t forget family history.”
- Involve children
by using a computer.
- Involve parents
by getting a maternal prenatal family history.
- Encourage
families to collect medical history information at family
gatherings. Publicize Thanksgiving Day as Family History Day.
- Review and update
family history every year.
Challenges to
overcome
- The main barrier
to collecting a complete family history is time. Fortunately,
pediatric clinicians see their patients often, so there are many
chances to gather this information. More detail can be added
over multiple visits.
- Busy parents
might not want to take time to find out more about their
family’s health history. Other parents might be reluctant to
seek out this information if it will bring back memories of
loss, illness, or broken relationships. Clearly explaining how
family history can benefit the child’s health and addressing the
family’s concerns might help in getting complete and reliable
information.
- A child might
have several caregivers, without a single adult being in charge
of health care. Becoming an active partner with parents and
other caregivers will help overcome this barrier.
For more
information, please see the following Pediatrics supplement
articles:
Family History in Pediatric Primary Care
Summary of Workgroup Meeting on Use of Family History Information in
Pediatric Primary Care and Public Health
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Date:
November 01, 2007
Content source: National Center on Birth Defects and Developmental
Disabilities
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