Abstract
BackgroundIt has been suggested that family history information may be effective in motivating people to adopt health promoting behaviour. The aim was to determine if diabetic familial risk information by using a web-based tool leads to improved self-reported risk-reducing behaviour among individuals with a diabetic family history, without causing false reassurance among those without a family history.MethodsAn online sample of 1,174 healthy adults aged 35–65 years with a BMI ≥ 25 was randomized into two groups receiving an online diabetes risk assessment. Both arms received general tailored diabetes prevention information, whilst the intervention arm also received familial risk information after completing a detailed family history questionnaire. Separate analysis was performed for four groups (family history group: 286 control versus 288 intervention group; no family history: 269 control versus 266 intervention group). Primary outcomes were self-reported behavioural outcomes: fat intake, physical activity, and attitudes towards diabetes testing. Secondary outcomes were illness and risk perceptions.ResultsFor individuals at familial risk there was no overall intervention effect on risk-reducing behaviour after three months, except for a decrease in self-reported saturated fat intake among low-educated individuals (Beta (b) -1.01, 95% CI −2.01 to 0.00). Familial risk information resulted in a decrease of diabetes risk worries (b −0.21, -0.40 to −0.03). For individuals without family history no effect was found on risk-reducing behaviour and perceived risk. A detailed family history assessment resulted in a greater percentage of individuals reporting a familial risk for diabetes compared to a simple enquiry.ConclusionsWeb-based familial risk information reduced worry related to diabetes risk and decreased saturated fat intake of those at greatest need of preventative care. However, the intervention was not effective for the total study population on improving risk-reducing behaviour. The emphasis on familial risk does not seem to result in false reassurance among individuals without family history. Additionally, a detailed family history questionnaire identifies more individuals at familial risk than a simple enquiry.Trial registrationNTR1938
Highlights
It has been suggested that family history information may be effective in motivating people to adopt health promoting behaviour
It has been suggested that family history information can be used to personalize health messages for individuals at risk, which may be more effective in motivating them to adopt a healthy lifestyle than general health messages [6]
For individuals without relevant family histories, the emphasis on familial risk information did not result in false reassurance as demonstrated by no significant difference in risk-reducing behaviour and diabetes risk perception
Summary
It has been suggested that family history information may be effective in motivating people to adopt health promoting behaviour. Current behavioural programs aimed at diabetes prevention that use general health messages have limited effect [3]. It has been suggested that family history information can be used to personalize health messages for individuals at risk, which may be more effective in motivating them to adopt a healthy lifestyle than general health messages [6]. Individuals with a diabetes family history have difficulty understanding the complex interaction between genetic and behavioural causes of diabetes and have limited concerns about getting the disease [7,8,9], which confines their motivation to adopt health promoting behaviour. Familial risk information resulted in increase diabetes risk perception among those who underestimated their risk [10]
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