Characteristics of Health Information Gatherers, Disseminators, and Blockers Within Families at Risk of Hereditary Cancer: Implications for Family Health Communication Interventions

Abstract
Objectives. Given the importance of the dissemination of accurate family history to assess disease risk, we characterized the gatherers, disseminators, and blockers of health information within families at high genetic risk of cancer. Methods. A total of 5466 personal network members of 183 female participants of the Breast Imaging Study from 124 families with known mutations in the BRCA1/2 genes (associated with high risk of breast, ovarian, and other types of cancer) were identified by using the Colored Eco-Genetic Relationship Map (CEGRM). Hierarchical nonlinear models were fitted to characterize information gatherers, disseminators, and blockers. Results. Gatherers of information were more often female (P < .001), parents (P < .001), and emotional support providers (P < .001). Disseminators were more likely female first- and second- degree relatives (both P < .001), family members in the older or same generation as the participant (P < .001), those with a cancer history (P < .001), and providers of emotional (P < .001) or tangible support (P < .001). Blockers tended to be spouses or partners (P < .001) and male, first-degree relatives (P < .001). Conclusions. Our results provide insight into which family members may, within a family-based intervention, effectively gather family risk information, disseminate information, and encourage discussions regarding shared family risk.