November brings three significant celebrations: Thanksgiving, National Family History Day, and National Nurse Practitioner Week. On Thanksgiving, we observe the American tradition of gathering families together to eat too much food, remember past and present blessings, and look forward to the future.
Since 2004, National Family History Day has also been observed on Thanksgiving, designated by then U.S. Surgeon General Dr. Richard Carmona as a day for families to learn about their family health history. A large campaign encouraged families to add this discussion to their list of traditional activities.
My Family Health Portrait (http://familyhistory.hhs.gov) was introduced that year as a downloadable computer software program. Individuals were able to enter information about their family health history, save and update it, and print and share it with other family members and healthcare providers. The program was modified to a web-based version in 2005, and in 2009, it was again revised to be standards-based, shareable, and electronic health record (EHR)-ready (as well as customizable only for organizations). The 2009 version could be reindexed when shared with family members, meaning that each individual in the family could make him or herself the central person in the program, thereby shifting all relationships accordingly and eliminating the need to reenter information for family members in common. I remember its ease of use and the time spent initially completing it. And more importantly, I realized I was missing a lot of information.
Secrecy of familial illnesses
In some families, cultural and generational norms for disclosing personal health information can be barriers to collecting a family history. Even engaging in a conversation about one's own health can meet resistance from family members. Secrecy can have negative consequences. An Ethiopian proverb states, "He who conceals his disease cannot expect to be cured." Family illness can impact others directly and indirectly. Efforts must be ongoing to raise awareness about the importance of knowing and sharing family history.
Family health history
As healthcare providers, we are expected to take a family history from our patients. We can use family history as a clinical decision support tool, especially in this age of technology. My Family Health Portrait was developed for integration into an EHR, provided there are no compatibility issues. Expanding knowledge about genetics and disease and the availability of genetic testing are advances we can use to help guide mutual patient-provider decisions about testing for conditions and management of risk, prevention, and treatment based on an adequate family history. Encourage your family, friends, and patients to share the CDC e-card (http://t.cdc.gov/ecards/message.aspx?cardid=526) with significant others to raise awareness and stimulate discussion. Healthier individuals foster healthier families, which in turn promote healthier communities.
Access to healthcare
Communities are also healthier if populations have access to healthcare. November 9-15, 2014 marks the annual celebration of National Nurse Practitioner Week. Its purpose is "to celebrate these exceptional healthcare providers and to remind lawmakers of the importance of removing outdated barriers to practice so that NPs will be allowed to practice to the full extent of their experience and education." (http://aanp.org/all-about-nps/np-week.) If you have not contacted your legislators recently, there is no better time than this month to remind them of what you do and what you would be able to do without restrictions on your practice authority. Midterm elections are this month. Be informed. Inform. Vote. Happy Thanksgiving.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP
EDITOR-IN-CHIEF [email protected]