Structural and Contextual Patterns in Family Health History Knowledge among African American Adults: A Mixed-Methods Social Network Analysis Study*

Sula M. Hood; Elizabeth H. Golembiewski; Hadyatoullaye Sow; Kyle Benbow; Jeremy Prather; Lisa D. Robison; Elisabeth Martin-Hagler

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Structural and Contextual Patterns in Family Health History Knowledge among African American Adults: A Mixed-Methods Social Network Analysis Study*

Sula M. Hood

Elizabeth H. Golembiewski

Elisabeth Martin-Hagler

| 01 ago 2019

Journal of Social Structure

Volumen 20 (2019): Edición 3 (January 2019)

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Article Category: research-article

Publicado en línea: 01 ago 2019

Páginas: 96 - 118

DOI: https://doi.org/10.21307/joss-2019-008

© 2019 Sula M. Hood et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Example Family Health History CEGRM for 41-year-old Male Study Participant

Example Familial Network, 33-year old Male Participant

Alter characteristics associated with alter being named as a personal health informant by ego

	Odds Ratio	95% Confidence Interval	p-value
Alter gender
Male	[Reference]
Female	2.14	1.65, 2.77	0.0519
Geographic homophily
Alter and ego lives in different states	[Reference]
Alter and ego live in same state	1.55	1.45, 3.46	0.2873
Gender homophily
Alter and ego are different genders	[Reference]
Alter and ego are the same gender	1.15	0.58, 2.27	0.6918
Alter generation
Alter and ego are in the same generation	[Reference]
Alter is 1 generation above ego	1.26	0.93, 3.19	0.6305
Alter is 2 generations above ego	0.82	0.31, 2.16	0.6804
Alter family side
Paternal	[Reference]
Maternal	1.12	0.48, 2.56	0.0006
Alter has ≥1 chronic health condition	2.41	1.32, 4.62	0.0041
Alter talks about ego’s health	16.28	6.42, 40.85	<0.0001
Alter avoids health discussions	5.00	2.51, 16.61	0.0969
Alter is a source of family health information	3.46	1.40, 8.50	0.0072
Ego monitors and tracks alter’s health	5.93	2.36, 14.88	0.0002
Ego helps alter with managing health	2.77	2.18, 16.78	0.2663
Alter shares helpful health facts	1.20	2.69, 3.86	0.7672

Alter and tie descriptive statistics (n = 1,078)

	Percent	Mean	Standard Deviation	Range
Gender
Female	51.8
Male	48.2
Age (Years)		49.6	23.5	1-97
Relationship to ego
Grandparent	12.1
Parent	6.5
Aunt or uncle	24.8
Sibling	13.0
Cousin	43.7
Lives in same state as ego	34.3
>1 health conditions reported	25.5
Health conditions*
Hypertension	10.8
Cancer	6.9
Diabetes	6.0
Heart disease	5.4
Mental illness	5.3
Kidney disease	2.1
Health communication exchanges
Alter talks to ego about ego’s health	11.0
Alter talks to ego about alter’s health	14.5
Reciprocal health discussions	8.5
Alter avoids discussions about health	9.2
Alter is a source of family health information		13.2
Ego monitors and tracks alter’s health	12.3
Ego helps alter with managing health	5.6
Alter shares helpful health facts	7.4

Network descriptive statistics (n = 37 networks)

	Mean	Standard Deviation	Range
Network size	29.14	15.54	10.00-67.00
Proportion male	0.48	0.07	0.39-0.67
Homophily
Gender	0.50	0.07	0.40-0.67
Generation	0.52	0.15	0.07-0.72
Same state	0.34	0.29	0.00-1.00
Proportion of network by family relationship
Grandparent	0.15	0.08	0.04-0.40
Parent	0.08	0.04	0.03-0.20
Aunt or uncle	0.25	0.10	0.10-0.71
Sibling	0.15	0.10	0.00-0.39
Cousin	0.36	0.19	0.00-0.63
Proportion of network reporting >1 health conditions	0.26	0.13	0.00-0.58
Proportion of network by health communication role
Alter talks to ego about alter’s health	0.17	0.11	0.00-0.50
Alter talks to ego about ego’s health	0.13	0.12	0.00-0.56
Reciprocal health discussions	0.10	0.09	0.00-0.40
Alter avoids discussions about health	0.09	0.10	0.00-0.50
Alter is a source of family health information	0.13	0.09	0.00-0.42
Ego monitors and tracks alter’s health	0.15	0.10	0.00-0.40
Ego helps alter with managing health	0.05	0.07	0.00-0.30
Alter shares helpful health facts	0.08	0.07	0.00-0.27
Proportion of network by generation
Same generation as ego	0.52	0.15	0.07-0.72
1 generation above ego	0.33	0.11	0.22-0.78
2 generations above ego	0.15	0.08	0.04-0.40

Emergent themes and exemplary quotes for family health history knowledge prompts

Theme	Quote
Open Communication	“Well growing up, my mother often talked about kidney disease as well as diabetes running in our family. So, we made an effort – on physicals and so forth – that they also check those organs out.”
Observation	“So that was known my entire life because…he [my grandfather] always had the syringe and the needle…It was something I saw and it was always a big deal. It was a really big deal… Him having to take insulin.”
Caregiving	“I took care of him [my father] for a while, so, I learned a lot of his health issues and concerns because I was the caretaker. I had to know his pill schedule and different little things… then [I] was able to talk to the doctors, because I was the one giving him his care, I learned a lot and did research about what they were telling me that his conditions were.”
Post-Death Knowledge	“I actually didn’t know while he [my father] was living that he had diabetes. I didn’t find out until after… when I had to clean out his things and then being the one who he left in charge of everything, I had to speak with the doctors. So, I was finding out a lot more about his health after he had passed.”
Speculation*	“I don’t know if she [my cousin] would even take meds, but she definitely is either manic depressant or bipolar or something. Even her mother thinks so…Observing her behavior.”

Participant demographics and self-reported health status (n = 37)

	Percent	Mean	Standard Deviation	Range
Gender
Female	48.6
Male	51.4
Age (Years)		43.8	16.8	19-68
Marital status
Single	47.2
Married or in long-term partnership	47.2
Divorced	2.8
Household size		1.6	1.3	0-5
Educational level
High school or less	11.1
Some college	19.4
College graduate	38.9
Master’s degree or higher	27.8
History of health issues
Hypertension	35.1
High cholesterol	27.0
Asthma	13.5
Diabetes or high blood sugar	10.8
Cancer	8.1
Stroke	5.4
Heart attack	0.0
Other	18.9
Health status
Excellent	13.9
Good	61.1
Fair	19.4
Poor or very poor	5.4
Experience working in health care field	40.5

eISSN:: 1529-1227
Idioma:: Inglés

Calendario de la edición:: Volume Open
Temas de la revista:: Social Sciences, other

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Structural and Contextual Patterns in Family Health History Knowledge among African American Adults: A Mixed-Methods Social Network Analysis Study*

Article Category: research-article

Publicado en línea: 01 ago 2019

Páginas: 96 - 118

DOI: https://doi.org/10.21307/joss-2019-008

© 2019 Sula M. Hood et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1.

Figure 2.

Alter characteristics associated with alter being named as a personal health informant by ego

Alter and tie descriptive statistics (n = 1,078)

Network descriptive statistics (n = 37 networks)

Emergent themes and exemplary quotes for family health history knowledge prompts

Participant demographics and self-reported health status (n = 37)