November/December 2004 Annals of Family Medicine tip sheet

arch articles about familial risk of common chronic diseases, researchers found that elements of family history may be perceived differently by patients and clinicians and thereby affect perceptions of disease risk. Whereas clinicians include in their assessment of family history the number of affected relatives and their age at illness and death, patients' perception of risk also includes other factors, including their personal experience of a relative's disease and sudden or premature death. The authors point out that conflicts between patients' and clinicians' understanding of heredity could result in persistent misconceptions and fears concerning familial risk.

Health Care Seeking Among Urban Minority Adolescent Girls: The Crisis at Sexual Debut
By M. Diane McKee, M.D., M.S., et al
In-depth interviews revealed that urban adolescent black and Latina girls dramatically shift how and where they seek help for health needs after becoming sexually active. Before the onset of sexual activity, most girls meet health needs within the context of family, relying heavily on mothers for health care and advice. Once sexually-active, girls attempt to meet reproductive needs by extending their search for advice and care to "mother alternatives," such as older female family members, but they still seek personalized care modeled on that they received from their mothers. The authors note that many sexually active adolescent girls fail to establish trusting relationships with clinicians or "mother alternatives," and, as a result, have unmet sexual health needs.

The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry
By Francesc Borrell-Carri, M.D., et al
Researchers suggest three clarifications to the biopsychosocial model posited by George Engle 25 years ago. They add to the model the need to balance a circular model of causality with the need to make linear ap

Contact: Angela Lower
American Academy of Family Physicians

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