183190 Determinants of Practitioner vs. Self Care Based CAM Use from the 2002 National Health Interview Survey

Monday, October 27, 2008

Dr. Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ava Joubert, MD, DrPH(c) , Morgan State University, Baltimore, MD
Rueben Warren, DDS, MPH, DrPH , ITC, Atlanta, GA
Yvonne L. Bronner, ScD , School of Community Health and Policy, Morgan State University, Baltimore, MD
Despite recent reports of increase in CAM use, little is known about the types and determinants of CAM use. Question remains whether CAM use is practitioner (PR) or self-care (SC) driven. To address this, we analyzed the 2002 National Health Interview Survey's (NHIS) CAM use supplemental files to determine 1) differences in prevalence of PR and SC based CAM use by individuals with chronic morbidities, and 2) if there is a differential association between chronic disease and the above two types of CAM use. The NHIS utilized a stratified, multi-level, probability sampling, which included 31,044 respondents who provided information on past year uses of six PR and six SC based CAM. Seven chronic co-morbidities and eight socio-demographic covariates were used in the analysis.

Twenty three percent used SC-CAM, 5% used PR-CAM and 7% used a combination thereof. Among individuals reporting co-morbidity (N=15,051), 48.5% had at least one chronic disease, and 22.3% reported >=2 co-morbidities. More than a quarter (28.6%) with >=1 co-morbidity used SC-CAM modalities. Conversely, only 8% with >=1 co-morbidity used PR-CAM compared to those who did not have any co-morbidity (p<0.01). Using multinomial multiple regression models after adjusting for covariates, the odds of CAM use among individuals who used SC+PR was 1.86 (95%CI: 1.66;2.08), 1.54 (95%CI:1.45;1.63) for SC-CAM 1.37 (95%CI:1.20;1.57) for PR-CAM, when compared to CAM use by individuals who did not report having any of the analyzed chronic diseases (p<0.001). The model explained 33% of variance.

Study implications include CAM use promotion strategies for different population segments who may or may not prefer professional practitioners providing CAM.

Learning Objectives:
1. Distinguish Practitioner based from Self-Care based CAM use 2. Evaluate holistic apporaches to CAM use 3. Measure determinants of Practitioner Based from Self-Care based CAM use

Keywords: Adult Health, Alternative Medicine/Therapies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical and Public Health Practitioner for more than 2 decades
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Morgan State University Chronic Disease/Allergy/CAM Currently a doctoral candidate at Morgan State University

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.