Integrating Complementary and Alternative Medicine Practices into Effective Prevention Programming for Low-Income Communities: The Canyon Ranch Institute Life Enhancement Program

While there is a growing body of research and documentation of the effectiveness of complementary and alternative medicine, there is little research on effective community-based programming that embraces an integrative approach to health. Further, there is a dearth of research investigating the effectiveness of such efforts in regard to improving the health and well-being of individuals living in low-income, medically underserved communities.  An integrative approach to health – mind, body, spirit, emotion – inherently embraces complementary and alternative approaches to medicine and well-being.

Statistically and clinically significant outcomes of the Canyon Ranch Institute Life Enhancement Program (CRI LEP) show that preventing chronic disease and eliminating inequities in health through emphasis on the integration of mind-body-spirit-emotion using the best practices of health literacy can produce positive changes in overall health and wellness. The CRI LEP has been conducted to date in low-income communities in New York, Ohio, Missouri, Massachusetts, Georgia, and Arizona. The CRI LEP integrates emotional, mental, social, and spirituality practices, including an emphasis on a sense of purpose, as well as guided practice in evidence-based best practices of complementary and alternative medicine, normally including meditation, prayer, yoga, tai chi, breathing, and other practices. In each community, CRI identifies and trains interdisciplinary teams of community health care professionals to provide the program. The team is composed of experts in spirituality, behavioral health, integrative health, nutrition, fitness, and pharmacy.

The CRI LEP provides at least 40 hours of community-based participatory and hands-on group sessions, fitness instruction, live cooking demonstrations, social support, a nutritionist-guided grocery store trip, and one-on-one planning consultations with the core team specialists. On a voluntary basis with Human Subjects approval at each site, participant data are rigorously collected at pre, post, three months post, and one year post intervention. Evaluation involves serum analysis that includes cholesterol, hemoglobin A1c, and C-reactive protein (a marker for inflammation). Other evaluation foci include an intensive knowledge, attitude, behavior, and belief interview, physical fitness test, and physical measurements. Evaluation from multiple cohorts and sites indicate healthy statistically significant reductions (at p < .05, matched pair) in depression (-32.8%), stress (-22.4%), the number of mentally and physically unhealthy days in the previous month (-24.6%), C-reactive protein (-16.9%); and improvements moderate exercise per week (+90.9%) and in exercise and nutrition self-efficacy (+12.5%). We will also report numerous other improvements in knowledge, attitudes, behaviors and indicators of physical and mental health status, and will discuss the effects of spirituality on local health and wellness program policies. We also conduct a cost-effectiveness analysis and have found that the gains in health are produced in a very cost-effective manner compared to the costs of other interventions.

We conclude that the evidence gathered to date strongly indicates that an integrative health and wellness program, fully embracing complementary and traditional approaches, that is based on the best practices of health literacy can be effective in improving participants’ health. This is true, especially, in low-income medically underserved communities across a broad range of cultural settings.