Ethnic Variation in CAM Use and Health Self Management among Rural Older Adults

Summary

Principal Investigator: Thomas Arcury
Abstract: DESCRIPTION (provided by applicant): Complementary and alternative medicine (CAM) is widely used among older adults. However, overall levels of CAM use and specific modalities used among elders differ by ethnicity, gender and age. Neither the causes of ethnic differences in CAM use nor the effects of CAM use on ethnic differences in the health status or quality of life have been clearly identified. Few studies of CAM use are conceptually driven, and most do not explore the social or cultural factors related to CAM use. Studies have not examined specific CAM use behaviors;rather, they rely on self-reports of use in the past month or past year without trying to measure the actual frequency of CAM modality use or the predictors of specific CAM modality use. Population based studies of CAM use have not measured how specific CAM therapy use is related to health status or quality of life among older adults or minority group members. The overall goals of this project are to delineate ethnic differences in the CAM therapies used by rural elders and to determine ethnic differences in how these modalities are incorporated into health self-management. To attain these goals, this project will: (1) delineate the cognitive models of CAM among African American and white rural older adults that shape health self-management (components of these cognitive models include knowledge and beliefs about CAM modalities, information sources about CAM modalities, the purposes for which these modalities are used, the reasons for using these modalities, and how they are integrated into conventional health care);(2) determine the actual use of CAM modalities among African American and white rural elders;(3) delineate how the use of CAM modalities among African American and white elders affects the use of conventional medical care, and (4) determine the association of CAM modality use among African American and white rural elders with health-related quality of life. This research is structured by a conceptual framework that integrates concepts of health self-management with concepts from cognitive models of health. The design includes two components. First, in-depth interviews will be completed with 64 rural African American and white elders. Second, 6 times at monthly intervals structured interviews will be completed for 3 consecutive days with a sample of 200 rural African American and white elders. This project addresses health disparities by investigating why and how ethnic and racial minority populations use CAM. It reflects the recommendations of the lOM's Committee on the Use of Complementary and Alternative Medicine by the American Public to use quantitative and qualitative methods to examine sociocultural dimensions of illness and health care- seeking processes and preferences, how well CAM users adhere to treatment guidelines, and how individuals evaluate information about CAM modalities.
Funding Period: 2006-09-30 - 2010-09-29
more information: NIH RePORT

Top Publications

  1. pmc Relationship between nonprescribed therapy use for illness prevention and health promotion and health-related quality of life
    Kathryn P Altizer
    Wake Forest School of Medicine, Winston Salem, NC, USA
    J Appl Gerontol 33:456-73. 2014
  2. pmc Self-reported sleep difficulties and self-care strategies among rural older adults
    Joanne C Sandberg
    Wake Forest School of Medicine, Winston Salem, NC, USA
    J Evid Based Complementary Altern Med 19:36-42. 2014
  3. pmc Medical skepticism and complementary therapy use among older rural African-Americans and Whites
    Ronny A Bell
    Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
    J Health Care Poor Underserved 24:777-87. 2013
  4. pmc Measuring differential beliefs in complementary therapy research: an exploration of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI)
    Joseph G Grzywacz
    Department of Family and Community Medicine, Wake Forest School of Medicine, USA
    Complement Ther Med 20:54-60. 2012
  5. pmc The relationship between cognitive function and non-prescribed therapy use in older adults
    Ha T Nguyen
    Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, USA
    Aging Ment Health 16:648-58. 2012
  6. pmc Older adults' self-management of daily symptoms: complementary therapies, self-care, and medical care
    Thomas A Arcury
    Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157 1084, USA
    J Aging Health 24:569-97. 2012
  7. pmc Daily symptom management practices for arthritis used by older adults
    Sara A Quandt
    Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
    J Aging Health 24:598-615. 2012
  8. pmc Gender and health lifestyle: an in-depth exploration of self-care activities in later life
    Joseph G Grzywacz
    Wake Forest University School of Medicine, Winston Salem, NC, USA
    Health Educ Behav 39:332-40. 2012
  9. pmc Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS)
    Rebecca H Neiberg
    Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest University School of Medicine, Medical Center Blvd, Winston Salem, NC 27157, USA
    J Altern Complement Med 17:363-70. 2011
  10. pmc Calling the doctor: a qualitative study of patient-initiated physician consultation among rural older adults
    Eleanor Palo Stoller
    Department of Sociology, Wake Forest University, Winston Salem, NC 27109, USA
    J Aging Health 23:782-805. 2011

Scientific Experts

Detail Information

Publications17

  1. pmc Relationship between nonprescribed therapy use for illness prevention and health promotion and health-related quality of life
    Kathryn P Altizer
    Wake Forest School of Medicine, Winston Salem, NC, USA
    J Appl Gerontol 33:456-73. 2014
    ..It also delineates the association of such therapy use with physical and mental health-related quality of life (HRQoL)...
  2. pmc Self-reported sleep difficulties and self-care strategies among rural older adults
    Joanne C Sandberg
    Wake Forest School of Medicine, Winston Salem, NC, USA
    J Evid Based Complementary Altern Med 19:36-42. 2014
    ..This information may enable health care providers to communicate with the older patients about sleep difficulty strategies to minimize sleep problems. ..
  3. pmc Medical skepticism and complementary therapy use among older rural African-Americans and Whites
    Ronny A Bell
    Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
    J Health Care Poor Underserved 24:777-87. 2013
    ..This study documents demographic, health, and complementary therapy (CT) correlates of medical skepticism among rural older adults...
  4. pmc Measuring differential beliefs in complementary therapy research: an exploration of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI)
    Joseph G Grzywacz
    Department of Family and Community Medicine, Wake Forest School of Medicine, USA
    Complement Ther Med 20:54-60. 2012
    ..Revision and additional development of the CAMBI is needed to enable its use in more diverse research samples...
  5. pmc The relationship between cognitive function and non-prescribed therapy use in older adults
    Ha T Nguyen
    Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, USA
    Aging Ment Health 16:648-58. 2012
    ....
  6. pmc Older adults' self-management of daily symptoms: complementary therapies, self-care, and medical care
    Thomas A Arcury
    Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157 1084, USA
    J Aging Health 24:569-97. 2012
    ..To describe older adults' use of complementary therapies, self-care practices, and medical care to treat daily symptoms and to delineate gender, ethnic, age, and education differences...
  7. pmc Daily symptom management practices for arthritis used by older adults
    Sara A Quandt
    Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
    J Aging Health 24:598-615. 2012
    ..This article describes the daily self-management practices of older adults with arthritis and examines the association of symptom experience with the use of self-management behaviors...
  8. pmc Gender and health lifestyle: an in-depth exploration of self-care activities in later life
    Joseph G Grzywacz
    Wake Forest University School of Medicine, Winston Salem, NC, USA
    Health Educ Behav 39:332-40. 2012
    ..OBJECTIVE. Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural-dwelling women and men...
  9. pmc Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS)
    Rebecca H Neiberg
    Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest University School of Medicine, Medical Center Blvd, Winston Salem, NC 27157, USA
    J Altern Complement Med 17:363-70. 2011
    ..Second, it was determined whether dominant linkages of CAM modalities differ by age, gender, ethnicity, and education...
  10. pmc Calling the doctor: a qualitative study of patient-initiated physician consultation among rural older adults
    Eleanor Palo Stoller
    Department of Sociology, Wake Forest University, Winston Salem, NC 27109, USA
    J Aging Health 23:782-805. 2011
    ..rural adults: What symptom characteristics prompt patient-initiated physician consultation? Do participants' accounts of responses to symptoms, including the decision to consult a physician, incorporate descriptions of change over time?..
  11. pmc Daily use of complementary and other therapies for symptoms among older adults: study design and illustrative results
    Thomas A Arcury
    Wake Forest University School of Medicine, Winston Salem, NC, USA
    J Aging Health 23:52-69. 2011
    ..This article describes research designed to specify complementary therapies used among older adults by obtaining daily use data and the specific purposes for use...
  12. pmc Effects of complementary therapy on health in a national U.S. sample of older adults
    Ha T Nguyen
    Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
    J Altern Complement Med 16:701-6. 2010
    ..The study objectives were to identify types of complementary therapy that are most predictive of health outcomes, including functional status, physical health-related quality of life (HRQoL), and mental HRQoL among older adults...
  13. pmc Development of an international questionnaire to measure use of complementary and alternative medicine (I-CAM-Q)
    Sara A Quandt
    Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27157 1063, USA
    J Altern Complement Med 15:331-9. 2009
    ....
  14. pmc Complementary therapy use and health self-management among rural older adults
    Thomas A Arcury
    Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157 1084, USA
    J Gerontol B Psychol Sci Soc Sci 64:635-43. 2009
    ....
  15. pmc How do parents of children with juvenile idiopathic arthritis (JIA) perceive their therapies?
    Kelly Rouster-Stevens
    Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC, USA
    BMC Complement Altern Med 8:25. 2008
    ..Little is known about parents' perceptions of these therapies. This study describes the views of parents of patients with juvenile idiopathic arthritis (JIA) regarding conventional and CAM therapies...
  16. ncbi Age-related differences in the conventional health care-complementary and alternative medicine link
    Joseph G Grzywacz
    Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA
    Am J Health Behav 32:650-63. 2008
    ..To determine if differences in conventional care among users and nonusers distinct CAM therapies varies by age and ethnicity...