Minorities and CAM Use: A Health Services Perspective

Columbia University Health Sciences, New York NY

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Abstract

DESCRIPTION (provided by applicant): The broad goal of the proposed study is to further our understanding of how CAM utilization might contribute to eliminating disparities in health. Toward this end, this study explores how CAM use is associated with potential strategies for improving quality of care among minority populations: cultural competency of health care providers and health-promoting beliefs such as perceived control of one's health. Cultural competence is the incorporation of an awareness of health beliefs and behaviors, treatment outcomes, and the social context of different patient populations. Research on the nuances of medical pluralism, the use of multiple healing practices, would further our understanding of cultural competency needs. How does biomedical care relate to patients' decisions to use CAM? Are racial/ethnic differences in access to and quality of biomedical care associated with CAM use? How do biomedicine and CAM collectively relate to health outcomes? The proposed study examines medical pluralism in diverse racial/ethnic populations from a health services perspective. More specifically, this study aims to: 1) Examine how social factors - race/ethnicity, socioeconomic position, and gender - are associated with differences in CAM utilization and medical pluralism; 2) Explore the direct and mediating effects of locus of control on CAM use; 3) Assess the association between CAM utilization and various facets of biomedical care, including access, quality, patient-provider relationship, and cultural competence; and 4) Evaluate adherence to physician recommendations and disclosure of CAM utilization within a framework of medical pluralism. Analyses will be conducted within and between four racial/ethnic groups, non-Hispanic Whites, non-Hispanic African-Americans, non-Hispanic Asians, and Hispanics, using two national surveys. Hypotheses will be tested through secondary analysis of two national surveys: the 2002 National Health Interview Survey and the Commonwealth Fund's 2001 Health Care Quality Survey. Both datasets oversampled minority populations and include rich data on respondents' experiences with biomedical health care and a variety of CAM domains, such as herbalism, chiropractic, acupuncture, and traditional ethnomedical therapies.