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A multivariate test of an expanded Andersen Health Care utilization model for complementary and alternative medicine (CAM) use in African Americans.对非裔美国人使用补充和替代医学(CAM)的扩展安徒生医疗保健利用模型进行的多变量测试。
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在美国一个地域多样的辖区内,比较包含或不包含祈祷作为一种方式的补充和替代医学的使用情况。

Comparing Complementary and Alternative Medicine Use with or without Including Prayer as a Modality in a Local and Diverse United States Jurisdiction.

作者信息

Robles Brenda, Upchurch Dawn M, Kuo Tony

机构信息

Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA; Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA.

Department of Community Health Sciences, UCLA Fielding School of Public Health , Los Angeles, CA , USA.

出版信息

Front Public Health. 2017 Mar 21;5:56. doi: 10.3389/fpubh.2017.00056. eCollection 2017.

DOI:10.3389/fpubh.2017.00056
PMID:28377918
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5359242/
Abstract

OBJECTIVES

Few studies to date have examined the utilization of complementary and alternative medicine (CAM) in a local, ethnically diverse population in the United States (U.S.). Fewer have addressed the differences in their use based on inclusion or exclusion of prayer as a modality. Variable definitions of CAM are known to affect public health surveillance (i.e., continuous, systematic data collection, analysis, and interpretation) or benchmarking (i.e., identifying and comparing key indicators of health to inform community planning) related to this non-mainstream collection of health and wellness therapies. The present study sought to better understand how including or excluding prayer could affect reporting of CAM use among residents of a large, urban U.S. jurisdiction.

DESIGN

Using population-weighted data from a cross-sectional Internet panel survey collected as part of a larger countywide population health survey, the study compared use of CAM based on whether prayer or no prayer was included in its definition. Patterns of CAM use by socio-demographic characteristics were described for the two operationalized definitions. Multivariable binomial regression analyses were performed to control for gender, age, race/ethnicity, education, employment, income, and health insurance status. One of the analyses explored the associations between CAM use and racial/ethnic characteristics in the study sample.

SETTING

Los Angeles County, California.

SUBJECTS

A socio-demographically diverse sample of Los Angeles County residents.

OUTCOME MEASURES

CAM use (with prayer) and CAM use (excluding prayer).

RESULTS

Blacks were among the highest users of CAM when compared to Whites, especially when prayer was included as a CAM modality. Regardless of prayer inclusion, being a woman predicted higher use of CAM.

CONCLUSIONS

How CAM is defined matters in gauging the utilization of this non-mainstream collection of therapies. Given that surveillance and/or benchmarking data are often used to inform resource allocation and planning decisions, results from the present study suggest that when prayer is included as part of the CAM definition, utilization/volume estimates of its use increased correspondingly, especially among non-White residents of the region.

摘要

目标

迄今为止,很少有研究在美国一个种族多样化的当地人群中调查补充和替代医学(CAM)的使用情况。更少的研究探讨了将祈祷作为一种治疗方式纳入或排除在CAM中所导致的使用差异。已知CAM的不同定义会影响与这种非主流健康和保健疗法相关的公共卫生监测(即持续、系统的数据收集、分析和解释)或基准设定(即识别和比较健康关键指标以指导社区规划)。本研究旨在更好地了解纳入或排除祈祷如何影响美国一个大型城市辖区居民对CAM使用情况的报告。

设计

该研究使用了作为更大范围的全县人口健康调查一部分收集的横断面互联网小组调查的人口加权数据,比较了基于CAM定义中是否包含祈祷的CAM使用情况。针对两个实施的定义,描述了按社会人口统计学特征划分的CAM使用模式。进行多变量二项式回归分析以控制性别、年龄、种族/民族、教育程度、就业情况、收入和健康保险状况。其中一项分析探讨了研究样本中CAM使用与种族/民族特征之间的关联。

地点

加利福尼亚州洛杉矶县。

研究对象

洛杉矶县居民的一个社会人口统计学多样化样本。

观察指标

CAM使用情况(包含祈祷)和CAM使用情况(不包含祈祷)。

结果

与白人相比,黑人是CAM的最高使用者之一,尤其是当祈祷被纳入CAM治疗方式时。无论是否包含祈祷,女性使用CAM的比例更高。

结论

在衡量这种非主流治疗方法的使用情况时,CAM的定义很重要。鉴于监测和/或基准数据通常用于为资源分配和规划决策提供信息,本研究结果表明,当祈祷被纳入CAM定义时,其使用的利用率/数量估计相应增加,尤其是在该地区的非白人居民中。