National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA.
Clinical Research in Complementary and Integrative Health Branch, National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA.
J Altern Complement Med. 2021 Jul;27(7):550-568. doi: 10.1089/acm.2020.0414. Epub 2021 Apr 20.
Complementary health approaches include herbal products and mind-body practices. Several studies have identified predictors for complementary health approach use, yet there are two gaps: (1) How does use change? (2) Do factors associated with use influence this change over time? Using the Midlife in the United States (MIDUS), we examined how sociodemographic factors affected use longitudinally, and whether these associations differed between new and continued/discontinued use of herbal products, meditation, chiropractic, and massage therapy. MIDUS is a national probability sample of adults aged 25 or older that has collected more than 20 years of longitudinal data, including the use of complementary health approaches. We employed the Andersen Model as a framework to identify predisposing, enabling, and health need factors associated with complementary health approach use based on previously identified and hypothesized factors. We ran Chi-square analyses to first test bivariate associations between our independent variables and four modalities to further guide logistic regression models. Each of the four approaches examined saw substantial increases in prevalent use. However, only about 25% to 38% of individuals continued use from one wave to the next, whereas only 2%-9% of individuals who did not use a given approach in a wave reported use in the subsequent wave. Age, spiritual importance, and previous wave one use were all significantly associated with new use across all four modalities. Previous wave one use was associated with continued/discontinued use for all modalities. Age and education were significantly associated with discontinued use of chiropractic. We present the first longitudinal analysis of complementary health approaches in a nationally representative sample. These data distinguish between new and continued/discontinued use of complementary health approaches over time and provide insights into the interpretation of complementary health approach prevalence data, as well as important predictors of use.
补充健康方法包括草药产品和身心实践。有几项研究已经确定了补充健康方法使用的预测因素，但存在两个差距：（1）使用情况如何变化？（2）与使用相关的因素是否会影响随着时间的推移而发生这种变化？我们使用美国中年（MIDUS）研究，考察了社会人口因素如何随时间纵向影响使用情况，以及这些关联是否因草药产品、冥想、脊骨神经医学和按摩疗法的新使用和持续/停止使用之间存在差异。MIDUS 是一项针对年龄在 25 岁或以上的成年人的全国概率抽样调查，已经收集了超过 20 年的纵向数据，包括补充健康方法的使用情况。我们采用安德森模型作为框架，根据先前确定和假设的因素，确定与补充健康方法使用相关的倾向因素、促成因素和健康需求因素。我们进行了卡方分析，首先测试我们的自变量与四种模式之间的双变量关联，以进一步指导逻辑回归模型。我们研究的四种方法都看到了流行使用的大幅增加。然而，只有约 25%至 38%的个体在下一个波次继续使用，而只有 2%至 9%的在一个波次中未使用特定方法的个体在下一个波次中报告使用。年龄、精神重要性和前一个波次的使用情况均与所有四种模式的新使用显著相关。前一个波次的使用与所有模式的持续/停止使用相关。年龄和教育与脊骨神经医学的停止使用显著相关。我们在全国代表性样本中首次进行了补充健康方法的纵向分析。这些数据区分了补充健康方法在一段时间内的新使用和持续/停止使用情况，并为补充健康方法流行率数据的解释提供了见解，以及使用的重要预测因素。
