Use and interest in complementary and alternative medicine among college students seeking healthcare at a university campus student health center

Complementary health approaches and dietary supplement use trends among U.S. college students: A brief report

OBJECTIVE

Examine differences over time in use of complementary health approaches (CHA) and dietary supplements among college students.

PARTICIPANTS

Two samples of undergraduate students (Sample 1, N = 370; Sample 2, N = 482) from a midsized Midwestern university.

METHOD

Using stratified random sampling, at two time points (spring 2008, spring 2019), students were surveyed. Frequency of CHA and supplement use in the past year were assessed and compared across the two time periods.

RESULTS

Of the CHAs compared, 53% had changed in frequency of use with only the practice of yoga significantly increasing. As for supplements, 78% changed in their frequency of use with the rate of melatonin being the only significant increase.

CONCLUSIONS

Although the reported use of many CHAs and supplements appeared to change in the time period between assessments, findings suggest that students still report using several CHA practices and, to a lesser extent, supplements.

International college students' perceptions on complementary and alternative medical practices

OBJECTIVE

The purpose of this study was to determine the complementary and alternative medicinal (CAM) choices of international college students in the U.S.

PARTICIPANTS

A total of 192 international college students participated in this study.

METHODS

Participants completed a survey with demographic and background information, such as gender, age, years living in the U.S., country of origin, cultural and religious influences on health decision-making, CAM usage, and the Complementary and Alternative Medicine Beliefs Inventory (CAMBI).

RESULTS

Results showed that there was a significant difference in CAMBI scores and age groups with those in the age groups of 20-29 and 30+ having higher CAMBI scores than those in the 18-19 age group. Participants had high scores on the CAMBI.

CONCLUSION

Overall, participants showed a wide range of CAM usage with most participants indicating a need for CAM options on university campuses.

Dietary Supplements: A Gateway to Doping?

Dietary supplements are widely used among athletes, but many may be unaware of the potential for unintentional doping, especially considering that supplements can often be contaminated with prohibited substances. The reason behind the widespread use of dietary supplements among athletes is often cited as being for the purposes of enhancing health or performance. However, many athletes turn to unreliable sources of information, and often lack knowledge of dietary supplement regulations. The aim of this narrative review is to explore the current research surrounding the psychological constructs (such as norms, attitudes, and beliefs) related to dietary supplement use among athletes that may lead to inadvertent doping. This review also covers possible programme structures that may be effective at preventing inadvertent doping.

Knowledge, attitude, perceived effectiveness and self-practice of complementary and alternative medicine: a cross-sectional comparison between medical and non-medical students of Bangladesh

BACKGROUND

Bangladesh's population commonly utilizes Complementary and alternative medicine (CAM) to treat their health issues. Despite the increasing interest in CAM, it has been excluded from conventional medical training in Bangladesh for many years. Therefore, this study assessed and compared the knowledge level, attitude, perceived effectiveness, and self-practice of CAM among undergraduate students of Bangladesh.

METHODS

This cross-sectional group comparison study was conducted among undergraduate (both medical and non-medical) students of Bangladesh between November and December 2021. Data was collected using a self-reported pretested semi-structured online questionnaire. The questionnaire contained questions regarding background information, knowledge regarding CAM, source of CAM knowledge, attitude towards CAM, interest in attaining CAM knowledge, perceived effectiveness of CAM, perceived adverse effects of CAM, self-practice of CAM, and whether would they refer CAM to others. A total of 576 students responded and the data gathered allowed for the following: (1) an overview of the study groups, (2) respondents' general perception and knowledge regarding CAM, and (3) a comparison of respondents' CAM knowledge, general perception, and usage by area of study. Data were analyzed using STATA (v.16) and descriptive statistics, Pearson's chi-square test, and Mann-Whitney U test were performed.

RESULTS

A total of 329 medical students and 247 non-medical students participated in the study. The mean age of the participants was 21.57 ± 1.8 years and 56.2% of them were male. The most known CAM among medical (M) students was homeopathy (44.6%) and among non-medical (NM) students were herbal medicine (45.7%). Non-medical students had significantly better knowledge about nine out of twelve CAM modalities included in the study, and no significant differences were present for the rest of the modalities. Medical (81.1%) and non-medical students (86.2%) perceived traditional Chinese medicine and homeopathy to be the most effective respectively. "Incorporating CAM with conventional medicine would result in increased patient satisfaction" showed the most statistically significant (p = 0.0002) difference among both groups. Yoga was the most often practiced modality among medical students and homeopathy among non-medical students.

CONCLUSION

Medical students have a lacking of knowledge and a positive attitude towards CAM, despite its very common practice among the people of Bangladesh. Therefore, emphasis should be put on the inclusion of CAM modules in medical training.

Meditative practices, stress and sleep among students studying complementary and integrative health: a cross-sectional analysis

Background

The International Cohort on Lifestyle Determinants of Health (INCLD Health) is an ongoing, prospective cohort study assessing the health behaviours and lifestyles of higher education students, including their use of specialty diets and complementary and integrative health (CIH) practices. Purpose: This cross-sectional analysis of the INCLD Health cohort aims to (1) evaluate the associations between perceived stress, sleep disturbance, and meditative practices with diurnal salivary free cortisol and (2) evaluate the associations of meditative practices as well as mind-body practices with perceived stress and sleep disturbance.

Methods

Serial multivariable linear regression models, adjusting for sociodemographic and lifestyle behaviours, were used to assess associations of (1) perceived stress, sleep disturbance, and meditative practices with salivary cortisol, and (2) meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Meditative and mind-body practices were evaluated using a stress-management and self-care survey; perceived stress and sleep disturbance were evaluated using the 10-item Perceived Stress Scale (PSS), and the patient reported outcome measures information system-29 (PROMIS-29) sleep sub-score respectively. Salivary cortisol was collected at 4 time points over a 24-hour period and area under the curve (AUC) calculations conducted.

Results

82.5% (n = 80) of participants utilized at least monthly meditative practices. Greater disturbed sleep, but not perceived-stress, meditative, nor mind-body practices was independently associated with increased AUC cortisol (b = 0.02, 95% CI: 0.002–0.05, p = 0.03) after adjusting for age, sex, race, ethnicity, and BMI. Neither meditative nor mind-body practices were associated with perceived stress or disturbed sleep.

Conclusions

Among INCLD Health participants, greater sleep disturbance, but not perceived stress or meditative practices were associated with daytime cortisol.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03582-5.

Experience With, Knowledge of, and Attitudes Toward Complementary and Alternative Medicine Among Pre-Nursing and Nursing Students

Our study explored pre-nursing and graduating nursing students' experience with, knowledge of, and attitude toward complementary and alternative medicine (CAM). Both pre-nursing and nursing students reported positive attitudes toward CAM in general, indicated being interested in learning about CAM, and planned on making CAM practices part of their future careers.

Academic education in health profession programs, knowledge and use of Complementary and Alternative Medicine (CAM) by university students

OBJECTIVES

To assess the association of academic education in health professions programs with the knowledge and use of Complementary and Alternative Medicine (CAM) by university students and to determine whether CAM can promote a healthy university environment.

METHODS

A cross-sectional study was carried out with 512 university students enrolled in health professions programs in the city of Fortaleza, Ceará, Brazil, from April to November 2017. The Assessment Tool for Health Promotion at the University was used to collect sociodemographic, academic and CAM data. Bivariate and multivariate analyses were performed considering the outcomes "knowledge of CAM" and "CAM in the promotion of a healthy university environment" using SPSS Statistic version 20.0.

RESULTS

Data from 512 participants were analyzed. Women (n = 357; 69.7%), young students (n = 393; 76.8%) and unemployed students (n = 429; 83.8%) predominated. Knowledge of CAM was associated with health profession program (OR = 0.934; p = 0.047), paternal education (OR = 0.641; p = 0.024), employment (OR = 0.542; p = 0.028) and participation in extracurricular activities (OR = 1.275; p = 0.007). There was a proportional difference between knowledge and use of CAM ranging from 2:1 to 11:1 among the 21 modalities. University students believed that CAM could promote a healthy university environment (p = 0.000), which was influenced by gender (OR = 2.089; p = 0.004) and knowledge of CAM (OR = 16.601; p = 0.000).

CONCLUSIONS

University students' knowledge of CAM was influenced by the health profession program, paternal education, employment and participation in extracurricular activities. The percentage of use of CAM modalities was lower than the percentage of knowledge. University students' belief that CAM could foster a healthy university environment is influenced by gender and knowledge of CAM.

A cross-sectional assessment of knowledge, attitudes and self-perceived effectiveness of complementary and alternative medicine among pharmacy and non-pharmacy university students

Background

Traditional medicine has always been Pakistan’s cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy.

Methods

A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22).

Results

Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones.

Conclusion

In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2503-y) contains supplementary material, which is available to authorized users.

The Use of Complementary and Alternative Medicine among Korean Young Adult Members of Fitness Centers

In general, the pattern and perception of complementary and alternative medicine (CAM) use in young people are little known. Particularly, given South Korea's dual health care system that includes both Korean traditional medicine and Western medicine, young adults in South Korea may be unique for the study of CAM use. Accordingly, this study investigated the modality, purpose, and perceptions of CAM use among young adults in South Korea and determined the predictors of CAM use. In addition, reasons for CAM use were compared to those for exercise. A survey was conducted among 649 young members of fitness centers (aged 20-39 years). The structured written questionnaire included the questions related to use of 30 CAM modalities, satisfaction with CAM use, factors associated with CAM use, reasons for exercise and CAM use, and perceptions of CAM. The most common therapies used in lifetime were acupuncture, massage, moxibustion/cupping, yoga, and diet-based therapies. The most satisfied therapy was massage followed by aroma therapy. The main reasons for using CAM were to relieve musculoskeletal pains while those for doing exercise were to lose weight, to promote health, and to have a positive body image. Multiple logistic regression analysis revealed that higher education level, having a religion, and having a health problem were significant independent predictors of CAM use after controlling for other factors. The majority of respondents reported "relief of pain and symptoms" as the perceived effect of CAM and "lack of advertising" as the weakness of CAM. The majority of respondents got CAM information from mass media and Internet. In conclusion, CAM use is significantly associated with education level, religious status, and health status in Korean young adult members of fitness centers. The main purposes of utilizing CAM and performing exercise are different.

Differences among health care students' attitudes, knowledge and use of dietary supplements: a cross-sectional study

OBJECTIVES

The objectives of this study were to evaluate the difference among pharmacy, dental and medical students' attitudes, knowledge and use of dietary supplements. Furthermore, factors likely to influence their personal use and willingness to recommend supplement to patient were investigated.

DESIGN

A cross-sectional survey study.

SETTING

The study was carried out at a single university.

MAIN OUTCOME MEASURES

Survey gathered socio-demographic data and questioned students' attitudes, knowledge and use of dietary supplements.

RESULTS

A total of 506 students were included in the study. Pharmacy students showed more positive attitudes about dietary supplements, and achieved higher knowledge scores when compared to dental or medical students (p < 0.001). Medical students were more likely to use evidence based sources of information about dietary supplements. There was no difference in supplements use across study programs (p = 0.177). As many as 59.7% of students that participated in the study reported using dietary supplements. Data analysis showed that the previous personal use supplements was a significant independent predictor whether students would recommend supplements to their patients (OR 27.03, 95% CI 14.08-50, p < 0.001).

CONCLUSIONS

Students' education did not influence their personal use of dietary supplements. However, their personal experience seems to influence their willingness to recommend supplements to patients. Pharmacy students showed greater knowledge about supplements than their dental or medical colleagues. In future practice, health care students could benefit from collaboration with pharmacists when they provide care to patients seeking advice about the use of dietary supplements.

Use of Mind-Body Therapies Among Young Adults Aged 18-24 Years: Findings From the 2012 National Health Interview Survey

PURPOSE

To investigate the prevalence, patterns, and satisfaction of use of mind-body therapies (MBTs) in a nationally representative sample of young adults (ages 18-24 years).

METHODS

Young adults interviewed in the 2012 National Health Interview Survey were analyzed (n = 3,286). Individual types (e.g., mindfulness) and a combined measure of use of any MBT were assessed. Reasons for and satisfaction with use was also investigated. Design-based F tests and logistic regression were used; all analyses were weighted and stratified by gender.

RESULTS

Overall, 14.6% of young adults used MBT in the past year (9.6% of men and 19.1% of women, p < .001). Among men, higher levels of education, greater numbers of health conditions, and healthy behaviors were associated with greater odds of MBT use. Among women, Latina and black women had lower odds of use (vs. white). Higher education, greater mental distress, and greater numbers of health conditions and healthy behaviors were associated with greater odds of use. While both men and women reported stress reduction and general wellness as top reasons for use, men also reported the use to improve athletic performance.

CONCLUSIONS

Young adulthood is a critical period in the life course when individuals are establishing lifestyle and health behaviors that can be enduring. Because stress is a persistent problem, and many MBTs can be helpful with management of stress and anxiety, young adult may be underutilizing these modalities. Public health and educational strategies for greater engagement in MBT among young adults are warranted.

Dietary supplement use, perceptions, and associated lifestyle behaviors in undergraduate college students, student-athletes, and ROTC cadets

OBJECTIVE

To identify the prevalence of dietary supplement (DS) use, perceptions of DS efficacy, and lifestyle behaviors of DS users and non-users.

PARTICIPANTS

Undergraduate students, student-athletes, and ROTC cadets at a Midwestern University between September 2014 and January 2015.

METHODS

A cross-sectional online survey was administered. Analysis included descriptive statistics, chi-square, and independent sample t-tests.

RESULTS

At least 50% of respondents from each group reported DS use. Users generally reported favorable perceptions of efficacy. Undergraduate student DS users reported more exercise and more healthful dietary habits compared to non-users; however, nearly 72% of undergraduates who reported tobacco use also reported DS use. Less significant differences were observed in the student-athlete and cadet samples.

CONCLUSIONS

DS use is common on college campuses, and many DS users report favorable perceptions of efficacy. With the exception of tobacco use, collegiate DS users generally report lifestyles that are as healthy or healthier than non-users.

Elevated salivary IgA, decreased anxiety, and an altered oral microbiota are associated with active participation on an undergraduate athletic team

BACKGROUND

Previous reports indicate that regular, but not excessive, exercise can moderate the response to anxiety and alter the immune response, therefore we hypothesized that college student athletes who were actively participating on an NCAA Division III athletics team ("in-season") would have lower levels of anxiety and higher salivary IgA levels than similar college athletes who were in their "off-season". NCAA Division III athletes participate in athletics at a level of intensity that is more moderate compared to other NCAA divisions. Alterations in the microbiome have been associated with alterations in psychosocial well-being and with exercise. Therefore, we also proposed that the oral microbiota would be different in "in-season" versus "off-season" athletes.

METHOD

In this pilot study, nineteen female students participating on a NCAA Division III athletic team (hockey="in-season"; soccer="off-season") were compared for level of fitness (modified Balke test of VO₂ max), salivary IgA levels by immunoassay, anxiety (using a GAD-7 survey), salivary cortisol levels by immunoassay, and numbers of culturable bacteria by growth of CFU/ml on blood agar, mitis salivarius agar and Staphylococcus 110 agar.

RESULTS

The proportion of subjects reporting "severe anxiety" on an anxiety scale (GAD-7) were significantly greater in the "off-season" group compared to the "in-season" group (p=0.047, Chi-squared test). "In-season" athletes had significantly higher salivary IgA/total protein levels than "off-season" athletes (one-sided Student's t-test; p=0.03). Cortisol levels were not significantly different in the two groups. The total culturable bacteria counts were higher among "in-season" athletes (p=0.0455, Wilcoxon Rank Sum test), as measured by CFUs on blood agar plates, an estimate of total culturable bacteria, including pathogenic and non-pathogenic bacteria. In contrast, there was a decrease in the growth of bacteria from the oral cavity of the "in-season" athletes, when the growth of bacteria on mitis salivarius agar (primarily oral streptococcus) was measured (p=0.0006, Wilcoxon Rank Sum test). There was a negative correlation (Spearman Rank correlation coefficient=-0.651, p=0.0018 one-sided) between high IgA levels and the growth of bacteria on mitis salivarius agar in the combined group of "in-season" and "off-season" athletes, suggesting a protective response of high IgA levels to the typical oral pathogenic bacteria. Anxiety levels (GAD-7) in the "in-season" group were positively correlated with growth of oral bacteria on blood agar (Spearman Rank correlation coefficient of 0.622 for "in-season", p value=0.033 one-sided) and mitis salivarius agar (Spearman Rank correlation coefficient=0.671 for "in-season, p value=0.021 one-sided), and negatively correlated in "off-season" athletes on blood agar (-0.689 for "off-season", p value=0.028 one-sided), supporting the hypothesis that the microbiota are distinct in "in-season" and "off-season" athletes and may be associated with anxiety levels.

CONCLUSION

These findings are supportive of the hypothesis that participation in college level athletics has a positive effect on student-athlete health, specifically enhanced protective oral immunity, reduced anxiety, and alterations in oral microbial populations.