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Yi EHG, Jang Y, Liang J. Utilization of Traditional Complementary and Alternative Medicine Across Ethnically Diverse Asian Americans. J Immigr Minor Health 2024; 26:527-538. [PMID: 38334856 DOI: 10.1007/s10903-024-01583-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations.
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Affiliation(s)
- Eun-Hye Grace Yi
- Department of Social Work, California State University, Fullerton, CA, USA.
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jiaming Liang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Xiong SQ, Chen Y, Wang LJ, Lyu PP, Liao W, Wang C, Ke JL, Zhu X, Wang JY, Shen XY, Li GP, Lin LZ. Usage of Chinese Herbs in Cancer Patients in Southern China: A Survey. Chin J Integr Med 2020; 27:502-508. [PMID: 32388824 DOI: 10.1007/s11655-019-3184-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study the use of Chinese medicine (CM) in cancer patients in southern China. METHODS A total of 1,950 cancer patients finished questionnaires in four provinces in southern China. The survey included socio-demographic and clinical characteristics of participants, dosage forms, efficacy, and side effects. RESULTS The study results showed that cancer patients with higher education (>12 years) were more likely to accept the treatment of Chinese herbs. There were 54.61% (1,065 cases) of patients chose Chinese herbs for the initial treatment and 14.46% (282 cases) chose Chinese herbs as monotherapy. Most patients (54.51%, 1,063 cases) continuously used CM for more than 6 months, and a few of them (212 cases) used CM for up to 3 years. All kinds of dosage forms of CM had been used, including CM decoction, CM patent prescription and CM injection. Concerning the efficacy in the view of patients, 40.31% (786 cases) believed that it would be effective to take Chinese herbs before they starting the anti-cancer treatment, and the percentage increased to 81.08% after 1-month CM treatment. The effect of Chinese herbs was mainly demonstrated by symptom relief and improvement of quality of life, and 8.31% (162 cases) of patients experienced control of tumor growth and decreased tumor markers. Furthermore, only 14.31% (279 cases) participants reported that they experienced side effects during CM treatment. CONCLUSION This large scale investigation reflects the current situation of domestic CM usage objectively and comprehensively, which might provide new ways for cancer treatment.
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Affiliation(s)
- Shao-Quan Xiong
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Yu Chen
- Department of Oncology, Friendship Hospital of Sichuan Provincial People's Hospital, Sichuan Province, Chengdu, 610000, China
| | - Li-Juan Wang
- Department of Oncology, Traditional Chinese Medicine Hospital of Shaanxi Province, Shaanxi Province, Xi'an, 710000, China.,School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Sichuan Province, Chengdu, 610075, China
| | - Pan-Pan Lyu
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Wan Liao
- State Key Laboratory of Characteristic Chinese Drug Resources in Southwest China, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Cui Wang
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Jian-Long Ke
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Xi Zhu
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Jin-Yang Wang
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Xian-Ying Shen
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Guang-Ping Li
- Department of Oncology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China
| | - Li-Zhu Lin
- Department of Oncology, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, China.
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Corsi MP, Jackson JD, McCarthy BC. Cultural Competence Considerations for Health-System Pharmacists. Hosp Pharm 2019; 54:385-388. [PMID: 31762486 PMCID: PMC6852030 DOI: 10.1177/0018578718809259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: An introduction to cultural competency is provided for health system pharmacists, including communication tools and considerations to personalize care for diverse patient populations. Summary: Disparities in patient outcomes, health care utilization, and treatment adherence exist across diverse patient populations in the United States. Cultural competence of health system pharmacists is important to optimize medication use in diverse patient populations. The LARA (Listen, Affirm, Respond, and Add) methodology, Kleinman's explanatory model, and the teach-back method are communication tools to facilitate culturally integrated discussions with patients. Health system pharmacists should be cognizant of cultural considerations that may emphasize spiritual care, nonpharmacologic therapy, patient privacy, and potential distrust of health care professionals. Conclusion: Health system pharmacists should strive to increase awareness of the impact that cultural beliefs and traditions have on patient care.
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Nimesh VV, Halder A, Mitra A, Kumar S, Joshi A, Joshi R, Pakhare A. Patterns of healthcare seeking behavior among persons with diabetes in Central India: A mixed method study. J Family Med Prim Care 2019; 8:677-683. [PMID: 30984694 PMCID: PMC6436270 DOI: 10.4103/jfmpc.jfmpc_433_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Management of diabetes is complex and requires multiple lifestyle modifications, drug therapy, and a sustained regular follow-up. Complexities of health-seeking pattern in individuals with diabetes have been poorly characterized. Objectives: To understand the health-seeking patterns, and reasons of provider preference and switching among persons with diabetes. Materials and Methods: We performed a mixed methods study in an urban slum setting of Bhopal. This urban slum was chosen as being a field practice area of the institute, a complete sampling frame with listing of households, and individuals with chronic disease conditions (including diabetes) was available. To be included in the study, the individual should have been an adult, aged ≥20 years, and diagnosed as type 2 diabetes mellitus. Descriptive statistical analysis of sociodemographic and disease management variables was performed. For qualitative component, interviews were transcribed and primary coding was done by two investigators followed by condensation of codes into themes or categories. The frequency of these content categories was presented with count and proportions. Results: In total, 60 individuals with diabetes were interviewed. Of all individuals, 36 (60%) were asymptomatic at the time of the first diagnosis, and 57 (95%) were currently under treatment from some healthcare provider. About 25 (41.6%) switched their first provider and remaining continued with the same provider. Second provider was sought by 9 (36%) of 25 patients. Reasons for switching were perceived nonrelief, cost of care, distance of facility, and behavior of care provider. Conclusions: Healthcare provider switching is common among persons with diabetes which has implications on continuity of care.
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Affiliation(s)
- V V Nimesh
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Anupam Halder
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arun Mitra
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sanjeev Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rajnish Joshi
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Abhijit Pakhare
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, French SD. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap 2017; 25:35. [PMID: 29201346 PMCID: PMC5698931 DOI: 10.1186/s12998-017-0165-8] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022] Open
Abstract
Background Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Methods Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition. Results The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). Conclusions This comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.
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Affiliation(s)
| | - Jessica J. Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Deborah A. Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
| | - Nir Ben Simon
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - André E. Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, Canada
| | - Silvano A. Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Simon D. French
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
- Department of Chiropractic, Macquarie University, Sydney, Australia
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Here or There: Recent U.S. Immigrants’ Medical and Dental Tourism and Associated Factors. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2017; 48:148-165. [DOI: 10.1177/0020731417732780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Applying Andersen’s health care utilization model, this paper shows the prevalence of immigrants’ medical and dental tourism and associated factors. An analysis of the 2003 New Immigrant Survey data shows that about 17% of immigrants received medical care in a foreign country, whereas about one-third obtained dental care outside the United States. Latino immigrants have a higher prevalence of both types of tourism than their Asian counterparts. Race, level of education, and health insured status are commonly associated with medical and dental tourism. The findings contribute to the scarce literature on immigrants’ health care utilization and medical and dental tourism.
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First-generation Korean immigrants' barriers to healthcare and their coping strategies in the US. Soc Sci Med 2016; 168:93-100. [PMID: 27639484 DOI: 10.1016/j.socscimed.2016.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 08/29/2016] [Accepted: 09/07/2016] [Indexed: 11/22/2022]
Abstract
This paper examines first-generation Korean immigrants' barriers to healthcare in the US and their strategies for coping with these issues by analyzing survey data from 507 Korean immigrants and in-depth interviews with 120 Korean immigrants in the New York-New Jersey area. It reports that more than half of Korean immigrants have barriers to healthcare in the US, with the language barrier being the most frequent response, followed by having no health insurance. Korean immigrants are not passive, but rather active entities who display coping strategies for these barriers, such as seeing co-ethnic doctors in the US, seeking Hanbang (traditional Korean medicine) in the US, and taking medical tours to the home country. However, their coping strategies are far removed from formal US healthcare as their behaviors are still restricted to the informal healthcare within the ethnic community or home country. This study methodologically and theoretically contributes to the literature on immigrants' healthcare behaviors by using a mixed-method approach and developing a specific framework for one particular immigrant group.
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Li J, Maxwell AE, Glenn BA, Herrmann AK, Chang LC, Crespi CM, Bastani R. Healthcare Access and Utilization among Korean Americans: The Mediating Role of English Use and Proficiency. INTERNATIONAL JOURNAL OF SOCIAL SCIENCE RESEARCH 2016; 4:83-97. [PMID: 29057278 PMCID: PMC5647155 DOI: 10.5296/ijssr.v4i1.8678] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization but studies on the relationships among length of stay in the US, English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the US and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N = 555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the US on having health insurance was significantly mediated by English use and proficiency (indirect effect = 0.166, SE = 0.07, p<.05; direct effect = 0.296, SE = 0.13, p<.05). Proportion of lifetime in the US was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population.
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Affiliation(s)
- Jiang Li
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-8954
| | - Annette E Maxwell
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-794-9282
| | - Beth A Glenn
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9715
| | - Alison K Herrmann
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-8483
| | - L Cindy Chang
- Jonsson Comprehensive Cancer Center and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-204-9038
| | - Catherine M Crespi
- Department of Biostatistics, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9364
| | - Roshan Bastani
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9266
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Gardiner P, Whelan J, White LF, Filippelli AC, Bharmal N, Kaptchuk TJ. A systematic review of the prevalence of herb usage among racial/ethnic minorities in the United States. J Immigr Minor Health 2014; 15:817-28. [PMID: 22723252 DOI: 10.1007/s10903-012-9661-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Clinical studies display a wide range of herb use prevalence among racial/ethnic minorities in the United States. We searched databases indexing the literature including CINAHL, EMBASE, Global Health, CAB Abstracts, and Medline. We included studies that reported herbal medicine prevalence among ethnic minorities, African American, Hispanic, or Asian adults living in the United States. Data from 108 included studies found the prevalence of herb use by African Americans was 17 % (range 1-46 %); for Hispanics, 30 % (4-100 %); and for Asians, 30 % (2-73 %). Smaller studies were associated with higher reported herb use (p = 0.03). There was a significant difference (p = 0.01) between regional and national studies with regional studies reporting higher use. While herb usage surveys in racial/ethnic minorities show great variability, indications suggest high prevalence. More research is needed to understand herb use among ethnic/racial minorities, reasons for use, and barriers to disclosure of use to clinicians.
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA.
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Huh J, Delorme DE, Reid LN, Kim J. Korean Americans' prescription drug information seeking and evaluation and use of different information sources. JOURNAL OF HEALTH COMMUNICATION 2013; 18:498-526. [PMID: 23472746 DOI: 10.1080/10810730.2012.743623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found.
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Affiliation(s)
- Jisu Huh
- School of Journalism and Mass Communication, University of Minnesota, Murphy Hall 338, 206 Church Street SE, Minneapolis, MN 55455, USA.
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Ayers SL, Kronenfeld JJ. Using factor analysis to create complementary and alternative medicine domains: An examination of patterns of use. Health (London) 2010; 14:234-52. [DOI: 10.1177/1363459309347491] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research on complementary and alternative medicine (CAM) in the United States has relied heavily on the National Center for Complementary and Alternative Medicine’s (NCCAM) domains of CAM but with noted limitations. We conducted a multifaceted examination of previous CAM domains and tested if they represent actual patterns of CAM use. The data come from the 2002 United States’ National Health Interview Survey and include 30,923 adults. Outcome measures included 20 types of CAM used in the last 12 months. Both exploratory and confirmatory factor analysis were used to test how CAM modalities should be categorized. Results indicate that prayer should be created as a new domain apart from Mind—Body Medicine. Herbs and vitamins fit best with Alternative Medical Systems while acupuncture best fits with chiropractic and massage. These findings suggest that how types of CAM have been previously categorized in earlier research is inconsistent with actual patterns of CAM utilization.These findings provided a framework for conducting and analyzing future CAM research, both in the USA and in other countries, and should be used in future research to try to explain and understand the variation and predictors of CAM utilization.
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Manheimer E, Wieland S, Kimbrough E, Cheng K, Berman BM. Evidence from the Cochrane Collaboration for Traditional Chinese Medicine therapies. J Altern Complement Med 2009; 15:1001-14. [PMID: 19757977 PMCID: PMC2856612 DOI: 10.1089/acm.2008.0414] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Cochrane Collaboration, an international not-for-profit organization that prepares and maintains systematic reviews of randomized trials of health care therapies, has produced reviews summarizing much of the evidence on Traditional Chinese Medicine (TCM). Our objective was to review the evidence base according to Cochrane systematic reviews. METHODS In order to detect reviews focusing on TCM, we searched the titles and abstracts of all reviews in Issue 4, 2008 of the Cochrane Database of Systematic Reviews. For each review, we extracted data on the number of trials included and the total number of participants. We provided an indication of the strength of the review findings by assessing the reviewers' abstract conclusions statement. We supplemented our assessment of the abstract conclusions statements with a listing of the comparisons and outcomes showing statistically significant meta-analyses results. RESULTS We identified 70 Cochrane systematic reviews of TCM, primarily acupuncture (n = 26) and Chinese herbal medicine (n = 42), and 1 each of moxibustion and t'ai chi. Nineteen (19) of 26 acupuncture reviews and 22/42 herbal medicine reviews concluded that there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment, while the remaining 7 acupuncture and 20 herbal medicine reviews and each of the moxibustion and t'ai chi reviews indicated a suggestion of benefit, which was qualified by a caveat about the poor quality and quantity of studies. Most reviews included many distinct interventions, controls, outcomes, and populations, and a large number of different comparisons were made, each with a distinct forest plot. CONCLUSIONS Most Cochrane systematic reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine's benefits to certain patient populations, underscoring the importance and appropriateness of further research. These preliminary findings should be considered tentative and need to be confirmed with rigorous randomized controlled trials.
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Affiliation(s)
- Eric Manheimer
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD 21207, USA.
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How Does Acculturation Affect the Use of Complementary and Alternative Medicine Providers Among Mexican- and Asian- Americans? J Immigr Minor Health 2008; 12:302-9. [DOI: 10.1007/s10903-008-9171-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 07/22/2008] [Indexed: 10/21/2022]
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Grzywacz JG, Suerken CK, Neiberg RH, Lang W, Bell RA, Quandt SA, Arcury TA. Age, ethnicity, and use of complementary and alternative medicine in health self-management. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2007; 48:84-98. [PMID: 17476925 DOI: 10.1177/002214650704800106] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Drawing on models of health self-management, we develop hypotheses that age and ethnicity will modify associations among indicators ofpoor health and use of complementary and alternative medicine. These hypotheses are evaluated using the 2002 National Health Interview Survey with the Alternative Health Supplement. Results produced partial support for hypotheses that the effects of ailments on use of complementary and alternative medicine differ by age. Results suggest that ailments such as bodily pain, chronic conditions, and functional impairment are associated with use of complementary and alternative medicine among midlife and younger adults, but these associations are generally attenuated among older adults. Hypothesized ethnic differences received weak support. These findings suggest that different interpretations of ailments and appropriate responses may explain why complementary and alternative medicine is used by fewer older adults. The results also highlight the significance of social and cultural factors in understanding patterns of complementary and alternative medicine use in the adult population.
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Affiliation(s)
- Joseph G Grzywacz
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA.
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