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Whitley MD, Maiers M, Gallego-Pérez DF, Boden-Albala B, Coulter ID, Herman PM. Building Bridges Toward Common Goals - A Call for Greater Collaboration Between Public Health and Integrative, Complementary and Traditional Health Providers. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023:2752535X231195522. [PMID: 37587566 PMCID: PMC10869632 DOI: 10.1177/2752535x231195522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
This commentary makes the case for greater collaboration between public health professionals and integrative, complementary and traditional health practitioners (ICTHP). Previous partnerships have been successful, and more such collaborative work is needed to help overcome division, enhance the health workforce, and move all involved toward shared goals. ICTHP providers may be uniquely able to work across ideological differences and engage individuals and communities who are less trusting of public health, including those who are vaccine hesitant. Diverse partnerships can be difficult to maintain, but the application of equitable processes may aid their success. In the face of highly complex public health challenges, partnerships with ICTHP are critical.
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Affiliation(s)
| | - Michele Maiers
- RAND Corporation, Santa Monica, CA, USA
- Northwestern Health Sciences University, Bloomington, MN, USA
| | - Daniel F. Gallego-Pérez
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bernadette Boden-Albala
- Department of Health, Society, and Behavior, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA
- Department of Neurology, School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA, USA
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Baca KJ, Salsbury SA. Adverse childhood experiences and trauma informed care for chiropractors: a call to awareness and action. Chiropr Man Therap 2023; 31:30. [PMID: 37580756 PMCID: PMC10426155 DOI: 10.1186/s12998-023-00503-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.S. population report experiencing at least one ACE, with over 1 billion children experiencing abuse and neglect annually worldwide. Chronic exposure to stressful circumstances or multiple traumatic events has negative physiologic impacts. Persons who experience 3 or more ACEs in childhood are at greater risk of poor mental health outcomes and may be more likely to engage in high-risk behaviors, predisposing them to long-term health impacts, such as metabolic diseases, anxiety, depression, substance use, and chronic pain. Trauma informed care (TIC) is a recommended approach to healthcare delivery across professions, especially when a trauma history is suspected. This commentary aims to increase awareness of the impact of ACEs on health outcomes and introduce TIC concepts as they may apply to chiropractic care for adults with a history of ACEs. DISCUSSION This commentary reviews an introductory model (4R's: realize, recognize, respond, resist re-traumatization) as one TIC framework used by healthcare practitioners. Prior trauma can lessen trust, alter perceptions of physical touch, and hands-on examinations and chiropractic treatments may trigger stress responses. Using TIC after appropriate training, includes referrals to multidisciplinary providers to address trauma-related concerns outside the scope of chiropractic, and screening for ACEs if deemed appropriate. Creating safe spaces, communicating clearly, avoiding victimizing language, explaining procedures, asking for consent before physical contact, and giving patients choice and control in their own care may avoid triggering prior traumas. CONCLUSION Given the high worldwide prevalence of persons experiencing 3 or more ACEs, TIC principles are practical adaptations to chiropractic care for use with many patient populations. As TIC and ACEs are emerging concepts within chiropractic, students and practitioners are encouraged to undertake additional training to better understand these complex and sensitive topics. Exploratory research on the incidence, presentation, and impacts of various trauma types, including ACEs, to support adoption of TIC in chiropractic settings is essential.
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Affiliation(s)
- Kira J Baca
- Palmer College of Chiropractic, 1000 Brady St, Davenport, IA, 52803, USA.
| | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady St, Davenport, IA, 52803, USA
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Unlocking Athletic Potential: The Integration of Chiropractic Care into the Sports Industry and Its Impact on the Performance and Health of Athletes and Economic Growth in China and Hong Kong. Cureus 2023; 15:e37157. [PMID: 37034139 PMCID: PMC10075015 DOI: 10.7759/cureus.37157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
This study explores the significant role chiropractic care can play in the sports industry, with a focus on countries like China and Hong Kong. As a vital component of sports medicine, chiropractic care can enhance athletic performance, health, and competitiveness by addressing biomechanical imbalances and optimizing neuromuscular function. The potential impact of chiropractic care on the sports industry includes attracting international events and investments, leading to increased economic opportunities, and the overall growth of the industry. Key strategies for promoting chiropractic care in the sports industry encompass developing a robust chiropractic care infrastructure, raising public awareness through targeted campaigns, and implementing supportive policies by governments and sports organizations. The integration of chiropractic care within sports medicine not only benefits individual athletes but also contributes to the broader development and success of the sports industry as a whole.
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Grabowska W, Burton W, Kowalski MH, Vining R, Long CR, Lisi A, Hausdorff JM, Manor B, Muñoz-Vergara D, Wayne PM. A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research. BMC Musculoskelet Disord 2022; 23:844. [PMID: 36064383 PMCID: PMC9442928 DOI: 10.1186/s12891-022-05783-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls in older adults are a significant and growing public health concern. There are multiple risk factors associated with falls that may be addressed within the scope of chiropractic training and licensure. Few attempts have been made to summarize existing evidence on multimodal chiropractic care and fall risk mitigation. Therefore, the broad purpose of this review was to summarize this research to date. BODY: Systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, PEDro, and Index of Chiropractic Literature. Eligible study designs included randomized controlled trials (RCT), prospective non-randomized controlled, observational, and cross-over studies in which multimodal chiropractic care was the primary intervention and changes in gait, balance and/or falls were outcomes. Risk of bias was also assessed using the 8-item Cochrane Collaboration Tool. The original search yielded 889 articles; 21 met final eligibility including 10 RCTs. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. The overall methodological quality of identified studies and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk to qualitative synthesis. CONCLUSION Little high-quality research has been published to inform how multimodal chiropractic care can best address and positively influence fall prevention. We propose strategies for building an evidence base to inform the role of multimodal chiropractic care in fall prevention and outline recommendations for future research to fill current evidence gaps.
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Affiliation(s)
- Weronika Grabowska
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
| | - Wren Burton
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA.
| | - Matthew H Kowalski
- Osher Clinical Center for Integrative Medicine, Brigham and Women's Healthcare Center, 850 Boylston Street, Suite 422, Chestnut Hill, MA, 02445, USA
| | - Robert Vining
- Palmer Center for Chiropractic Research, 1000 Brady Street, Davenport, IA, 52803, USA
| | - Cynthia R Long
- Palmer Center for Chiropractic Research, 1000 Brady Street, Davenport, IA, 52803, USA
| | - Anthony Lisi
- Yale University Center for Medical Informatics, 300 George Street, Suite 501, New Haven, CT, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement Cognition and Mobility, Tel Aviv Sourasky Medical Center, Dafna St 5, Tel Aviv-Yafo, Israel
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, 1200 Centre Street, Boston, MA, 02131, USA
| | - Dennis Muñoz-Vergara
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
| | - Peter M Wayne
- Brigham and Women's Hospital and Harvard Medical School Division of Preventive Medicine, Osher Center for Integrative Medicine, 900 Commonwealth Avenue, 3rd Floor, Boston, MA, 02215, USA
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Amorin-Woods LG, Woods BL, Moore CS, Leach MJ, Kawchuk GN, Adams J. Research Priorities of the Australian Chiropractic Profession: A Cross-Sectional Survey of Academics and Practitioners. J Manipulative Physiol Ther 2022; 45:73-89. [PMID: 35760594 DOI: 10.1016/j.jmpt.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/08/2021] [Accepted: 03/17/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the research priorities of Australian practicing chiropractors and academics across a set of research domains to determine the agreement or disagreement based on these domains. METHODS We conducted a pilot-tested online survey focusing on the following 5 principal research domains: basic science, conditions (disorders chiropractors may encounter), patient subgroups, clinical interventions, and practice and public health/health services. Responses were sought regarding support for funding research scholarships, practice-based research networks, scientific conferences/symposia, journals, and existing research agendas. Data were collected (February 19 to May 24, 2019) from a sample of chiropractic academics (n1 = 33) representing 4 Australian programs and practicing chiropractors (n2 = 340). Collected data were ranked and analyzed to determine agreement across domains and items. RESULTS There was agreement between the 2 groups across the majority (>90%) of domain items. The closest agreement and highest rankings were achieved for the "clinical interventions and practice" and "conditions" domains. Disagreement was observed within specific domain items, such as patient subgroups (infants), and for 1 intervention (chiropractic-specific techniques). Disagreement also occurred outside of the main domains, including research agenda support and funding. CONCLUSIONS There was overall agreement between practicing chiropractors and academics across most research area domain items, which should help facilitate consensus-led development of any potential Australian Chiropractic research agenda. Disagreements across specific domain items, such as population subgroups, interventions, and funding require further investigation.
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Affiliation(s)
- Lyndon G Amorin-Woods
- Murdoch University Chiropractic Clinic/College of Science, Health, Engineering and Education (SHEE), Perth, Western Australia.
| | - Beau L Woods
- Private Practice, Perth, Western Australia, Australia
| | - Craig S Moore
- Department of Chiropractic, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, New South Wales, Australia
| | - Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales, Australia
| | | | - Jon Adams
- School of Public Health, University of Technology, Sydney, New South Wales, Australia
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Cupler ZA, Daniels CJ, Anderson DR, Anderson MT, Napuli JG, Tritt ME. Suicide prevention, public health, and the chiropractic profession: a call to action. Chiropr Man Therap 2021; 29:14. [PMID: 33853629 PMCID: PMC8048297 DOI: 10.1186/s12998-021-00372-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Suicide is a major public health concern that has wide-reaching implications on individuals, families, and society. Efforts to respond to a public health concern as a portal-of-entry provider can reduce morbidity and mortality of patients. The objective of this commentary is a call to action to initiate dialogue regarding suicide prevention and the role the chiropractic profession may play. DISCUSSION This public health burden requires doctors of chiropractic to realize current strengths and recognize contemporaneous deficiencies in clinical, research, and policy environments. With this better understanding, only then can the chiropractic profession strive to enhance knowledge and promote clinical acumen to target and mitigate suicide risk to better serve the public. CONCLUSION We implore the profession to transition from bystander to actively engaged in the culture of suicide prevention beholden to all aspects of the biopsychosocial healthcare model. The chiropractic profession's participation in suicide prevention improves the health and wellness of one's community while also impacting the broader public health arena.
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Affiliation(s)
- Zachary A Cupler
- Butler VA Health Care System, Butler, PA, USA.
- Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Boloori A, Arnetz BB, Viens F, Maiti T, Arnetz JE. Misalignment of Stakeholder Incentives in the Opioid Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7535. [PMID: 33081276 PMCID: PMC7589670 DOI: 10.3390/ijerph17207535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 12/14/2022]
Abstract
The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we explore evidence in the literature for the working hypothesis that misalignment rooted in the cost, quality, or access to care can be a significant contributor to the opioid epidemic. The review identified several problems that can contribute to incentive misalignment by compromising the triple aims (cost, quality, and access) in this epidemic. Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients' non-adherence to opioid substitution treatments. In discussing these issues, we also shed light on factors that can facilitate the alignment of incentives among stakeholders to effectively address the current crisis.
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Affiliation(s)
- Alireza Boloori
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA; (F.V.); (T.M.)
- Department of Family Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (B.B.A.); (J.E.A.)
| | - Bengt B. Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (B.B.A.); (J.E.A.)
| | - Frederi Viens
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA; (F.V.); (T.M.)
| | - Taps Maiti
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA; (F.V.); (T.M.)
| | - Judith E. Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (B.B.A.); (J.E.A.)
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The Chiropractic Research Priorities in Australia (ChiRPA) project: A study protocol. ADVANCES IN INTEGRATIVE MEDICINE 2020. [DOI: 10.1016/j.aimed.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Buettner-Schmidt K, Maack B, Larson M, Orr M, Miller DR, Mills K. Systems change to improve tobacco use identification and referral in the chiropractic setting: a pilot study. Chiropr Man Therap 2018; 26:45. [PMID: 30534361 PMCID: PMC6260883 DOI: 10.1186/s12998-018-0214-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/30/2018] [Indexed: 11/30/2022] Open
Abstract
Background Tobacco use remains a leading cause of death and disability in the United States. Health professionals need to address the use of tobacco products by their patients, but chiropractic clinical systems often remain unsupported and underappreciated in their role to facilitate tobacco use cessation. Methods This pilot study tested an intervention to assist a chiropractic community to implement sustainable health systems changes for tobacco use based on U.S. Public Health Service guidelines. Chiropractors were educated on the Ask, Advise, Refer (AAR) approach, provided with ongoing guidance, and followed for six months to assess systems change. The study was conducted from March 2016 to July 2017. Results Evidence of a systematic process in place to conduct AAR was present in all clinics by the end of the fourth month of the intervention period. Although no clinic had sustained health system change for full AAR, all six of the clinics made progress in the individual AAR components. Furthermore, five clinics achieved sustained system change for the Ask component, as after systems change was achieved, the rate of tobacco user identifications did not drop below 50%. For the Advise component, five clinics succeeded in having individual months of ≥50% of tobacco users being advised, and three clinics achieved the formal definition of systems change. For the Refer component, no clinic achieved system change, although four had individual months of ≥50% of tobacco users being referred. The patient quit rate was 13.3% (n = 15) for the 30-day follow-up and 16.7% (n = 6) for the three-month follow-up. Conclusions This study demonstrates the feasibility of implementing a health systems change in the chiropractic setting to identify tobacco users, to advise them to quit, and to refer users for cessation services.
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Affiliation(s)
- Kelly Buettner-Schmidt
- 1College of Health Professions, School of Nursing, North Dakota State University, 1919 University Drive North, D102, Fargo, ND 58102 USA
| | - Brody Maack
- 2College of Health Professions, School of Pharmacy, North Dakota State University, Fargo, ND 58102 USA
| | - Mary Larson
- 3College of Health Professions, Department of Public Health, North Dakota State University, Fargo, ND 58102 USA
| | - Megan Orr
- 4Department of Statistics, North Dakota State University, Fargo, ND 58102 USA
| | - Donald R Miller
- 2College of Health Professions, School of Pharmacy, North Dakota State University, Fargo, ND 58102 USA
| | - Katelyn Mills
- 5Roger Maris Cancer Center, Sanford Health, Fargo, ND 58102 USA
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