NCCAM's 2005 Strategic Plan includes the exploration of organized health care delivery models which integrate complementary and alternative medicines (CAM) with conventional care. The 2007 National Health Interview Survey reports that approximately one in five adults use Herbs and non-vitamin Dietary Supplements (HDS). However, little is known about the number of inpatients in urban underserved hospitals who continue to use HDS while receiving treatment with allopathic medicines. Similarly, little is known about factors associated with potential HDS adverse events in hospital settings. Health information technology holds promise as an innovative and effective way to deliver HDS information to underserved patients and their physicians. This K07 application proposes essential first steps toward (1) developing a solid knowledge base about HDS use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based HDS information to underserved inpatients and their physicians, in particular through health information technology. The research objectives of this application are: (1) to contribute to the knowledge base about HDS use among minority inpatients;(2) to design culturally sensitive literacy-informed patient-centered information technology systems to teach about HDS;and (3) to develop a patient safety curriculum that will help clinicians document HDS use and communicate effectively with their patients about HDS. To achieve these objectives, this K07 application has three specific aims: (1) Investigate the association between HDS use, health literacy, medication use, and hospital utilization in a sample of 750 hospitalized patients;(2) Conduct a randomized clinical trial in sixty women who will receive a hospitalized discharge plan on cranberry delivered by a virtual patient advocate (a computerized, animated, empathic character), and a control group who receives the same information via a cranberry patient information sheet;and (3) Design, program, and evaluate a web-based HDS patient safety curriculum for clinicians, then utilize pre and post measures and chart reviews to assess its impact on clinician-patient HDS communication. Completion of this research will be supported by: (1) a core of highly skilled mentors and consultants;and (2) completion of a Graduate Certificate in Instructional Technology at the Boston University School of Education. The candidate's career goals are to become (1) an independent HDS research investigator and educator for underserved populations, and (2) a national leader in the use of health information technology for HDS patient and clinician education. To prepare herself to accomplish these career goals, as well as the research objectives outlined above, the candidate proposes (1) to undertake mentored training in patient safety, health care disparities, health literacy, and epidemiologic methods, and (2) to pursue course-working clinical trial design, statistical analysis, human subject protections, and online curriculum development. This award will effectively prepare the candidate to become a successful independently-funded HDS investigator, focused on the needs of underserved patients, and an expert in applying health information technology to the study and teaching of CAM.

Public Health Relevance

Despite widespread herb use, little is known about inpatient use of herbs and non-vitamin dietary supplements in urban underserved hospitals. In this K07 Academic Career Development application, the candidate proposes essential first steps toward (1) developing a solid knowledge base about herb use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based herbal information to underserved inpatients and their physicians using health information technology. Project Narrative Despite widespread herb use, little is known about inpatient use of herbs and non-vitamin dietary supplements in urban underserved hospitals. In this K07 Academic Career Development application, the candidate proposes essential first steps toward (1) developing a solid knowledge base about herb use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based herbal information to underserved inpatients and their physicians using health information technology.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07AT005463-05
Application #
8722445
Study Section
Special Emphasis Panel (ZAT1)
Program Officer
Weber, Wendy J
Project Start
2010-09-01
Project End
2015-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02118
Nguyen, Long T; Kaptchuk, Ted J; Davis, Roger B et al. (2016) The Use of Traditional Vietnamese Medicine Among Vietnamese Immigrants Attending an Urban Community Health Center in the United States. J Altern Complement Med 22:145-53
Gardiner, Paula; Sadikova, Ekaterina; Filippelli, Amanda C et al. (2015) Medical reconciliation of dietary supplements: don't ask, don't tell. Patient Educ Couns 98:512-7
Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia et al. (2015) The incorporation of stress management programming into family medicine residencies-results of a national survey of residency directors: a CERA study. Fam Med 47:272-8
Gardiner, Paula; Sadikova, Ekaterina; Filippelli, Amanda C et al. (2015) Stress Management and Relaxation Techniques use among underserved inpatients in an inner city hospital. Complement Ther Med 23:405-12
Gardiner, Paula; Filippelli, Amanda C; Kabbara, Karim et al. (2015) Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting. J Altern Complement Med 21:638-44
Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell et al. (2014) Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey. J Womens Health (Larchmt) 23:824-9
Gardiner, Paula; Adams, Denise; Filippelli, Amanda C et al. (2013) A systematic review of the reporting of adverse events associated with medical herb use among children. Glob Adv Health Med 2:46-55
Gardiner, Paula; Mitchell, Suzanne; Filippelli, Amanda C et al. (2013) Health literacy and complementary and alternative medicine use among underserved inpatients in a safety net hospital. J Health Commun 18 Suppl 1:290-7
Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia et al. (2013) Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies. Explore (NY) 9:299-307
Kemper, Kathi J; Gardiner, Paula; Birdee, Gurjeet S (2013) Use of complementary and alternative medical therapies among youth with mental health concerns. Acad Pediatr 13:540-5

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