To date suggest that complementary and alternative medicine (CAM) use is increasingly common among children and youth in the United States. However, national, population-based estimates and correlates of CAM use for all and diverse subgroups of children are not known. Especially incomplete is knowledge of health status, health services factors related to CAM use, prevalence among children with specific conditions, the impact of CAM on health outcomes and utilization and expenditures for allopathic care. This study has five specific aims.
Specific Aim 1 : Specify a pediatric CAM health services and policy research model relevant to address priority pediatric CAM health services and policy research questions, taking into account unique needs and characteristics of children and implications for data requirements and methods.
Specific Aim 2 : Develop and confirm the cognitive salience and construct validity of pediatric CAM survey modules suitable and feasible for use in one or more routinely collected population-based surveys.
Specific Aim 3 : Empirically evaluate the significance of key child level demographic, resource and need based factors that may predict the use of CAM in children, including the child's age, sex, race/ethnicity, family income, health insurance status, health status and other predisposing, enabling and need based factors historically used in evaluating conventional medical care services utilization.
Specific Aim 4 : Empirically evaluate the significance of parental and other health system factors that may predict the use of CAM in children, including parental demographics, perceptions of their child's health risk, parental self-care behaviors, parental reported use of CAM and parental perceptions of the quality of conventional medical care for their child.
Specific Aim 5 : Evaluate associations and the potential impact of CAM use in children on both their matched year and future year utilization and/or expenditures for conventional health services use and selected health outcomes. Overall, this study will place the use of CAM in children in the context of their health status, demographics and social characteristics and their use and experiences with conventional medical care. We will incorporate factors not studied together previously by capitalizing on new population-based survey data about children's use of CAM with a sufficiently large sample to permit studying many variables and their interactions simultaneously. Specifically, this study will use data from the 2007 National Health Interview Survey (NHIS), which for the fist time includes a CAM supplement to the child version. We will link this data at the child level to the 2007 adult NHIS/CAM supplement and other NHIS data as well as to the matched year Medical Expenditure Panel Survey dataset (MEPS). Study findings will contribute to the currently nascent foundation of health services knowledge to inform the increasing integration of CAM use into pediatric care and will be summarized in a series of peer reviewed publications and other products.
This study employs available national data to empirically evaluate factors associated with children's use of CAM and the potential impact of CAM use on outcomes and utilization of allopathic medicine. Standardized research models and methods will be developed to advance clinical, public health and translational health services research.
|Bethell, Christina; Gombojav, Narangerel; Solloway, Michele et al. (2016) Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems. Child Adolesc Psychiatr Clin N Am 25:139-56|
|Bethell, Christina; Kemper, Kathi J; Gombojav, Narangerel et al. (2013) Complementary and conventional medicine use among youth with recurrent headaches. Pediatrics 132:e1173-83|
|Stussman, Barbara J; Bethell, Christina D; Gray, Caroline et al. (2013) Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey. BMC Complement Altern Med 13:328|