Complementary and alternative medicine (CAM) is widely used among older adults. However, overall levels of CAM use and specific modalities used among elders differ by ethnicity, gender and age. Neither the causes of ethnic differences in CAM use nor the effects of CAM use on ethnic differences in the health status or quality of life have been clearly identified. Few studies of CAM use are conceptually driven, and most do not explore the social or cultural factors related to CAM use. Studies have not examined specific CAM use behaviors; rather, they rely on self-reports of use in the past month or past year without trying to measure the actual frequency of CAM modality use or the predictors of specific CAM modality use. Population based studies of CAM use have not measured how specific CAM therapy use is related to health status or quality of life among older adults or minority group members. The overall goals of this project are to delineate ethnic differences in the CAM therapies used by rural elders and to determine ethnic differences in how these modalities are incorporated into health self-management. To attain these goals, this project will: (1) delineate the cognitive models of CAM among African American and white rural older adults that shape health self-management (components of these cognitive models include knowledge and beliefs about CAM modalities, information sources about CAM modalities, the purposes for which these modalities are used, the reasons for using these modalities, and how they are integrated into conventional health care); (2) determine the actual use of CAM modalities among African American and white rural elders; (3) delineate how the use of CAM modalities among African American and white elders affects the use of conventional medical care, and (4) determine the association of CAM modality use among African American and white rural elders with health-related quality of life. This research is structured by a conceptual framework that integrates concepts of health self-management with concepts from cognitive models of health. The design includes two components. First, in-depth interviews will be completed with 64 rural African American and white elders. Second, 6 times at monthly intervals structured interviews will be completed for 3 consecutive days with a sample of 200 rural African American and white elders. This project addresses health disparities by investigating why and how ethnic and racial minority populations use CAM. It reflects the recommendations of the lOM's Committee on the Use of Complementary and Alternative Medicine by the American Public to use quantitative and qualitative methods to examine sociocultural dimensions of illness and health care- seeking processes and preferences, how well CAM users adhere to treatment guidelines, and how individuals evaluate information about CAM modalities. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Project (R01)
Project #
5R01AT003635-02
Application #
7291655
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Weber, Wendy J
Project Start
2006-09-30
Project End
2010-09-29
Budget Start
2007-09-30
Budget End
2008-09-29
Support Year
2
Fiscal Year
2007
Total Cost
$401,863
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Family Medicine
Type
Schools of Medicine
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
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Sandberg, Joanne C; Grzywacz, Joseph G; Suerken, Cynthia K et al. (2015) Older adults' use of care strategies in response to general and upper respiratory symptoms. J Appl Gerontol 34:NP41-61
Arcury, Thomas A; Nguyen, Ha T; Sandberg, Joanne C et al. (2015) Use of Complementary Therapies for Health Promotion Among Older Adults. J Appl Gerontol 34:552-72
Quandt, Sara A; Sandberg, Joanne C; Grzywacz, Joseph G et al. (2015) Home Remedy Use Among African American and White Older Adults. J Natl Med Assoc 107:121-9
Sandberg, Joanne C; Suerken, Cynthia K; Quandt, Sara A et al. (2014) Self-reported sleep difficulties and self-care strategies among rural older adults. J Evid Based Complementary Altern Med 19:36-42
Paige Altizer, Kathryn; Grzywacz, Joseph G; Quandt, Sara A et al. (2014) A qualitative analysis of how elders seek and disseminate health information. Gerontol Geriatr Educ 35:337-53
Altizer, Kathryn P; Nguyen, Ha T; Neiberg, Rebecca H et al. (2014) Relationship between nonprescribed therapy use for illness prevention and health promotion and health-related quality of life. J Appl Gerontol 33:456-73
Arcury, Thomas A; Bell, Ronny A; Altizer, Kathryn P et al. (2013) Attitudes of older adults regarding disclosure of complementary therapy use to physicians. J Appl Gerontol 32:627-45
Bell, Ronny A; Quandt, Sara A; Grzywacz, Joseph G et al. (2013) Patterns of Complementary Therapy Use for Symptom Management for Older Rural Adults with Diabetes. J Evid Based Complementary Altern Med 18:
Bell, Ronny A; Grzywacz, Joseph G; Quandt, Sara A et al. (2013) Medical skepticism and complementary therapy use among older rural African-Americans and Whites. J Health Care Poor Underserved 24:777-87

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