Large numbers of Americans use complementary and alternative medicine (CAM). Despite the high prevalence of CAM use, knowledge of factors related to CAM use is incomplete. In particular, minority group differences in the use of CAM modalities, especially among minority elders, are poorly documented or understood. This project will address minority elder use of CAM through the analysis of several existing data sets. This project is based on a conceptual model in which CAM is understood as one component of an individual's overall approach to selfcare, or activities undertaken to maintain or improve health. It will incorporate the analysis of several existing data sets to address 3 specific aims: (1) to describe ethnic differences in CAM use, and delineate how these ethnic differences are influenced by gender, age/generation, and rural-urban residence; (2) to delineate the predisposing, enabling and need factors (including social, economic, cultural, health status and health care access variables) related to CAM modality use among minority older adults and to estimate the effect size of these factors, and (3) to determine the factors related to CAM use for highly prevalent chronic conditions among minority older adults. The data sets include (a) the 2002 National Health Interview Survey (NHIS) CAM supplement; (b) the 1993-1994 wave of National Survey of Self-Care and Aging; (c) the 1993-1994 Hispanic Established Populations for the Epidemiologic Study of the Elderly (I-IEPESE); and (d) the Evaluating Long-term Diabetes Self management among Elder Rural Adults (ELDER) Study. Together, these data sets allow this project to address national rates in CAM use among African Americans and Hispanics and regional CAM use rates among African Americans and Native Americans in the Southeast and Hispanics in the Southwest, while also allowing it to consider understudied CAM modalities that are most likely to be used by minority elders, as well as specific conditions for which CAM is used. This project will enhance the understanding of CAM use by racial and ethnic minority populations. It will delineate the types of CAM used and the patterns of use among older minority adults, the duration of use, the conditions for which CAM is used, the preventive, palliative and therapeutic uses of CAM, and differences in these domains among older adults from different minority groups. The results of this project will provide the foundation for a study in which the investigators will collect primary data that will delineate ethnic differences in the use and integration of specific CAM modalities among minority older adults into health self-management regime for (a) maintaining existing health status or preventing the onset of a new condition, (b) treating a newly experienced illness, and (c) treatment or palliative activities for a specific, existing health condition; and determinin8 the predisposing, enabling and need factors related to the uptake or maintenance of CAM.
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