Use of complementary and alternative medicine for treatment among African-Americans: a multivariate analysis.

BACKGROUND: The use of complementary and alternative medicine (CAM) is substantial among African-Americans; however, research on characteristics of African-Americans who use CAM to treat specific conditions is scarce. OBJECTIVE: To determine what predisposing, enabling, need, and disease-state factors are related to CAM use for treatment among a nationally representative sample of African-Americans. METHODS: A cross-sectional study design was employed using the 2002 National Health Interview Survey (NHIS). A nationwide representative sample of adult (> or =18 years) African-Americans who used CAM in the past 12 months (n=16,113,651 weighted; n=2,952 unweighted) was included. The Andersen Health Care Utilization Model served as the framework with CAM use for treatment as the main outcome measure. Independent variables included the following: predisposing (eg, age, gender, and education); enabling (eg, income, employment, and access to care); need (eg, health status, physician visits, and prescription medication use); and disease state (ie, most prevalent conditions among African-Americans) factors. Multivariate logistic regression was used to address the study objective. RESULTS: Approximately 1 in 5 (20.2%) who used CAM in the past 12 months used CAM to treat a specific condition. Ten of the 15 CAM modalities were used primarily for treatment by African-Americans. CAM for treatment was significantly (P<.05) associated with the following factors: graduate education, smaller family size, higher income, region (northeast, midwest, west more likely than south), depression/anxiety, more physician visits, less likely to engage in preventive care, more frequent exercise behavior, more activities of daily living (ADL) limitations, and neck pain. CONCLUSIONS: Twenty percent of African-Americans who used CAM in the past year were treating a specific condition. Alternative medical systems, manipulative and body-based therapies, and folk medicine, prayer, biofeedback, and energy/Reiki were used most often. Health care professionals should routinely ask patients about the use of CAM, but when encountering African-Americans, there may be a number of factors that may serve as cues for further inquiry.

Patterns of complementary and alternative medicine use in African Americans.

OBJECTIVES: This study sought to determine (1) characteristics of complementary and alternative medicine (CAM) users in the African-American (AA) population; (2) the prevalence of CAM use; and (3) CAM use for treatment and prevention of disease. DESIGN: The authors analyzed data from the 2002 National Health Interview Survey (NHIS), which included 4256 AA adults representing 23,828,268 AA adults nationwide. Chi-squared tests based on weighted data were used to examine differences in CAM users and nonusers. OUTCOME MEASURES: CAM use was categorized as CAM Ever, CAM Past 12 Months, and CAM for Treatment. RESULTS: A total of 23,828,268 (weighted) AAs were identified in the NHIS dataset. Of those, 67.6% used CAM in the past 12 months, when prayer for health was included. Users were more likely older (43.3 +/- 0.4 versus 39.5 +/- 0.5 years; p < 0.0001); female (60.9% versus 44.0%; p < 0.0001), college educated (17.4% versus 9.8%; p < 0.0001); and insured (91.0% versus 88.1%; p < 0.0001) compared to nonusers. Prayer was the most common CAM used by more than 60% of respondents, followed by herbals (14.2%) and relaxation (13.6%). A majority utilized CAM to treat illness. The use of CAM was significantly (p < 0.0001) higher across all the disease states common in AAs compared to nonuse. CONCLUSIONS: A substantial number of AAs use CAM, with use varying across sociodemographic characteristics. Prayer was the most commonly used therapy. Overall, CAM was most often used for the treatment of specific conditions as opposed to prevention, and its use was common among AAs with prevalent disease states. The extent to which CAM served as a complement or an alternative to conventional medical treatment among AAs is unknown and should be investigated.