Comparative Analysis of Factors Affecting the Use of Complementary and Alternative Medicine and Prayer and Spiritual Healing by Catherine M. Simile, Patricia M. Barnes, Barbara J. Stussman, Beth Taylor, and Catherine M. Simile Beth Taylor, and Catherine M. Simile National Center for Health Statistics Kim McFann and Richard L. Nahin National Center for Complementary and Alternative Medicine by Catherine M. Simile, Patricia M. Barnes, Barbara J. Stussman, Beth Taylor, and Catherine M. Simile Beth Taylor, and Catherine M. Simile National Center for Health Statistics Kim McFann and Richard L. Nahin National Center for Complementary and Alternative Medicine

The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

BackgroundBackground CAM – a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.CAM – a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.

MethodsMethods CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS)CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS) –Administered to 31,044 sample adults (74.3% response rate) –Addressed 17 types of CAM therapies (including prayer and spiritual healing) –Sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH) CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS)CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS) –Administered to 31,044 sample adults (74.3% response rate) –Addressed 17 types of CAM therapies (including prayer and spiritual healing) –Sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH)

Methods (cont’d) Topical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measuresTopical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measures –respondent health behaviors –access to conventional medical services Logistic regression used to identify independent associations with CAM use and use of prayerLogistic regression used to identify independent associations with CAM use and use of prayer Topical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measuresTopical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measures –respondent health behaviors –access to conventional medical services Logistic regression used to identify independent associations with CAM use and use of prayerLogistic regression used to identify independent associations with CAM use and use of prayer

Dependent Variables CAM use -- use of any of the following in the past 12 months: Acupuncture Chiropractic care Massage Special diets AyurvedaEHT-ReikiNaturopathy High dose/mega- vitamin therapy Biofeedback Folk medicine Natural herbs Yoga/Tai Chi/Qi Gong Chelation therapy Hypnosis Homeopathic treatment Relaxation techniques Prayer/spiritual healing for health reasons -- any of the following in the past 12 months: Prayed for your own health Others prayed for your health Participated in a prayer chain or group for your own health Had a healing ritual or sacrament performed for your own health

Model Variables: Health Behaviors and Status Health behaviors:Health behaviors: –Physical activity (no exercise, some, regular) –Body weight status (underweight, normal weight, overweight, obese) –Drinking status (<12 drinks in lifetime, 0 drinks in past year, <1 per week, 1-7 per week, 8-14 per week, 15+ per week) –Smoking status (never smoked, former smoker, current smoker) Health status:Health status: –Number of health conditions (0, 1-2, 3-5, 6+) –Functional limitation (yes, no) –Health compared to 12 months ago (worse, same, better) Health behaviors:Health behaviors: –Physical activity (no exercise, some, regular) –Body weight status (underweight, normal weight, overweight, obese) –Drinking status (<12 drinks in lifetime, 0 drinks in past year, <1 per week, 1-7 per week, 8-14 per week, 15+ per week) –Smoking status (never smoked, former smoker, current smoker) Health status:Health status: –Number of health conditions (0, 1-2, 3-5, 6+) –Functional limitation (yes, no) –Health compared to 12 months ago (worse, same, better)

Model Variables: Health Care Access to conventional care:Access to conventional care: –Delayed care due to cost (yes, no) –Delayed care for reasons other than cost (yes, no) –Insurance status (uninsured, private coverage, public coverage) –Poverty status (at or below poverty line, %, %, %, %, 500%+) Use of conventional medical services:Use of conventional medical services: –Number of doctor visits in past 12 months (0, 1, 2-3, 4-9, 10+) –Used over-the-counter medications in past 12 months (yes, no) –Used prescription medications in past 12 months (yes, no) Access to conventional care:Access to conventional care: –Delayed care due to cost (yes, no) –Delayed care for reasons other than cost (yes, no) –Insurance status (uninsured, private coverage, public coverage) –Poverty status (at or below poverty line, %, %, %, %, 500%+) Use of conventional medical services:Use of conventional medical services: –Number of doctor visits in past 12 months (0, 1, 2-3, 4-9, 10+) –Used over-the-counter medications in past 12 months (yes, no) –Used prescription medications in past 12 months (yes, no)

Model Variables: Sociodemographics –Gender (male, female) –Employment status (not employed, private sector, public sector, self-employed/family business) –Race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, non-Hispanic AIAN, non-Hispanic API) –Region (Northeast, Midwest, South, West) –Education (< than HS, HS grad/GED, some college/Associate’s, Bachelor’s, Master’s/Doctorate/Professional) –Age (18-44, 45-64, 65+) –Gender (male, female) –Employment status (not employed, private sector, public sector, self-employed/family business) –Race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, non-Hispanic AIAN, non-Hispanic API) –Region (Northeast, Midwest, South, West) –Education (< than HS, HS grad/GED, some college/Associate’s, Bachelor’s, Master’s/Doctorate/Professional) –Age (18-44, 45-64, 65+)

ResultsResults Overall, 36.1% of adults used CAM (excluding prayer) and 45.1% used prayer for health reasons in the past 12 monthsOverall, 36.1% of adults used CAM (excluding prayer) and 45.1% used prayer for health reasons in the past 12 months

Results: Health Behaviors CAM (OR) PRAYER (OR) Exercise Nonerefref Some Regular Body Weight Status Underweight Normal weight refref Overweight Obese

Results: Health Behaviors CAM (OR) PRAYER (OR) Drinking Status < 12 drinks lifetime refref 0 drinks past yr < 1 drink per week drinks per week drinks per week drinks per week Smoking Status Never smoked refref Former smoker Current smoker

Results: Health Status CAM (OR) PRAYER (OR) No. of Health Problems 0refref Functional Limitation Yes Norefref Health Compared to 12 Months Ago Worse Samerefref Better

Results: Access to Conventional Care CAM (OR) PRAYER (OR) Delayed Care Due to Cost Yes Norefref Delayed—Other Than Cost Yes Norefref Insurance Coverage Uninsuredrefref Public Private------

Results: Access to Conventional Care CAM (OR) PRAYER (OR) Poverty Status At or below refref % % % % %

Results: Use of Conventional Care CAM (OR) PRAYER (OR) No. of Doctor Visits 0refref Used OTC Meds Yes Norefref Used Prescription Meds Yes Norefref

Results: Sociodemographics CAMPRAYER Gender Female Malerefref Employment Status Not working refref Private sector Public sector Self-emp/fam business

Results: Sociodemographics CAM (OR) PRAYER (OR) Race/Ethnicity Hispanic Non-Hispanic white refref Non-Hispanic black Non-Hispanic AIAN Non-Hispanic API Region Southrefref Northeast Midwest West

Results: Sociodemographics CAM (OR) PRAYER (OR) Age refref Education < HS refref HS/G.E.D Some coll./AA Bachelors Master’s

ConclusionsConclusions Different segments of population using CAM and PRAYER; similar findings within these segmentsDifferent segments of population using CAM and PRAYER; similar findings within these segments Cost and non-cost barriers to conventional care increase likelihood of CAM useCost and non-cost barriers to conventional care increase likelihood of CAM use Respondent health behaviors associated with both CAM use and use of PRAYERRespondent health behaviors associated with both CAM use and use of PRAYER Different segments of population using CAM and PRAYER; similar findings within these segmentsDifferent segments of population using CAM and PRAYER; similar findings within these segments Cost and non-cost barriers to conventional care increase likelihood of CAM useCost and non-cost barriers to conventional care increase likelihood of CAM use Respondent health behaviors associated with both CAM use and use of PRAYERRespondent health behaviors associated with both CAM use and use of PRAYER

Contact Information Catherine M. Simile, Ph.D. National Center for Health Statistics Division of Health Interview Statistics 3311 Toledo Road, Room 2115 Hyattsville, MD Phone: (301) Catherine M. Simile, Ph.D. National Center for Health Statistics Division of Health Interview Statistics 3311 Toledo Road, Room 2115 Hyattsville, MD Phone: (301)