Minorities and CAM Use: A Health Services Perspective

描述（由申请人提供）： 拟议研究的广泛目标是进一步了解CAM的利用如何有助于消除健康方面的差距。为此，本研究探讨了CAM的使用是如何与潜在的战略，以提高少数民族人口的保健质量：卫生保健提供者的文化能力和健康促进的信念，如感知控制一个人的健康。文化能力是对不同患者群体的健康信念和行为、治疗结果以及社会背景的认识的结合。研究医学多元化的细微差别，使用多种治疗方法，将进一步我们对文化能力需求的理解。生物医学护理与患者使用CAM的决定有何关系？在获得生物医学护理的机会和质量方面的种族/民族差异是否与CAM的使用相关？生物医学和CAM如何共同与健康结果相关？拟议的研究探讨医疗多元化在不同种族/民族人口从卫生服务的角度来看。更具体地说，这项研究旨在： 1)检查社会因素-种族/民族，社会经济地位和性别-如何与CAM利用和医疗多元化的差异相关; 2)探讨心理控制源对CAM使用的直接和中介作用; 3)评估CAM利用率与生物医学护理各个方面之间的关联，包括可及性、质量、医患关系和文化能力; 4)评价遵守医生的建议和披露CAM利用的框架内的医疗多元化。 将使用两项全国性调查，在四个种族/族裔群体（非西班牙裔白人、非西班牙裔非洲裔美国人、非西班牙裔亚洲人和西班牙裔美国人）内部和之间进行分析。将通过对两项全国性调查（2002年全国健康访谈调查和英联邦基金2001年保健质量调查）的次级分析来检验假设。这两个数据集都对少数民族人口进行了过采样，并包括受访者在生物医学医疗保健和各种CAM领域（如草药、脊椎按摩、针灸和传统民族医学疗法）方面的丰富数据。

DESCRIPTION (provided by applicant): The broad goal of the proposed study is to further our understanding of how CAM utilization might contribute to eliminating disparities in health. Toward this end, this study explores how CAM use is associated with potential strategies for improving quality of care among minority populations: cultural competency of health care providers and health-promoting beliefs such as perceived control of one's health. Cultural competence is the incorporation of an awareness of health beliefs and behaviors, treatment outcomes, and the social context of different patient populations. Research on the nuances of medical pluralism, the use of multiple healing practices, would further our understanding of cultural competency needs. How does biomedical care relate to patients' decisions to use CAM? Are racial/ethnic differences in access to and quality of biomedical care associated with CAM use? How do biomedicine and CAM collectively relate to health outcomes? The proposed study examines medical pluralism in diverse racial/ethnic populations from a health services perspective. More specifically, this study aims to: 1) Examine how social factors - race/ethnicity, socioeconomic position, and gender - are associated with differences in CAM utilization and medical pluralism; 2) Explore the direct and mediating effects of locus of control on CAM use; 3) Assess the association between CAM utilization and various facets of biomedical care, including access, quality, patient-provider relationship, and cultural competence; and 4) Evaluate adherence to physician recommendations and disclosure of CAM utilization within a framework of medical pluralism. Analyses will be conducted within and between four racial/ethnic groups, non-Hispanic Whites, non-Hispanic African-Americans, non-Hispanic Asians, and Hispanics, using two national surveys. Hypotheses will be tested through secondary analysis of two national surveys: the 2002 National Health Interview Survey and the Commonwealth Fund's 2001 Health Care Quality Survey. Both datasets oversampled minority populations and include rich data on respondents' experiences with biomedical health care and a variety of CAM domains, such as herbalism, chiropractic, acupuncture, and traditional ethnomedical therapies.