Ethnic Variation in CAM Use and Health Self Management among Rural Older Adults

描述(申请人提供)：补充和替代医学(CAM)在老年人中广泛使用。然而，老年人使用CAM的总体水平和使用的具体方式因种族、性别和年龄而异。无论是CAM使用的种族差异的原因，还是CAM使用对健康状况或生活质量的种族差异的影响，都没有明确的确定。很少有关于CAM使用的研究是概念驱动的，而且大多数研究都没有探讨与CAM使用相关的社会或文化因素。研究没有考察特定的CAM使用行为；相反，他们依赖于过去一个月或过去一年的自我报告，而没有试图衡量CAM情态使用的实际频率或特定CAM情态使用的预测因素。基于人群的关于CAM使用的研究还没有衡量在老年人或少数群体成员中，具体的CAM治疗使用与健康状况或生活质量之间的关系。该项目的总体目标是确定农村老年人使用的CAM疗法的种族差异，并确定如何将这些模式纳入保健自我管理。为了实现这些目标，本项目将：(1)描绘形成健康自我管理的非洲裔美国人和白人农村老年人的CAM认知模型(这些认知模型的组成部分包括关于CAM模式的知识和信念、关于CAM模式的信息来源、这些模式的使用目的、使用这些模式的原因以及它们如何融入传统医疗保健)；(2)确定非洲裔美国人和白人农村老年人对CAM模式的实际使用；(3)描述非洲裔美国人和白人老年人使用CAM模式如何影响传统医疗的使用，以及(4)确定非洲裔美国人和白人农村老年人使用CAM模式与健康相关生活质量的关系。这项研究是由一个概念框架构成的，该框架将健康自我管理的概念与健康认知模型的概念相结合。该设计包括两个组成部分。首先，将完成对农村非裔美国人和白人长老的深度采访。第二，每月6次，连续3天完成结构化访谈，样本为200名农村非裔美国人和白人长老。该项目通过调查少数民族和少数族裔人口为什么以及如何使用CAM来解决健康差距问题。它反映了罗姆美国公众使用补充和替代医学委员会的建议，即使用定量和定性方法来检查疾病的社会文化层面和寻求医疗保健的过程和偏好，CAM用户遵守治疗指南的情况，以及个人如何评估关于CAM模式的信息。

DESCRIPTION (provided by applicant): 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.