Use and Impact of Complementary and Alternative Medicine Among US Children

补充和替代医学在美国儿童中的使用和影响

• 批准号: 8090402
• 负责人: Christina D Bethell
• 金额: $ 19.06万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8090402
• 关键词: Accounting; Acupuncture procedure; Address; Adolescent; Adult; Age; Alexander technique; Attitude; Behavior; Belief; Benefits and Risks; Biofeedback; Botanica; Caring; Characteristics; Child; Child Health Services; Child health care; Childhood; Chiropractic manipulation; Clinical; Clinical Trials; Cognitive; Complementary and alternative medicine; Coupled; Data; Data Collection; Data Files; Data Set; Demographic Factors; Development; Diet; Epidemiology; Ethnic Origin; Expenditure; Family; Foundations; Future; Group Meetings; Guided imagery; Guidelines; Healed; Health; Health Insurance; Health Policy; Health Sciences; Health Services; Health Services Research; Health Status; Health system; Homeopathy; Hypnosis; Income; Insurance Coverage; Knowledge; Link; Massage; Measurement; Measures; Medical; Medicine; Meditation; Methods; Minerals; Modality; Modeling; National Health Interview Survey; Native Americans; Naturopathy; Oregon; Osteopathic manipulation; Outcome; Parents; Pediatrics; Peer Review; Perception; Policies; Policy Research; Population; Prevalence; Provider; Public Health; Publications; Qi Gong; Race; Reporting; Research; Resources; Risk; Sampling; Self Care; Series; Services; Shamanism; Sobador; Social Characteristics; Specific qualifier value; Subgroup; Support Groups; Surveys; Tai Ji; Testing; Time; Trager Psychophysical Integration; Translational Research; United States; Universities; Variant; Vitamins; Yoga; ayurveda; base; chelation; deep breathing exercises; demographics; design; evidence base; experience; feldenkrais; healing; hierbero; medicine man; meetings; model development; patient oriented; pilates exercise; population based; progressive relaxation therapy; public health relevance; service utilization; sex; social; stress management

DESCRIPTION (provided by applicant): To date suggest that complementary and alternative medicine (CAM) use is increasingly common among children and youth in the United States. However, national, population-based estimates and correlates of CAM use for all and diverse subgroups of children are not known. Especially incomplete is knowledge of health status, health services factors related to CAM use, prevalence among children with specific conditions, the impact of CAM on health outcomes and utilization and expenditures for allopathic care. This study has five specific aims. Specific Aim 1: Specify a pediatric CAM health services and policy research model relevant to address priority pediatric CAM health services and policy research questions, taking into account unique needs and characteristics of children and implications for data requirements and methods. Specific Aim 2: Develop and confirm the cognitive salience and construct validity of pediatric CAM survey modules suitable and feasible for use in one or more routinely collected population-based surveys. Specific Aim 3: Empirically evaluate the significance of key child level demographic, resource and need based factors that may predict the use of CAM in children, including the child's age, sex, race/ethnicity, family income, health insurance status, health status and other predisposing, enabling and need based factors historically used in evaluating conventional medical care services utilization. Specific Aim 4: Empirically evaluate the significance of parental and other health system factors that may predict the use of CAM in children, including parental demographics, perceptions of their child's health risk, parental self-care behaviors, parental reported use of CAM and parental perceptions of the quality of conventional medical care for their child. Specific Aim 5: Evaluate associations and the potential impact of CAM use in children on both their matched year and future year utilization and/or expenditures for conventional health services use and selected health outcomes. Overall, this study will place the use of CAM in children in the context of their health status, demographics and social characteristics and their use and experiences with conventional medical care. We will incorporate factors not studied together previously by capitalizing on new population-based survey data about children's use of CAM with a sufficiently large sample to permit studying many variables and their interactions simultaneously. Specifically, this study will use data from the 2007 National Health Interview Survey (NHIS), which for the fist time includes a CAM supplement to the child version. We will link this data at the child level to the 2007 adult NHIS/CAM supplement and other NHIS data as well as to the matched year Medical Expenditure Panel Survey dataset (MEPS). Study findings will contribute to the currently nascent foundation of health services knowledge to inform the increasing integration of CAM use into pediatric care and will be summarized in a series of peer reviewed publications and other products. PUBLIC HEALTH RELEVANCE: This study employs available national data to empirically evaluate factors associated with children's use of CAM and the potential impact of CAM use on outcomes and utilization of allopathic medicine. Standardized research models and methods will be developed to advance clinical, public health and translational health services research.

描述(由申请人提供)：到目前为止，补充和替代医学(CAM)的使用在美国的儿童和青年中越来越普遍。然而，所有和不同的儿童亚群使用CAM的全国性、基于人口的估计和相关性尚不清楚。尤其是对健康状况、与使用CAM有关的卫生服务因素、有特殊情况的儿童的患病率、CAM对健康结局的影响以及对抗治疗的利用和支出的了解不完整。这项研究有五个具体目标。具体目标1：具体说明儿科CAM保健服务和政策研究模式，以解决优先的儿科CAM保健服务和政策研究问题，同时考虑到儿童的独特需求和特点以及对数据要求和方法的影响。具体目标2：开发和确认适合和可行于一个或多个常规收集的基于人群的调查的儿科CAM调查模块的认知突显和结构效度。具体目标3：经验性地评估关键的儿童层面人口、资源和需求因素的重要性，这些因素可以预测儿童使用社区卫生服务的情况，包括儿童的年龄、性别、种族/族裔、家庭收入、医疗保险状况、健康状况以及传统上用于评估传统医疗保健服务利用情况的其他诱因、使能因素和需求因素。具体目标4：经验性地评估可能预测儿童使用CAM的父母和其他卫生系统因素的重要性，包括父母人口统计数据、对其子女健康风险的看法、父母的自我照顾行为、父母报告的对CAM的使用情况以及父母对其子女传统医疗保健质量的看法。具体目标5：评估在儿童中使用CAM对其匹配的一年和未来一年的常规卫生服务使用和/或选定的健康结果的利用和/或支出的相关性和潜在影响。总体而言，这项研究将根据儿童的健康状况、人口统计学和社会特征以及他们对传统医疗的使用和经历来考虑儿童对CAM的使用情况。我们将结合以前没有研究过的因素，利用关于儿童使用CAM的新的基于人口的调查数据，并利用足够大的样本，以便同时研究许多变量及其相互作用。具体地说，这项研究将使用2007年全国健康访谈调查(NHIS)的数据，这是第一次包括儿童版的CAM补充。我们将在儿童层面将这些数据与2007年成人NHIS/CAM补充资料和其他NHIS数据以及匹配年份医疗支出小组调查数据集(MEPS)联系起来。研究结果将有助于为目前刚刚建立的卫生服务知识基础提供信息，使人们越来越多地将CAM应用于儿科护理，并将在一系列同行评议的出版物和其他产品中进行总结。 公共卫生相关性：这项研究使用现有的国家数据来经验性地评估与儿童使用CAM相关的因素，以及使用CAM对结果和对抗疗法药物使用的潜在影响。将开发标准化的研究模式和方法，以促进临床、公共卫生和转化性卫生服务研究。