Access and Utilization of CAM by Minorities

描述(由申请人提供)：近年来，美国补充和替代医学(CAM)的使用大幅增加，不同种族/少数族裔群体的CAM使用率存在显著差异。此前，CAM的使用增加与一些因素有关，如对医疗保健使用的个人赋权需求，以及CAM与患者的个人信仰、灵性和价值观之间的哲学一致性。然而，CAM的使用也可能与他们在其他国家和/或美国的不同文化中使用CAM的少数群体特定亚群的经历有关。拟议的研究的目的是确定种族和民族群体中不同CAM疗法的使用特点，并研究这些使用率的差异是如何产生的。核心假设是，不同种族和民族之间的CAM使用和有效性的差异是由社会经济地位、个人对传统医疗保健系统的体验、传统医疗保健的获得/成本、种族/民族特定的文化信仰、CAM立法/法规以及个人对传统医学可以有效地改善健康的信念推动的。拟议研究的具体目标是：分析在种族/少数族裔亚群中使用CAM的情况和感知的有效性；确定传统药物的成本与不同种族/民族的CAM使用差异之间的关系；以及通过保险地位和基于国家的监管措施来描述特定种族/民族的CAM使用模式。2002年全国健康访谈调查的数据将被用来调查不同种族/少数民族亚群之间使用CAM的差异。将估计逻辑和计数数据模型，以评估与CAM利用率相关的因素以及不同形式的CAM的感知有效性。结果将被用来开发关于种族/少数民族群体成员使用特定CAM疗法的潜在机制的可检验的假说。

DESCRIPTION (provided by applicant): The use of complementary and alternative medicine (CAM) in the U.S. has increased substantially in recent years and there are significant CAM utilization differences across ethnic/racial minority groups. The increasing use of CAM has been previously linked to factors such as the need for individual empowerment over healthcare use and the philosophical congruence between CAM and personal beliefs, spirituality and values of patients. However, CAM use may also be related to minority subpopulation-specific experiences with the healthcare system and their prior experiences with CAM in other countries and/or with different cultures in the U.S. The objective of the proposed research is to characterize the use of different CAM therapies among racial and ethnic groups and to study how these differences in utilization rates arise. The central hypothesis is that differences in CAM use and the effectiveness of CAM across different racial and ethnic groups are driven by socioeconomic status, personal experiences with the conventional healthcare system, access/cost of conventional healthcare, race/ethnic-specific cultural beliefs, CAM legislation/regulation and personal beliefs as to what conventional medicine can effectively accomplish to improve health. The specific aims of the proposed research are: to analyze CAM utilization and perceived effectiveness across racial/ethnic minority subpopulations; to determine how the cost of conventional medicine is related to CAM use differences across racial/ethnic groups; and to characterize race/ethnic- specific patterns of CAM use by insurance status and state-based regulatory measures. Data from the 2002 National Health Interview Survey will be used to investigate the differences in CAM use across different racial/ethnic minority subpopulations. Logistic and count data models will be estimated to assess the factors that are related to CAM utilization and the perceived effectiveness of the different modalities of CAM. Results will be used to develop testable hypotheses regarding the mechanisms underlying the usage of specific CAM therapies by members of racial/ethnic minority groups.