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Thorburn S.,Oregon State University | Faith J.,Oregon State University | Keon K.L.,Independent Consultant | Tippens K.M.,Helfgott Research Institute
Journal of Alternative and Complementary Medicine | Year: 2013

Objectives: Discrimination in medical settings may influence patient attitudes about health care and health-seeking behaviors. Patients who experience discrimination may seek alternative means of health care, including use of complementary and alternative medicine (CAM). The objective of this study was to examine the relationship between discrimination in health care and CAM use. Design: Data come from the 2001 Health Care Quality Survey (HCQS), which used a multistage sampling design with random-digit dialing, oversampling telephone exchanges with higher densities of African-American, Hispanic, and Asian households. The 2001 HCQS sample consisted of 6722 adults living in the continental United States. To correct for the disproportionate sample design, data were adjusted using sample weights to make the results representative of the U.S. population 18 years and older. Present analyses were limited to 6008 respondents who had visited a doctor or clinic or had been admitted to the hospital in the last 2 years. Outcome measures: Outcome measures were CAM use, practitioner-provided CAM use, and herbal medicine use. Results: In adjusted logistic regression analyses, discrimination in health care was significantly associated with use of herbal medicines alone (adjusted odds ratio=1.47, confidence interval: 1.05, 2.04), but not with use of practitioner-provided CAM (i.e., use of acupuncture, chiropractor, traditional healer or herbalist, alone or in combination with herbal medicines). Conclusions: Further research is needed to examine the direction of the relationship between discrimination and CAM use and differences by CAM modality. © 2013, Mary Ann Liebert, Inc.

Wahbeh H.,Oregon Health And Science University | Zwickey H.,Helfgott Research Institute | Oken B.,Oregon Health And Science University
Journal of Alternative and Complementary Medicine | Year: 2011

Objectives: Home practice is frequently prescribed as part of mind-body medicine interventions, although rarely objectively measured. This brief methods report describes one method for objectively measuring home practice adherence using a custom monitoring software program. Design: Methods for objectively measuring adherence were developed as part of a randomized controlled trial on the mechanisms of mindfulness meditation. Settings/location: The study was conducted at Oregon Health & Science University, Portland, Oregon. Subjects: The subjects comprised 11 combat veterans with post-traumatic stress disorder. Interventions: The method used was mindfulness meditation. Outcome measures: There were subjective and objective adherence measurements of mindfulness meditation home practice. Results: The first iteration of objective adherence monitoring used an iPod device and had limitations in participant usage and correctly capturing data. In the second iteration, objective data were easily collected, uploaded, and viewed using the custom software application, iMINDr. Participants reported that iMINDr was straightforward to use, and they returned the monitoring units as directed. Conclusions: The iMINDr is an example of a simple objective adherence measurement system that may help mind-body researchers examine how home practice adherence may affect outcomes in future clinical trials. © 2011, Mary Ann Liebert, Inc.

Litchy A.P.,Helfgott Research Institute
Journal of Dietary Supplements | Year: 2011

The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine. © 2011 Informa Healthcare USA, Inc.

He J.,Tulane University | Wofford M.R.,University of Mississippi Medical Center | Reynolds K.,Tulane University | Reynolds K.,Kaiser Permanente | And 7 more authors.
Circulation | Year: 2011

Background-Observational studies have reported an inverse association between dietary protein intake and blood pressure (BP). We compared the effect of soy protein, milk protein, and carbohydrate supplementation on BP among healthy adults. Methods and Results-We conducted a randomized, double-blind crossover trial with 3 intervention phases among 352 adults with prehypertension or stage 1 hypertension in New Orleans, LA, and Jackson, MS, from September 2003 to April 2008. The trial participants were assigned to take 40 g/d soy protein, milk protein, or carbohydrate supplementation each for 8 weeks in a random order. A 3-week washout period was implemented between the interventions. Three BPs were measured at 2 baseline and 2 termination visits during each of 3 intervention phases with a random-zero sphygmomanometer. Compared with carbohydrate controls, soy protein and milk protein supplementations were significantly associated with -2.0 mm Hg (95% confidence interval -3.2 to -0.7 mm Hg, P=0.002) and -2.3 mm Hg (-3.7 to -1.0 mm Hg, P=0.0007) net changes in systolic BP, respectively. Diastolic BP was also reduced, but this change did not reach statistical significance. There was no significant difference in the BP reductions achieved between soy or milk protein supplementation. Conclusions-The results from this randomized, controlled trial indicate that both soy and milk protein intake reduce systolic BP compared with a high-glycemic-index refined carbohydrate among patients with prehypertension and stage 1 hypertension. Furthermore, these findings suggest that partially replacing carbohydrate with soy or milk protein might be an important component of nutrition intervention strategies for the prevention and treatment of hypertension. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00107744. © 2011 American Heart Association, Inc.

Faith J.,Oregon State University | Thorburn S.,Oregon State University | Tippens K.M.,Helfgott Research Institute
Complementary Therapies in Medicine | Year: 2013

Objectives: To improve understanding of factors that may influence disclosure of complementary and alternative medicine (CAM) use in the U.S. Design: Cross-sectional survey. Methods: Data are from the 2001 Health Care Quality Survey (HCQS), a nationally representative study of adults aged 18 and older living in the continental United States. Using the Behavioral Model of Health Services Use, we conducted multivariate logistic regressions to identify factors associated with disclosing CAM use among the sub-sample of recent CAM users (n=1995). Main outcome measure: Disclosure of CAM use. Results: Most CAM users (71.0%) disclosed their use of CAM to their doctors. Contextual, individual, and health behavior factors were associated with CAM use disclosure. Of particular interest, disclosure was significantly more likely among those who perceived high quality relationships with their providers (AOR = 1.59, CI: 1.01, 2.49) and among those who had a regular source of medical care (AOR = 1.54, CI: 1.03, 2.29). The odds of disclosure were also higher among those who used practitioner-provided CAM, with (AOR = 2.02, CI: 1.34, 3.06) or without (AOR = 1.52, CI: 1.05, 2.20) concurrent herbal medicine use, compared to those who used herbal medicines only. Conclusions: The Behavioral Model of Health Services Use is a useful framework for examining factors that may influence disclosure of CAM use. Further research should examine these relationships using more comprehensive measures. © 2013 Elsevier Ltd.

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