368 research outputs found
Artist, Teacher, Scholar, Organizational Leader, Administrator, Collector: Art Educators\u27 Beliefs About Roles and Status
P05.62. Clinical identification of patient propensities to choose integrative medicine for back pain: results from the SPICER project
P02.196. Changes in medication use associated with Traditional Chinese Medicine for chronic pain
Knowledge, Attitudes and Beliefs That May Influence Infant Feeding Practices in American Indian Mothers
The promotion of healthy infant feeding is increasingly recognized as an important obesity
prevention strategy. This is relevant for American Indian (AI) populations, who exhibit high levels
of obesity and low compliance with infant feeding guidelines. The literature examining the
knowledge, attitudes and beliefs (KAB) surrounding infant feeding within the AI population is
sparse and focuses primarily on breastfeeding, with limited information on the introduction of solid foods and related practices that may be important in an obesity prevention context. This
research presents descriptive findings from a baseline KAB questionnaire on infant feeding and
related behaviors, administered to mothers (n=438) from five Northwest AI tribes that participated
in the Prevention of Toddler Overweight and Teeth Health Study (PTOTS). Enrollment occurred
during pregnancy or up to 6 months postpartum. The KAB questionnaire focused on themes of
Breastfeeding/Formula Feeding and Introducing Solid Foods, with supplemental questions on
Physical Activity. Knowledge questions were multiple-choice or true/false. Attitudes and beliefs
were assessed on Likert scales. Descriptive statistics included frequencies and percents, and means
and standard deviations. Most women knew basic breastfeeding recommendations and facts, but
fewer recognized the broader health benefits of breastfeeding (e.g., reducing diabetes risk), or
knew when to introduce solid foods. Women believed breastfeeding to be healthy and perceived
their social networks to agree. Attitudes and beliefs about formula feeding and social support were
more ambivalent. This work suggests opportunities to increase the perceived value of
breastfeeding to include broader health benefits, increase knowledge about solid foods, and
strengthen social support
OA16.01. Patients, physicians, and CAM providers regard communication as central for integrating conventional and CAM therapies for chronic pain
Acupuncture and Chiropractic Care: Utilization and Electronic Medical Record Capture
Objectives: To describe acupuncture and chiropractic use among patients with chronic musculoskeletal pain (CMP) at a health maintenance organization, and explore issues of benefit design and electronic medical record (EMR) capture. Study Design: Cross-sectional survey.
Methods: Kaiser Permanente members meeting EMR diagnostic criteria for CMP were invited to participate. The survey included questions about self-identified presence of CMP, use of acupuncture and chiropractic care, use of ancillary self-care modalities, and communication with conventional medicine practitioners. Analysis of survey data was supplemented with a retrospective review of EMR utilization data.
Results: Of 6068 survey respondents, 32% reported acupuncture use, 47% reported chiropractic use, 21% used both, and 42% used neither. For 25% of patients using acupuncture and 43% of those using chiropractic care, utilization was undetected by the EMR. Thirty-five percent of acupuncture users and 42% of chiropractic users did not discuss this care with their health maintenance organization (HMO) clinicians. Among chiropractic users, those accessing care out of plan were older (P \u3c.01), were more likely to use long-term opioids (P = .03), and had more pain diagnoses (P = .01) than those accessing care via clinician referral or self-referral. For acupuncture, those using the clinician referral mechanism exhibited these same characteristics.
Conclusions: A majority of participants had used acupuncture, chiropractic care, or both. While benefit structure may materially influence utilization patterns, many patients with CMP use acupuncture and chiropractic care without regard to their insurance coverage. A substantial percentage of acupuncture and chiropractic use thus occurs beyond detection of EMR systems, and many patients do not report such care to their HMO clinicians
Developing a patient-centered outcome measure for complementary and alternative medicine therapies II: Refining content validity through cognitive interviews
BACKGROUND: Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were subsequently focused through interviews on a new cohort of participants. Here we present the development of the final version in which the content and format is refined through cognitive interviews. METHODS: We conducted cognitive interviews across five iterations of questionnaire refinement with a culturally diverse sample of 28 CAM users. In each iteration, participant critiques were used to revise the questionnaire, which was then re-tested in subsequent rounds of cognitive interviews. Following all five iterations, transcripts of cognitive interviews were systematically coded and analyzed to examine participants' understanding of the format and content of the final questionnaire. Based on this data, we established summary descriptions and selected exemplar quotations for each word pair on the final questionnaire. RESULTS: The final version of the Self-Assessment of Change questionnaire (SAC) includes 16 word pairs, nine of which remained unchanged from the original draft. Participants consistently said that these stable word pairs represented opposite ends of the same domain of experience and the meanings of these terms were stable across the participant pool. Five pairs underwent revision and two word pairs were added. Four word pairs were eliminated for redundancy or because participants did not agree on the meaning of the terms. Cognitive interviews indicate that participants understood the format of the questionnaire and considered each word pair to represent opposite poles of a shared domain of experience. CONCLUSIONS: We have placed lay language and direct experience at the center of questionnaire revision and refinement. In so doing, we provide an innovative model for the development of truly patient-centered outcome measures. Although this instrument was designed and tested in a CAM-specific population, it may be useful in assessing multi-dimensional shifts in well-being across a broader patient population
P02.11. Adherence and satisfaction with the experimental mind and body intervention in the LIFE weight loss maintenance study
P04.09. Acupuncture and chiropractic utilization among chronic musculoskeletal pain patients at a health maintenance organization
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