# Presentation: 467992

## Comparative Analysis of  Factors Affecting the Use of Complementary and Alternative Medicine and Prayer and Spiritual Healing

**by **
**Catherine M. Simile, Patricia M. Barnes, Barbara J. Stussman,**
** ****Beth Taylor, and Catherine M. Simile**
**National Center for Health Statistics**
**Kim McFann and Richard L. Nahin**
**National Center for Complementary and Alternative Medicine**

** ****	****The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.**

## Background

**CAM – a group of diverse medical and health care systems , practices, and products that are not presently considered to be part of conventional medicine.**

## Methods

**CAM supplement to the sample adult core of the 2002 National Health Interview Survey (NHIS)**
- Administered to 31,044 sample adults (74.3% response rate)
- Addressed 17 types of CAM therapies (including prayer and spiritual healing)
- Sponsored by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH)

## Methods (cont’d)

**Topical scope of NHIS allows inclusion of previously unexplored and underutilized concepts and measures**
- respondent health behaviors
- access to conventional medical services
**Logistic regression used to identify independent associations with CAM use and use of prayer**

## Dependent Variables

| CAM use -- use of any of the following in the past 12 months: |  |  |  |
| --- | --- | --- | --- |
| Acupuncture | Chiropractic care | Massage | Special diets |
| Ayurveda | EHT-Reiki | Naturopathy | High dose/mega-vitamin therapy |
| Biofeedback | Folk medicine | Natural herbs | Yoga/Tai Chi/Qi Gong |
| Chelation therapy | Hypnosis | Homeopathic treatment | Relaxation techniques |
| 

Prayer/spiritual healing for health reasons --  any of the following in the past 12 months: |  |  |  |
| Prayed for your own health |  | Others prayed for your health |  |
| Participated in a prayer chain or  group for your own health |  | Had a healing ritual or sacrament performed for your own health |  |

## Model Variables:Health Behaviors and Status

**Health behaviors:**
- Physical activity (no exercise, some, regular)
- Body weight status (underweight, normal weight, overweight, obese)
- Drinking status (<12 drinks in lifetime, 0 drinks in past year, <1 per week, 1-7 per week, 8-14 per week, 15+ per week)
- Smoking status (never smoked, former smoker, current smoker)
**Health status:**
- Number of health conditions (0, 1-2, 3-5, 6+)
- Functional limitation (yes, no)
- Health compared to 12 months ago (worse, same, better)

## Model Variables: Health Care

**Access to conventional care:**
- Delayed care due to cost (yes, no)
- Delayed care for reasons other than cost (yes, no)
- Insurance status (uninsured, private coverage, public coverage)
- Poverty status (at or below poverty line, 101-199%, 200-299%, 300-399%, 400-499%, 500%+)
**Use of conventional medical services:**
- Number of doctor visits in past 12 months (0, 1, 2-3, 4-9, 10+)
- Used over-the-counter medications in past 12 months (yes, no)
- Used prescription medications in past 12 months (yes, no)

## Model Variables: Sociodemographics

- Gender (male, female)
- Employment status (not employed, private sector, public sector, self-employed/family business)
- Race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, non-Hispanic AIAN, non-Hispanic API)
- Region (Northeast, Midwest, South, West)
- Education (< than HS, HS grad/GED, some college/Associate’s, Bachelor’s, Master’s/Doctorate/Professional)
- Age (18-44, 45-64, 65+)

## Results

**Overall, 36.1% of adults used CAM (excluding prayer) and 45.1% used prayer for health reasons in the past 12 months**

## Results: Health Behaviors

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Exercise |  |  |
| None | ref | ref |
| Some | 1.73 | 1.21 |
| Regular | 2.38 | 1.31 |
| Body Weight Status |  |  |
| Underweight | --- | --- |
| Normal weight | ref | ref |
| Overweight | --- | --- |
| Obese | 0.83 | --- |

## Results: Health Behaviors

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Drinking Status |  |  |
| < 12 drinks lifetime | ref | ref |
| 0 drinks past yr | 1.21 | --- |
| < 1 drink per week | 1.43 | 0.76 |
| 1-7 drinks per week | 1.59 | 0.61 |
| 8-14 drinks per week | 1.50 | 0.48 |
| 15+ drinks per week | --- | 0.50 |
| Smoking Status |  |  |
| Never smoked | ref | ref |
| Former smoker | 1.13 | --- |
| Current smoker | --- | 0.79 |

## Results: Health Status

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| No. of Health Problems |  |  |
| 0 | ref | ref |
| 1-2 | 1.55 | 1.25 |
| 3-5 | 2.29 | 1.59 |
| 6+ | 3.34 | 2.13 |
| Functional Limitation |  |  |
| Yes | 1.30 | 1.23 |
| No | ref | ref |
| Health Compared to 12 Months Ago |  |  |
| Worse | --- | 1.48 |
| Same | ref | ref |
| Better | 1.39 | 1.32 |

## Results: Access to Conventional Care

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Delayed Care Due to Cost |  |  |
| Yes | 1.34 | --- |
| No | ref | ref |
| Delayed—Other Than Cost |  |  |
| Yes | 1.51 | 1.17 |
| No | ref | ref |
| Insurance Coverage |  |  |
| Uninsured | ref | ref |
| Public | 0.83 | --- |
| Private | --- | --- |

## Results: Access to Conventional Care

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Poverty Status |  |  |
| At or below | ref | ref |
| 101-199% | --- | --- |
| 200-299% | --- | --- |
| 300-399% | --- | --- |
| 400-499% | --- | --- |
| 500% + | 1.30 | 0.70 |

## Results: Use of Conventional Care

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| No. of Doctor Visits |  |  |
| 0 | ref | ref |
| 1 | --- | --- |
| 2-3 | 1.21 | --- |
| 4-9 | 1.30 | 1.28 |
| 10+ | 1.78 | 1.68 |
| Used OTC Meds |  |  |
| Yes | 1.23 | 1.27 |
| No | ref | ref |
| Used Prescription Meds |  |  |
| Yes | --- | 1.29 |
| No | ref | ref |

## Results: Sociodemographics

|  | CAM | PRAYER |
| --- | --- | --- |
| Gender |  |  |
| Female | 1.55 | 1.53 |
| Male | ref | ref |
| Employment Status |  |  |
| Not working | ref | ref |
| Private sector | --- | --- |
| Public sector | --- | --- |
| Self-emp/fam business | 1.41 | --- |

## Results: Sociodemographics

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Race/Ethnicity |  |  |
| Hispanic | --- | 1.89 |
| Non-Hispanic white | ref | ref |
| Non-Hispanic black | --- | 2.61 |
| Non-Hispanic AIAN | --- | --- |
| Non-Hispanic API | 1.56 | --- |
| Region |  |  |
| South | ref | ref |
| Northeast | 1.12 | 0.57 |
| Midwest | 1.20 | 0.78 |
| West | 1.58 | 0.62 |

## Results: Sociodemographics

|  | CAM (OR) | PRAYER (OR) |
| --- | --- | --- |
| Age |  |  |
| 18-44 | 1.73 | 0.75 |
| 45-64 | 1.64 | --- |
| 65+ | ref | ref |
| Education |  |  |
| < HS | ref | ref |
| HS/G.E.D. | 1.37 | --- |
| Some coll./AA | 1.85 | --- |
| Bachelors | 2.40 | --- |
| Master’s + | 2.79 | --- |

## Conclusions

**Different segments of population using CAM and PRAYER; similar findings within these segments**
**Cost and non-cost barriers to conventional care increase likelihood of CAM use**
**Respondent health behaviors associated with both CAM use and use of PRAYER**

## Contact Information

**Catherine  M.  Simile, Ph.D.**
**National Center for Health Statistics**
**Division of Health Interview Statistics**
**3311 Toledo Road, Room 2115**
**Hyattsville, MD 20782**
**Phone: (301) 458-4499**
**Email: cus4@cdc.gov**