Exploring Pathways to Health

Exploring Pathways to Health is intended to provide information about different forms of complementary and alternative medicine (CAM) to patients as well as opportunities for reflection and discussion to discuss how CAM can be integrated into current medical treatments. 

This program is designed for patients looking to supplement traditional medical treatment plans with complementary and alternative medicine. Program participants will be adult patients recruited through doctor’s offices at local hospitals. Primary offices to be recruited out of will be cancer specialists, pain management specialists, and primary care offices to correlate back to the most common reasons patients use CAM.

The goal of Exploring Pathways to Health is to provide patients who are interested in learning more about CAM practices with knowledge, skills, and resources to bring back to their physician so that CAM can be integrated in a safe and effective manner allowing patients the opportunity to explore new pathways to health.  

The objectives for this lesson plan are as follows:

• Through the use of reflection exercises, 75% of participants will identify what they would like to achieve by learning more about or integrating CAM practices into their current medical treatment plan through the use of the action plan cards. 

• Following the presentation, 75% of participants will be able to identify a minimum of 2 key characteristics of CAM through group discussion periods.

• After the presentation, 75% of participants will identify CAM safety concerns and demonstrate how to communicate with providers through group discussion and role-play. 

Lesson Materials

A copy of the strategy presentation can be found here. This presentation includes the introduction, program goal, program objectives, priority population, key health issue, strategy introduction, procedures and methodology, additional resources, and the evaluation component.

A copy of the lesson plan can be found here.

Also, if you would like copies of the handouts for your own use, please feel free to download them and begin discovering your own pathway towards health!

{ CAM Building Blocks     Individual Action Plan     Facilitator Evaluation }

**Please note that in order to view the correct format, please download the files**

Video

A 10 minute sample of the strategy presentation can be found below.

Presentation Reflection

 Overall, I was very pleased with this presentation. It was very fun to share something that has such great meaning to me with a group of people. I found it to be very helpful to have an interactive group. This program is focused on helping individuals decide how CAM can be a part of their treatment plan; therefore, a certain level of motivation and interest is required. At the same time, this was clearly a test audience, so I feel that this program would have taken on new meaning had it been made up of patients who were actually interested in incorporating CAM methods into their current program. I did experience technical difficulties and was not able to use PowerPoint. However, I feel that the lack of technology actually encouraged group interaction and a level of cohesiveness that I found to be very effective for this type of program.

CAM and Minority Populations: Overcoming the Accessibilty and Affordability Barriers

The link between CAM and minority populations is an incredibly unique connection. If you examine the history of CAM, you’ll find a medical perspective that is rooted in ancient practices, all of which have ties to minority populations. However, if you examine CAM usage among minority populations, you’ll find a large discrepancy.

Who is reporting using CAM?

• ·         36%  of Caucasians

• ·         27% of Hispanics

• ·         26% of African Americans

How is this connected to health disparities?

CAM is becoming a much more common approach in prevention and provides increased treatment options. Despite the proven benefits, accessibility is a primary concern.

“The next decade will see a myriad of advances in prevention and treatment that will yield significant health gains. Notable advances are likely in community approaches to prevention, healthy eating and active living, the expanded care model, patient navigation, complementary and alternative medicine, and biomonitoring. Typically the poor and underserved are the last to benefit from such advances as health disparities in the U.S. are significant with African Americans being 23% more likely to die from all types of cancer than whites. Additionally, in 2001 the death rate from diabetes among Hispanics was 40% higher than the death rates of whites” (Bezold, Calvo, Fritts, & Jonas, 2008, p. 5).

While differences exist among the different racial groups, researchers have found that differences exist within the same race. In fact, income and education are the two most significant predictors of using CAM.

What is the primary barrier to using CAM?

Hint: What is all too often linked to education and income? Insurance!

This is a perfect example of the power of the ripple effect. Insurance has proven to be an incredible barrier for CAM usage. Many insurance companies don’t cover CAM. Even still, many CAM practitioners don’t take insurance, leaving patients with pricey out-of-pocket expenses. From a Medicare and Medicaid perspective, CAM is only covered in Vermont.

So what’s the solution?

It’s a fairly simple solution with an incredibly complex design: address accessibility and affordability. Integrating CAM therapies into hospitals, clinics, and community health centers would increase accessibility, affordability, and help to begin a shift within the medical community that focus more on holistic health, wellbeing, and prevention. Training and education should be at the forefront of this movement working to provide communities with more CAM practitioners and patients with education and resources.

Community Spotlight

Pam Durham recognized this exact need within the city of Fort Worth, TX. In an effort to serve the city, Pam opened Acupuncture Wellness Community Clinic. The premise of her practice is that “health and wellbeing should be affordable for everyone;” therefore, the clinic operates on a sliding scale of $20-$40. Patients have the ability to choose their payment amount so that they can continue to return for treatment. Acupuncture Wellness Community clinic is located in the hospital district of Fort Worth, conveniently located near the major hospitals and many doctor’s offices. Pam provides a range of CAM services such as, acupuncture, acupressure, cupping, moxibustion, electrical stimulation, herbal supplements, nutritional counseling, body work, Qi Gong, mediation, and allergy elimination to a community of patients by working to eliminate the accessibility and affordability barriers.

For more information on Pam Durham and the Acupuncture Wellness Community Clinic, visit her website at www.pamdurham.com.

References

Bezold, C., Calvo, A., Fritts, M., & Jonas, W. (2008). Integrative medicine and health disparities: A scoping meeting. Retrieved from http://www.altfutures.org/pubs/DRA/Report_09_04_Integrative_Medicine_and_Health_Disparities_A_Scoping_Meeting.pdf

Chao, M. T., & Wade, C. M. (2008). Socioeconomic factors and women’s use of complementary and alternative medicine in four racial/ethnic groups. Ethnicity and Disease, 18, 65-71.

National Center for Complementary and Alternative Medicine. (2013). Weekly and twice-weekly yoga classes offer similar low-back pain relief in low-income minority populations. Retrieved from http://nccam.nih.gov/research/results/spotlight/072013

Why use CAM? And who is using it?

These are great questions. There are so many people asking the same thing, so let’s examine a few myths first.

Myth #1: The only reason people use CAM is because they had a bad experience with traditional medicine. 
Past experiences are actually not predictive of CAM use. Most people actually use CAM to help them relieve symptoms and that this perspective took into account the mind-body connection.

Myth #2: I have to choose between alternative medicine and traditional medicine. 
Research shows that most people who use CAM use it in addition to traditional medicine. So in actuality, CAM provides many people with more options.

Myth #3: Only individuals from certain cultures use CAM.
Actually, research shows it’s not necessarily about culture, use of CAM is really about health beliefs. The two might be connected, but not always. People who use CAM are often have a holistic philosophy that considers mind, body, and spirit.

What’s the reality? Almost 50% of the population has used alternative medicine at some point.

What’s the driving force behind the continued use of CAM? People found something that works for them!

If you have found yourself in a place looking for more options, CAM may be what you are looking for. The most important thing to remember is to consult with your doctor use CAM safely. Learn more about how to be a part of this conversation here.
 

The information provided in this posting is adapted from the article “Why Patients Use Alternative Medicine” by John A. Astin and can be found in The Journal of the American Medical Association, Volume 309, Number 24 on pages 1548-1553. 

What do you need to know to be an informed consumer?

Brochure: What do you need to know to be an informed consumer?

Facts and Figures

Complementary and alternative medicine (CAM) can be used as an incredibly beneficial approach, but education regarding CAM is an essential component in making safe health decisions.

Let’s start with the basics. The National Center for Complementary and Alternative Medicine (NCCAM) (2013a) provides definitions to help consumers get started.

• Complementary: utilizing a non-mainstream approach together with conventional medicine

• Alternative: utilizing a non-mainstream approach in place of conventional medicine

• Integrative: an evidence-based complementary approach (example: prescribing acupuncture to help with pain management for cancer patients)

What makes an approach complementary or alternative?

According to NCCAM (2013a), CAM can be stratified into the following two categories: 

• Natural products: herbs, vitamins, minerals, probiotics 

• Mind-body practices: acupuncture, massage therapy, meditation, movement therapy, relaxation, spinal manipulation, tai chi, yoga

The graph below published by NCCAM (2013a) shows the usage of different forms of CAM by adults and children. Natural products are the most utilized form of CAM. This emphasizes the need for safety information to ensure that consumers are able to make educated health decisions to minimize risk of drug-interaction and product contamination (NCCAM, 2013a).

Who uses CAM?

According to Briggs (2009), 38% of adults and 12% of children utilize CAM as a part of their healthcare approach. The most common uses of CAM involve chronic illnesses or pain such as back, neck, and joint pain, arthritis, and anxiety.

Be empowered to research!

NCCAM provides an excellent safety resource on their website. This guide can be found at http://nccam.nih.gov/health/safety/topics.htm (NCCAM, 2013b). It is important to remember that this is a guide. Conversations with medical providers are an essential component in order to ensure that patient safety is kept at the forefront of any treatment. 

A growing field

To learn more about the more recent growth of CAM, I encourage you watch this short video by PBS.

 

References

Briggs, J. P. (2009). Expanding horizons of health care. MedlinePlus, 4(1), 16-17. Retrieved from http://www.nlm.nih.gov/medlineplus/magazine/issues/winter09/articles/winter09pg16-17a.html

National Center for Complementary and Alternative Medicine. (2013a). Cam basics. Retrieved from http://nccam.nih.gov/health/whatiscam

National Center for Complementary and Alternative Medicine (2013b). How safe is this product or practice? Retrieved from http://nccam.nih.gov/health/safety/topics.htm

Public Broadcasting Service. (2009, October 5). PBS nightly business report: Complementary and alternative medicine. Retrieved June 12, 2013 from https://www.youtube.com/watch?v=b-Ek9i05HkE