An Analysis of Complementary and Alternative Medicine (CAM) Use Among Adolescents

Purpose:   The purpose of this presentation is to provide researchers and clinicians with an analysis on the use of complementary and alternative medicine (CAM) among adolescents in the United States. While the outcomes of research studies may provide information on the patterns of CAM use among adults, information on CAM use and the outcomes of such use in racial and ethnic minority adolescent populations is needed. Previous studies have reported how minority adolescents are not as likely to disclose CAM use ^{1, 5} to include spiritual meditation/prayer ² and that they are more likely to report other CAM health methods such as yoga or diet.² In addition, greater frequency of praying was associated with better psychosocial health related quality of life among adolescents.³Additional insight into CAM use among ethnic minority adolescents will provide a greater understanding of the types of CAM approaches preferred, the conditions for which CAM is used, and the physical and psychosocial outcomes as a result of CAM use for this population.

Methods:  A secondary data analysis was completed to investigate which variables were associated with CAM use in a national sample of adolescents aged 12-17 years. Data from the 2012 National Health Interview Survey (NHIS) were examined for this analysis with most of the data coming from the 2012 Child Complementary and Alternative Medicine supplement of NHIS.⁴ The sample from the 2012 Child Complementary and Alternative Medicine supplement included 13,275 interviews with adults knowledgeable about children aged 4–17 years. The data set contains an over-sampling of ethnic minorities. For this analysis interviews with 4653 adults knowledgeable about adolescents aged 12-17 years were studied (35.1%). Chi-square tests were used to compare the socio-demographic characteristics of the adolescents.

Results:  Among those who used spiritual meditation, parents with more than a high school level of education reported greater CAM use with their adolescents (89.7%) than those with a high school (HS) diploma/General Education Development Certificate (GED) (10.3 %) (Χ² = 9.180, and p < .05). When comparing parents of adolescents (ages 12-17 years) and parents of school age children (ages 6-11 years), parents of adolescents used CAM more often with their adolescents (56.2%) than parents did with their school age children (40.1%) or children 0-4 years of age (3.7%). When evaluating CAM use in relationship to income, 38.7 % of those at a Federal Poverty Level (FPL) of 400%, used CAM, 23.4% were between a FPL of 200 -399% , 24.1% were between a FPL of 100 – 199%, and 13.9% were between 0 – 99% FPL. CAM was most often used among adolescents who experienced pain, anxiety or stress, and other musculoskeletal conditions when compared to younger children. The majority of the adolescents (61.5%) were more likely to experience one or more pain related symptoms in the last 12 months. Pain conditions include: severe headaches (including migraines), neck pain, low back pain, muscle and bone pain, other chronic pain, and severe sprain/strains. Parents of Black and Hispanic adolescents reported using spiritual meditation less than parents of other adolescents.

Conclusion:  CAM use was prevalent among parents on behalf of their adolescents experiencing pain or mental health conditions. Based on the results of this analysis CAM was used more often in those with a higher education and a higher income level. The potential for parents and adolescents to withhold information regarding CAM use should not be disregarded. Given the history and salience of spirituality to include prayer in Black and Hispanic populations, it is surprising that they reported using this category of CAM approaches less often than other parents. We determined that CAM use was evident among ethnic minority adolescents. What is not clear is how education level and income impact CAM use and whether this further contributes to health disparities among ethnic adolescents. Additional research to explore CAM use among specific ethnic minority groups is vital. Analyzing survey instruments for construct validity prior to working with various ethnic populations will enhance the information that is obtained and ensure that information is presented and elicited in a culturally appropriate manner. Additional ethnic specific research will lend a greater understanding of CAM use among ethnic minority adolescents, insight into how CAM use intersects health and illness beliefs and outcomes, and inform providers regarding assessment and health delivery options to promote health equity and quality of life.

References:

1. Clayton-Jones, D. (2014). Spirituality and Religiosity in Adolescents with Sickle Cell Disease: A Descriptive Qualitative Study [Abstract]. e-Publications @Marquette  http://epublications.marquette.edu/dissertations_mu/341/

2. Cotton, S., Luberto, C.M., Yi, M.S., & Tsevat, J. (2011). Complementary and alternative medicine behaviors and beliefs in urban adolescents with asthma. Journal of Asthma, 48, 531-538.

3. Luberto, C.M., Yi, M.S., & Tsevat, J., Leonard, A.C., & Cotton, S. (2012). Complementary and alternative medicine use and psychosocial outcomes among urban adolescents with asthma. Journal of Asthma, 49(4), 409-415.

4. National Health Interview Survey (2012). Maternal and Child Health Bureau in collaboration with the National Center for Health Statistics. [IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.]  2012 NHIS Child CAM Data Set prepared by the Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative. http://childhealthdata.org

5. Seburg, E.M., Horvath, K.J., Garwick, A.W., McMorris, B.J., Vehe, R.K., Scal. P. (2012). Complementary and alternative medicine use among youth with juvenile arthritis: Are youth using CAM, but not talking about it? Journal of Adolescent Health, 51(2), 200-202.