All ETDs from UAB

Advisory Committee Chair

Kevin Fontaine

Advisory Committee Members

Robin Lanzi

Ann Elizabeth Montgomery

Gregory Pavela

Scott Snyder

Larrell Wilkinso

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

One health care trend is the growing public interest in, and use of, complementary and alternative medicine (CAM). Research in the United States suggests that significant numbers of children are involved in various forms of alternative medicine. The purpose of this dissertation is to assess the predictors of parental decision-making of CAM use for their child using five categories of CAM therapies: alternative medical systems, biologically- based, mind-body, manipulative, and a separate and distinct category to include all CAM medical systems. Andersen’s health care Utilization Model (HUM), which holds that health service use is a function of predisposing, enabling, needs and health care experience factors, is used as the theoretical framework for linking specific predictors with the five categories of CAM use. Data are taken from the National Health Interview Survey (NHIS)1 of parents (N = 6,416) collected in 2012. This dissertation examined: (1) the extent predisposing and enabling factors predict overall CAM use; (2) the extent needs factors explain overall CAM use; and (3) the extent health care experiences explain overall CAM use. For the first paper, a logistic regression analyses was conducted to estimate the associations and predictive utility of selected predisposing and enabling variables across CAM categories. For the second paper, predictive utility of selected needs variables after controlling for predisposing and enabling factors across CAM categories. For the third paper, logistic regression analyses was conducted to estimate the associations and predictive utility of selected healthcare experiences after controlling for predisposing, enabling and needs factors across CAM categories. For each paper, after running the full models, a data splitting approach was used to validate the models. In the first paper the predictors that associated significantly across all CAM categories were predisposing factors (race/ethnicity and education). In the second paper, the predictors that associated significantly across all CAM categories were predisposing factors (race/ethnicity and education) and need factors (chronic pain). In the third paper, the predictors that associated significantly across all CAM categories were predisposing factors (education), need factors (chronic pain) health care experience (parental use of CAM). Results from the analyses demonstrate that there is variation in the predictors of the use of different categories of CAM therapies. The strongest predictors of child CAM use in Andersen’s HUM were need factors and health care experience. Overall, the results indicate that future research on the determinants of CAM must delineate between various CAM therapies to gain an accurate portrayal of the factors contributing to CAM use.

Included in

Public Health Commons

Share

COinS