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    A cross-sectional review of the prevalence of integrative medicine in pediatric pain clinics across the United States

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    Authors
    Bodner, Kristen
    D'Amico, Salvatore
    Luo, Man
    Sommers, Elizabeth
    Goldstein, Laura
    Neri, Caitlin
    Gardiner, Paula
    UMass Chan Affiliations
    Department of Family Medicine and Community Health
    Center for Integrated Primary Care
    Document Type
    Journal Article
    Publication Date
    2018-06-01
    Keywords
    Chronic pain programs
    Integrative medicine
    Pediatric chronic pain
    Pediatric pain clinics
    Prevalence
    Alternative and Complementary Medicine
    Behavioral Medicine
    Health Psychology
    Health Services Administration
    Integrative Medicine
    Mental and Social Health
    Movement and Mind-Body Therapies
    Pain Management
    Pediatrics
    Primary Care
    Psychiatry and Psychology
    Psychological Phenomena and Processes
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    https://doi.org/10.1016/j.ctim.2018.05.001
    Abstract
    PURPOSE: This project assesses the prevalence of integrative medicine (IM) in pediatric pain clinics (PPCs) across the United States. METHODS: PPCs were identified through the American Pain Society and cross referenced through the International Association for the Study of Pain (IASP). A cross-sectional review using each PPC's website was then utilized for further information. We collected data regarding each program's target population, non-profit status (where non-profits were designated as hospitals that do not operate for-profit purpose, and private as institutions receiving private funding), location, services provided and participating providers. Descriptive statistics were used for data analysis. RESULTS: Of the 53 PPCs identified, 43 (81%) were part of a non-profit healthcare organization, and 10 (19%) were within a private hospital; 85% were located in urban settings, 15% in rural settings; 83% were located in free-standing children's hospitals. Thirty-two (60%) PPCs utilized IM, including acupuncture (38%), mind-body (21%), massage (21%), aromatherapy (19%), nutrition counseling (17%) and/or art/music therapy (11%). The most prevalent providers within PPCs offering IM were yoga instructors (84%), nutritionists (56%) and mind-body specialists (44%). IM was offered in 63% of programs in non-profit organizations and 50% in private hospitals; 58% of urban sites and 75% of rural sites. Within each region, 91% (n=10) of PPCs in the West offer IM, 53% of PPCs in the Midwest (n=10) and Northeast (n=8) offer IM and 50% (n=4) of PPCs in the South offer IM compared to PPCs who do not. CONCLUSIONS: Of 53 current identified PPCs, over half offer IM services. While children in the US are more likely to find a PPC offering IM services, access to do so is more limited in rural and southern regions.
    Source

    Complement Ther Med. 2018 Jun;38:79-84. doi: 10.1016/j.ctim.2018.05.001. Epub 2018 May 4. Link to article on publisher's site

    DOI
    10.1016/j.ctim.2018.05.001
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/26789
    PubMed ID
    29857885
    Notes

    At the time of publication, Paula Gardiner was not yet affiliated with the University of Massachusetts Medical School.

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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ctim.2018.05.001
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      Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved

      Berz, Jonathan P.B.; Gergen Barnett, Katherine A.; Gardiner, Paula; Saper, Robert B. (2015-11-01)
      The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs.
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      Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies

      Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert (2013-09-01)
      CONTEXT: Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. OBJECTIVE: The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. DESIGN: A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. RESULTS: Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). CONCLUSIONS: While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies.
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      The incorporation of stress management programming into family medicine residencies-results of a national survey of residency directors: a CERA study

      Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert (2015-04-01)
      BACKGROUND AND OBJECTIVES: Residents' stress and burnout is a concern among family medicine residency programs. Our objective is to assess stress management options available to family medicine residents. METHODS: In 2012, the Council of Academic Family Medicine Educational Research Alliance (CERA) e-mailed a survey to US residency directors. Questions were asked on four types of stress management programming (SMP): (1) access to counselors, social workers, or mental health providers, (2) residency support or Balint groups, (3) stress management lectures or workshops, and (4) residency retreats. We assessed how many programs contained all four types of SMP and their relationship to the following topics: stress management techniques for patients, spirituality, mind/body techniques, and self-care for residents. RESULTS: Of the 212 responses, 29% reported having all four types of SMP. Eighty-three percent reported stress management lectures or workshops, and 79% reported residency retreats. Smaller and mid-size residencies (36%) and residencies in the West (36%) were more likely to have all four types of SMP. There was a correlation between having didactics, clinical rotations, and electives on stress management techniques for patient care and having stress management lectures or workshops for residents. There was statistical significance between having resident self-care curriculum and (1) having retreats and (2) stress management lectures or workshops. CONCLUSIONS: It is necessary to evaluate whether residency programs are providing appropriate stress management skills for residents that will improve physician wellness and patient outcomes.
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