Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved
UMass Chan AffiliationsDepartment of Family Medicine and Community Health
Center for Integrated Primary Care
Alternative and Complementary Medicine
Community Health and Preventive Medicine
Health Services Administration
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AbstractThe 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.
Am J Prev Med. 2015 Nov;49(5 Suppl 3):S290-5. doi: 10.1016/j.amepre.2015.07.031. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/26839
At the time of publication, Paula Gardiner was not yet affiliated with the University of Massachusetts Medical School.
RightsCopyright 2015 American Journal of Preventive Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Family medicine residency program directors attitudes and knowledge of family medicine CAM competenciesGardiner, 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.
The use of complementary and alternative medicine among refugees: a systematic reviewMacDuff, Sabrina; Grodin, Michael A.; Gardiner, Paula (2011-06-01)Little is known about the use of Complementary and Alternative Medicine (CAM) among refugees, despite the common practice of CAM in many non-Western countries. We performed a systematic review of peer-reviewed literature using nine electronic databases. We included articles pertaining to refugees and CAM (whole medical systems, mind body medicine, herbal remedies, manipulative therapies, energy medicine). Qualitative and quantitative data were compiled and analyzed through descriptive statistics and chi square distribution tables. We reviewed 237 abstracts, and 47 publications met our inclusion criteria. Twenty-six papers documented whole medical systems; 11 mind-body medicine; 5 biologically based practices; 4 manipulative and body-based therapies; and 1 study documented the use of energy medicine. There were 3 clinical trials, 20 surveys, 12 case reports, 2 participant-observer qualitative papers, and 10 review papers. Most studies focused on Asian refugee populations (66%; n = 31). Mental problems related to trauma accounted for 36% of CAM use (17). Among included articles, methodological quality was extremely low. Our results show evidence that type of CAM used by refugees may vary based on ethnicity, yet this is most likely due to a bias in the medical literature. Efforts are needed to further explore these results and expand research within this field.
Patterns of Variation in Botanical Supplement Use among Hispanics and Latinos in the United StatesFaurot, Keturah R.; Filipelli, Amanda C.; Poole, Charles; Gardiner, Paula (2015-07-31)Background: The prevalence of botanical supplement use among Hispanics/Latinos in the United States varies widely, thwarting efforts to understand patterns of use in these rapidly growing populations. In this systematic review of the literature, we present an analysis of patterns of botanical supplement use across available studies including Hispanics/Latinos in the United States, 1998-2011. Methods: Search strategies included CINAHL, EMBASE, Global Health, CAB Abstracts, AMED and Medline resulting in 33 studies reporting botanical supplement prevalence among Hispanic/Latino adults, limiting studies to those with similar outcomes and Hispanic/Latino sample ≥1%. Results: Median prevalence of botanical supplement use among Hispanics/Latinos varied from 12% for ≤30 days of use to 27% for 6-12 months of use and 45% for 2+ years of use. Variation in prevalence of botanical use among Hispanics/Latinos was largely dependent on study design factors, particularly sampling strategy and target population. Patterns associated with higher median prevalence included regional (42%, 95% CI: 35, 57%) vs. national (15%; 8, 22%) samples, convenience (45%; 35, 63%) vs. probability sampling (21%; 10, 42%), and majority Hispanic/Latino (45%; 32, 67%) vs. majority non-Hispanic/ Latino (21%; 15, 42%) samples. Studies targeting Hispanic/Latino populations with botanical assessments specific to these populations resulted in higher prevalence estimates (49% vs. 18%). The most common botanicals reported by Hispanics/ Latinos across studies were chamomile, aloe, and garlic. Conclusions: Although studies with probability sampling are less affected by selection bias, most target the general US population and exclude botanical supplements common among Hispanic/Latino populations. Improved estimates of botanical supplement use among Hispanics/Latinos require culturally-relevant assessment instruments and strategies. Assessments of botanical supplement use in other ethnic populations, e.g., among immigrants from Asian countries, are also likely to suffer from information bias.