Patterns of Variation in Botanical Supplement Use among Hispanics and Latinos in the United States
UMass Chan AffiliationsDepartment of Family Medicine and Community Health
Center for Integrated Primary Care
Document TypeJournal Article
complementary and alternative medicine
Alternative and Complementary Medicine
Community Health and Preventive Medicine
Dietetics and Clinical Nutrition
Race and Ethnicity
MetadataShow full item record
AbstractBackground: 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.
Faurot KR, Filipelli AC, Poole C, Gardiner PM (2015) Patterns of Variation in Botanical Supplement Use among Hispanics and Latinos in the United States. Epidemiol 5: 195. doi:10.4172/2161-1165.1000195.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/26843
At the time of publication, Paula Gardiner was not yet affiliated with the University of Massachusetts Medical School.
RightsCopyright: © 2014 Faurot KR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban UnderservedBerz, 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.
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 incorporation of stress management programming into family medicine residencies-results of a national survey of residency directors: a CERA studyGardiner, 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.