Correlates of Complementary and Alternative Medicine among African-American Menopausal Women 公开

Abstract

Background:  In the United States, 30% of adults use complementary and alternative medicine (CAM) for treating symptoms and other ailments. CAM use is heightened among middle to older-aged African-American (AA) women for treating menopause. However, there are mixed results in how several socioeconomic, health, and interpersonal factors influence whether AA women use CAM. In addition, these factors may also intensify “weathering” as indicated by allostatic load (AL), a stress indicator. Taken together, this warrants more research in seeing how these factors may be associated with CAM, as AA women use CAM to treat intense menopausal symptoms due to AL.

 

Methods: The Jackson Heart Study (JHS) Wave 1 was used as secondary data analysis. For inclusion criteria, participants who experienced menopause within the past 25 years were included (n=1,447). The Healthy Environments Partnership Model was used as a theoretical framework, which included CAM use and AL as dependent variables, and predictor variables as predisposing (demographics, health status, and health behaviors); menopause; medical (insurance, trust, and routine visits); and interpersonal factors (depression, stress, lifetime discrimination, anger, and hostility). A block multivariable logistic regression (MLR) was conducted for CAM, and a block multivariable linear regression was conducted for AL. For missing data, multiple imputations were created yielding a robust dataset.

 

Results: Cigarette smoking was a significant predictor for CAM use (p= 0.04), suggesting that participants who report cigarette smoking engage in CAM use. Significant AL predictors include health insurance, menopause duration, natural menopause vs. surgery, and income at p ≤ 0.05. Participants with lower income, experienced an earlier menopause, and have no insurance reported high AL. Participants who experienced natural menopause reported higher AL than participants who had surgery. However, CAM use and AL were not significant (p = 0.13).

 

 

Discussion: Cigarette smokers may use CAM due to the long-term smoking effects for palliative symptom relief.  Additionally, our AL findings were consistent with other research studies concerning AA women’s health disparities due to “weathering”. Overall, future studies should include genetic variables such as AL to examine socioeconomic patterns. Total CAM use should be adequately measured based on short-term or long-term use.

Table of Contents

Table of Contents

Introduction...........................1

What is Complementary-Alternative Medicine (CAM?)........................1

Importance of CAM Use and Menopause......................................... 2

CAM User Profile among African-American Women...........................3

Importance of Allostatic Load........................................................8

Theoretical Framework, Study Aims, and Hypotheses............. 10

Literature Review..................................12

General Overview of CAM and its Potential Benefits................................. 12

Importance of CAM use among Menopausal Women.................................... 12

Demographic Characteristics among African-American who use CAM.................. 13

Health Behaviors and Medical Relationships................................................. 14

Interpersonal Stressors..................................................................................... 16

Allostatic Load as a Health Indicator for Stress................................................ 18

Study Importance........................................................................................ 19

The Healthy Environments Partnership (HEP) Model.......................................... 20

Adapted Healthy Environments Partnership Model .............................................. 21

Methods....................................................... 22

Participants.................................................................. 22

Procedures................................................................................ 25

Measures.................................................................... 26

Analysis Plan..................................................................................... 33

Results........................................................ 36

Descriptive Statistics..................................................................................... 36

Bivariate Analyses—Total CAM Use.................................................................. 38

Bivariate Analyses—Allostatic Load................................................................. 39

Bivariate Analyses—Natural Menopause vs. Surgery.......................................... 40

Multivariable Logistic Regression—Total CAM Use.............................................. 41

Multivariable Linear Regression—Allostatic Load............................................ 41

Discussion...................................... 42

Conclusion....................................................................................... 42

Limitations....................................................................................... 43

Implications and Recommendations for Future Research and Interventions................ 45

References............................................... 49

Table 1. Descriptive Statistics and Bivariate Analyses of Total CAM Use............... 54

Table 2. Bivariate Analyses of Natural Menopause vs. Surgery................................................ 55

Table 3. Bivariate Analyses of Allostatic Load...................... 56

Table 4. Multivariable Logistic Regression—Total CAM Use...................... 57

Table 5. Multivariable Linear Regression—Allostatic Load ........................ 58

 

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Behavioral Sciences Health Sciences, Alternative Medicine
关键词	Complementary and alternative medicine allostatic load African-American women menopause
Committee Chair / Thesis Advisor	McBride, Colleen, Emory University Haardoerfer, Regine, Emory University White, Wendy, Jackson Heart Study Undergraduate Training and Education Center
Partnering Agencies	University, college or education institution (other than Emory)

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