Zhang, Lixin2011-05-192011-05-192011-03https://hdl.handle.net/11299/104632University of Minnesota Ph.D. dissertation. March 2011. Major: Health Services Research, Policy and Administration. Advisor: Kathleen Thiede Call, Ph.D., 1 computer file (PDF); viii, 166 pages.Background --- Though substantial and growing use of complementary and alternative medicine (CAM) in the general population has been documented in recent years, little is known about CAM utilization patterns among racial, ethnic and immigrant (REI) populations groups. Objectives --- To examine variation in the use of CAM among REI populations, and assess the influence of cultural heritage and access to medical care on CAM use Conceptual Model --- Adapted Behavioral Model of Vulnerable Population with added REI domains. Method --- Data are from Survey of Health of Adults, the Population and the Environment (SHAPE) collected in Hennepin County, Minnesota in 2002. The final sample consists of 9,959 respondents with 2,794 from racial and ethnic minorities and 1,007 interviews were completed in languages other than English. The outcome measures were the use of five CAM therapies in the previous 12 months. Results --- Overall, 42% of the adults in the total population used at least one of the five CAM therapies in the past 12 month. CAM use is prevalent among REI populations, particularly among American Indians, Asians and Whites. The use of individual CAM varies across racial and ethnic populations and the pattern of use conforms to the racial and ethnic origins of the modalities. Cultural heritage influences CAM use and the level of influence is stronger for culturally-relevant CAM. Lack of insurance coverage, delayed medical care and not having a physician’s clinic as regular source of care are associated with a higher likelihood of CAM use. Lack of access to conventional health care has a stronger influence on CAM use in some racial and ethnic groups. Lack of insurance coverage and barriers to needed medical care play a larger role in the use of CAM among immigrants. Conclusion --- CAM has an important role in promoting culturally competent care particularly in REI populations. CAM may serve as an alternative option for those lacking adequate access to medical care, particularly among immigrants and people of racial and ethnic populations.en-USAlternativeComplementaryEthnicImmigrantMedicineRacialHealth Services Research, Policy and AdministrationThesis or Dissertation