Elizabeth A Evans1, Patricia M Herman2, Donna L Washington3, Karl A Lorenz4, Anita Yuan5, Dawn M Upchurch6, Nell Marshall7, Alison B Hamilton8, Stephanie L Taylor9. 1. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts. Electronic address: eaevans@umass.edu. 2. RAND Corporation, Santa Monica, California. 3. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, California. 4. RAND Corporation, Santa Monica, California; Center for Innovation to Implementation (ci2i), VA Palo Alto Health Care System, Palo Alto, California; Stanford School of Medicine, Stanford, California. 5. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. 6. Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California. 7. Center for Innovation to Implementation (ci2i), VA Palo Alto Health Care System, Palo Alto, California. 8. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California. 9. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California.
Abstract
AIMS: The Veterans Health Administration promotes evidence-based complementary and integrative health (CIH) therapies as nonpharmacologic approaches for chronic pain. We aimed to examine CIH use by gender among veterans with chronic musculoskeletal pain, and variations in gender differences by race/ethnicity and age. METHODS: We conducted a secondary analysis of electronic health records provided by all women (n = 79,537) and men (n = 389,269) veterans age 18 to 54 years with chronic musculoskeletal pain who received Veterans Health Administration-provided care between 2010 and 2013. Using gender-stratified multivariate binary logistic regression, we examined predictors of CIH use, tested a race/ethnicity-by-age interaction term, and conducted pairwise comparisons of predicted probabilities. RESULTS: Among veterans with chronic musculoskeletal pain, more women than men use CIH (36% vs. 26%), with rates ranging from 25% to 42% among women and 15% to 29% among men, depending on race/ethnicity and age. Among women, patients under age 44 who were Hispanic, White, or patients of other race/ethnicities are similarly likely to use CIH; in contrast, Black women, regardless of age, are least likely to use CIH. Among men, White and Black patients, and especially Black men under age 44, are less likely to use CIH than men of Hispanic or other racial/ethnic identities. CONCLUSIONS: Women veteran patients with chronic musculoskeletal pain are more likely than men to use CIH therapies, with variations in CIH use rates by race/ethnicity and age. Tailoring CIH therapy engagement efforts to be sensitive to gender, race/ethnicity, and age could reduce differential CIH use and thereby help to diminish existing health disparities among veterans.
AIMS: The Veterans Health Administration promotes evidence-based complementary and integrative health (CIH) therapies as nonpharmacologic approaches for chronic pain. We aimed to examine CIH use by gender among veterans with chronic musculoskeletal pain, and variations in gender differences by race/ethnicity and age. METHODS: We conducted a secondary analysis of electronic health records provided by all women (n = 79,537) and men (n = 389,269) veterans age 18 to 54 years with chronic musculoskeletal pain who received Veterans Health Administration-provided care between 2010 and 2013. Using gender-stratified multivariate binary logistic regression, we examined predictors of CIH use, tested a race/ethnicity-by-age interaction term, and conducted pairwise comparisons of predicted probabilities. RESULTS: Among veterans with chronic musculoskeletal pain, more women than men use CIH (36% vs. 26%), with rates ranging from 25% to 42% among women and 15% to 29% among men, depending on race/ethnicity and age. Among women, patients under age 44 who were Hispanic, White, or patients of other race/ethnicities are similarly likely to use CIH; in contrast, Black women, regardless of age, are least likely to use CIH. Among men, White and Black patients, and especially Black men under age 44, are less likely to use CIH than men of Hispanic or other racial/ethnic identities. CONCLUSIONS:Women veteran patients with chronic musculoskeletal pain are more likely than men to use CIH therapies, with variations in CIH use rates by race/ethnicity and age. Tailoring CIH therapy engagement efforts to be sensitive to gender, race/ethnicity, and age could reduce differential CIH use and thereby help to diminish existing health disparities among veterans.
Authors: Lori A Bastian; Steven P Cohen; Lily Katsovich; William C Becker; Bradley R Brummett; Diana J Burgess; Andrea E Crunkhorn; Lauren M Denneson; Joseph W Frank; Christine Goertz; Brian Ilfeld; Kathryn E Kanzler; Akshaya Krishnaswamy; Kathryn LaChappelle; Steve Martino; Kristin Mattocks; Cindy A McGeary; Thomas E Reznik; Daniel I Rhon; Stacie A Salsbury; Karen H Seal; Alicia M Semiatin; Marlena H Shin; Corey B Simon; Deydre S Teyhen; Kara Zamora; Robert D Kerns Journal: Pain Med Date: 2020-12-12 Impact factor: 3.637
Authors: Elizabeth S Goldsmith; Richard F MacLehose; Agnes C Jensen; Barbara Clothier; Siamak Noorbaloochi; Brian C Martinson; Melvin T Donaldson; Erin E Krebs Journal: Med Care Date: 2020-09 Impact factor: 3.178
Authors: Marissa L Donahue; Eugene M Dunne; Emily C Gathright; Julie DeCosta; Brittany L Balletto; Robert N Jamison; Michael P Carey; Lori A J Scott-Sheldon Journal: Psychol Serv Date: 2020-03-05
Authors: Jolie N Haun; Amy C Alman; Christine Melillo; Maisha Standifer; Julie McMahon-Grenz; Marlena Shin; W A Lapcevic; Nitin Patel; A Rani Elwy Journal: JMIR Med Inform Date: 2020-06-26
Authors: Stacie A Salsbury; Elissa Twist; Robert B Wallace; Robert D Vining; Christine M Goertz; Cynthia R Long Journal: Pilot Feasibility Stud Date: 2022-01-14
Authors: Rachel E Golden; Ruth Klap; Diane V Carney; Elizabeth M Yano; Alison B Hamilton; Stephanie L Taylor; Benjamin Kligler; Alison M Whitehead; Fay Saechao; Yevgeniya Zaiko; Alyssa Pomernacki; Susan M Frayne Journal: Healthc (Amst) Date: 2021-06-23