title: Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: a qualitative study.
abstract: BACKGROUND
  The rise in complementary and alternative medicine (CAM) use is well documented. Surveys provide varying estimates of the prevalence of CAM use. Qualitative research has explored individuals' decision-making regarding CAM. This study aimed to examine the family as a context for beliefs, decision-making, and dialogue about CAM.
  
  
  METHODS
  Families were recruited via the Avon Longitudinal Study of Parents and Children. A subsample of CAM users was targeted using purposeful sampling. Focus groups and interviews were conducted with 15 families and the data were analyzed thematically.
  
  
  RESULTS
  Family understandings and beliefs about CAM: CAM was understood as treatments provided outside mainstream care, offering a more "natural" and "holistic" approach, tailored to individual needs and overlapping with wider healthy lifestyle practices. Hierarchies of acceptability of CAM: Physical and "mainstream" therapies were widely supported, with "fringe" therapies producing the most polarized views. There was a belief particularly among fathers and young people that certain therapies rely on "placebo" effects and their value was contested. Types of CAM users within families: Family members were predominantly "pragmatic" CAM users, with "committed" users (all mothers) characterized by deeper philosophical commitment to CAM and skepticism toward conventional medicine. Family dynamics of CAM decision-making: Mothers tended to "champion" CAM within families, while not determining family CAM use. Fathers largely positioned themselves as lacking expertise or skeptical of CAM. Young people were beginning to articulate independent and more critical views of CAM, some directly challenging their mother's perspective. However, all families shared openness to CAM as part of broader beliefs in proactive healthy lifestyles.
  
  
  CONCLUSIONS
  Family focus groups and interviews allow a window on beliefs, decision-making, and dialogue about CAM within families, illuminating the CAM "champion" role held by mothers, and young people's developing autonomy regarding health beliefs and decision-making.
authors.affiliation: School of Social and Community Medicine Department, University of Bristol, Bristol, UK.
authors.forename: James
authors.initials: J
authors.lastname: Nichol
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Thompson
authors.forename: Alison
authors.initials: A
authors.lastname: Shaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000529:Complementary Therapies; D003469:Culture; D003657:Decision Making; D005190:Family; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006694:Holistic Health; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D010287:Parent-Child Relations; D010919:Placebos; D036301:Qualitative Research
chemical_list: D010919:Placebos