title: Complementary and alternative medicine behaviors and beliefs in urban adolescents with asthma.
abstract: OBJECTIVE
  Up to 80% of adolescents with asthma have used complementary and alternative medicine (CAM) for symptom management. However, little is known about patient characteristics associated with CAM factors other than use. Previous studies recommend provider-patient discussion of CAM use, although few adolescents with asthma disclose their CAM use to their providers. To inform clinical interactions, this study examined prevalence and predictors of CAM use, consideration of use, disclosure of use, and perceived efficacy of use, in urban adolescents with asthma.
  
  
  METHODS
  Adolescents with asthma (N = 151) recruited from a children's hospital completed questionnaires addressing demographic and clinical variables and 10 CAM modalities. Response frequencies to four questions assessing CAM use, consideration of use, disclosure, and perceived efficacy were calculated for each modality. Multivariable logistic regression analyses examined characteristics associated with responses to each question for the two most commonly used CAM modalities.
  
  
  RESULTS
  Participants' mean age was 15.8 (SD = 1.8), 60% were female and 85% were African-American. Seventy-one percent reported using CAM for symptom management in the past month. Relaxation (64%) and prayer (61%) were the most frequently reported modalities and were perceived to be the most efficacious. Adolescents most commonly reported considering using relaxation (85%) and prayer (80%) for future symptom management. Participants were most likely to disclose their use of yoga (59%) and diet (57%), and least likely to disclose prayer (33%) and guided imagery (36%) to providers. In multivariable analyses, older adolescents (OR = 1.27, p < .05) and African-Americans (OR = 2.76, p < .05) were more likely to use relaxation. Adolescents with more frequent asthma symptoms (OR = 0.98, p < .05) were more likely to use prayer. African-Americans were more likely to report using prayer (OR = 3.47, p < .05) and consider using prayer (OR = 7.98, p < .01) in the future for symptom management.
  
  
  CONCLUSIONS
  Many urban adolescents used and would consider using CAM, specifically relaxation and prayer, for asthma symptom management. African-Americans, older adolescents, and those with more frequent symptoms were more likely to use and/or consider using CAM. Providers caring for urban adolescents with asthma should discuss CAM with patients, particularly those identified as likely to use CAM. Future studies should examine relationships between CAM use and health outcomes.
authors.affiliation: Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0840, USA. sian.cotton@uc.edu
authors.forename: Sian
authors.initials: S
authors.lastname: Cotton
authors.forename: Christina M
authors.initials: CM
authors.lastname: Luberto
authors.forename: Michael S
authors.initials: MS
authors.lastname: Yi
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001294:Attitude to Health; D000529:Complementary Therapies / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data*; D003469:Culture; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009820:Ohio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010358:Patient Participation / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014505:Urban Population