title: Tibetan medicine and integrative health: validity testing and refinement of the constitutional self-assessment tool and lifestyle guidelines tool.
abstract: BACKGROUND
  Tibetan medicine offers an ancient, timely model for the promotion of health and treatment of disease by teaching individuals to make healthy lifestyle choices. This holistic model consists of analyzing one's unique constitution and recommending supportive lifestyle modifications. An experienced Tibetan medicine practitioner is the gold standard for constitutional assessment. Because few Tibetans practice Tibetan medicine in the United States, research-based tools with content and criterion validity are needed for self-assessment.
  
  
  OBJECTIVE
  To test the validity of and refine the Constitutional Self-Assessment Tool (CSAT) and Lifestyle Guidelines Tool (LGT).
  
  
  METHODS
  Mixed methods pilot study conducted in three phases.
  
  
  METHODS
  Tibetan Medical Institute (TMI) of His Holiness the Dalai Lama, Dharamsala, India and the University of Minnesota, a U.S. research University.
  
  
  METHODS
  Six TMI senior faculty; 88 students at the university.
  
  
  METHODS
  Phase 1: TMI faculty evaluated the tools' content validity. Phase 2: 59 students completed the CSAT, had a Tibetan medicine consultation, completed the LGT, and answered qualitative questions. Phase 3: 29 students studying Tibetan medicine followed a modified phase 2 method. Quantitative and phenomenological analyses were performed to investigate the CSAT's criterion validity (agreement of CSAT results and consultations) and refine the tools.
  
  
  RESULTS
  The tools were shown to have high content validity. Phase 2 CSAT had 51% agreement and 0.24 kappa statistic, suggesting fair criterion validity. Phase 3-refined CSAT had 76% agreement and 0.50 kappa statistic, suggesting moderate criterion validity.
  
  
  CONCLUSIONS
  The refined CSAT and LGT in Appendix A and B demonstrate the potential for additional research and use in integrated care.
authors.affiliation: Tibetan Healing Initiative, Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Cameron
authors.forename: Carolyn
authors.initials: C
authors.lastname: Torkelson
authors.forename: Susan
authors.initials: S
authors.lastname: Haddow
authors.forename: Tenzin
authors.initials: T
authors.lastname: Namdul
authors.forename: Aimee
authors.initials: A
authors.lastname: Prasek
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Gross
mesh_terms: D000328:Adult; D000368:Aged; D001824:Body Constitution; D005178:Faculty; D005260:Female; D017408:Guidelines as Topic; D015438:Health Behavior; D006694:Holistic Health; D006801:Humans; D007194:India; D055048:Integrative Medicine / Q000379:methods; D008019:Life Style; D008297:Male; D038861:Medicine, Tibetan Traditional / Q000379:methods*; D008875:Middle Aged; D008910:Minnesota; D010865:Pilot Projects; D012017:Referral and Consultation; D012647:Self-Assessment; D013334:Students; D055815:Young Adult