%0 Journal Article %J J Prim Prev %D 2012 %T Project həli?dx(w)/Healthy Hearts Across Generations: development and evaluation design of a tribally based cardiovascular disease prevention intervention for American Indian families. %A Walters, Karina L %A LaMarr, June %A Levy, Rona L %A Pearson, Cynthia %A Maresca, Teresa %A Mohammed, Selina A %A Simoni, Jane M %A Evans-Campbell, Teresa %A Fredriksen-Goldsen, Karen %A Fryberg, Sheryl %A Jobe, Jared B %K Adolescent %K Adult %K Body Mass Index %K Cardiovascular Diseases %K Community-Based Participatory Research %K Community-Institutional Relations %K Cultural Competency %K Family Relations %K Humans %K Indians, North American %K Inuits %K Life Style %K Male %K Motivational Interviewing %K Northwestern United States %K Parents %K Risk Factors %K Young Adult %X

American Indian and Alaska Native (AIAN) populations are disproportionately at risk for cardiovascular disease (CVD), diabetes, and obesity, compared with the general US population. This article describes the həli?dx(w)/Healthy Hearts Across Generations project, an AIAN-run, tribally based randomized controlled trial (January 2010-June 2012) designed to evaluate a culturally appropriate CVD risk prevention program for AI parents residing in the Pacific Northwest of the United States. At-risk AIAN adults (n = 135) were randomly assigned to either a CVD prevention intervention arm or a comparison arm focusing on increasing family cohesiveness, communication, and connectedness. Both year-long conditions included 1 month of motivational interviewing counseling followed by personal coach contacts and family life-skills classes. Blood chemistry, blood pressure, body mass index, food intake, and physical activity were measured at baseline and at 4- and 12-month follow-up times.

%B J Prim Prev %V 33 %P 197-207 %8 2012 Aug %G eng %N 4 %R 10.1007/s10935-012-0274-z %0 Journal Article %J BMC Complement Altern Med %D 2008 %T Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO. %A van Tilburg, Miranda A L %A Palsson, Olafur S %A Levy, Rona L %A Feld, Andrew D %A Turner, Marsha J %A Drossman, Douglas A %A Whitehead, William E %K Abdominal Pain %K Adult %K Complementary Therapies %K Constipation %K Cost-Benefit Analysis %K Delivery of Health Care, Integrated %K Diarrhea %K Female %K Ginger %K Health Maintenance Organizations %K Humans %K Irritable Bowel Syndrome %K Male %K Massage %K Middle Aged %K Patient Satisfaction %K Phytotherapy %K Professional-Patient Relations %K Prospective Studies %K Surveys and Questionnaires %K United States %K Yoga %X

BACKGROUND: Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain.

METHODS: 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims.

RESULTS: CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice.

CONCLUSION: CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

%B BMC Complement Altern Med %V 8 %P 46 %8 2008 %G eng %R 10.1186/1472-6882-8-46