Using the Behavioral Model for Complementary and Alternative Medicine: The CAM Healthcare Model

Abstract

Complementary and alternative medicine (CAM) therapies, products and practices are increasingly being used across the United States and worldwide by individuals who are healthy, as well as by those who are ill (Barnes, Powell-Griner, McFann & Nahin et al., 2004; Burstein, Gelber, Guadagnoli, & Weeks, 1999; Eisenberg, et al., 1998; Ernst & Cassileth, 1998; Kessler, et al., 2001; Richardson & Straus, 2002). This trend, which is anticipated to continue, reflects changing health care behavior. Individuals, who are experiencing illness, use CAM for treatment, management of illness related symptoms and to enhance quality of life. Those who are well also use CAM to promote health, and prevent disease. This increasing prevalence of CAM has created a need to identify patterns and predictors of use among the diverse populations of users. Concurrently, this trend evokes questions about the effect of CAM on the utilization of conventional health services and providers, health outcomes and quality of life. This paper presents an emerging conceptual framework, referred to as the CAM Healthcare Model. This model aims to identify factors associated with the use of CAM providers, therapies, products and practices within a health services framework, thereby providing a guide for CAM research and practice. The CAM Healthcare Model is a modification of Andersen's Behavioral Model for Health Service Use, a framework that has guided research on conventional health services for more than three decades (Andersen, 1969, 1995). The CAM Healthcare Model identifies factors influencing the use of CAM health services and resources that are provider-directed, and CAM use as a self-directed health care activity and/or practice. The authors propose that CAM use, with or without a provider, has the potential to affect utilization of conventional health services as it offers more choices to healthcare consumers. These choices ultimately affect healthcare outcomes, research, health service delivery and policy, hence the importance of this work Understanding the trends and implications of CAM use further emphasizes the need for a model to study CAM within a health service/resource context.