Traditional Service Providers Research Articles

An open ecosystem engagement strategy through the lens of global food safety.

The Global Food Safety Partnership (GFSP) is a public/private partnership established through the World Bank to improve food safety systems through a globally coordinated and locally-driven approach. This concept paper aims to establish a framework to help GFSP fully leverage the potential of open models. In preparing this paper the authors spoke to many different GFSP stakeholders who asked questions about open models such as: what is it?what's in it for me?why use an open rather than a proprietary model?how will open models generate equivalent or greater sustainable revenue streams compared to the current "traditional" approaches? This last question came up many times with assertions that traditional service providers need to see opportunity for equivalent or greater revenue dollars before they will buy-in. This paper identifies open value propositions for GFSP stakeholders and proposes a framework for creating and structuring that value. Open Educational Resources (OER) were the primary open practice GFSP partners spoke to us about, as they provide a logical entry point for collaboration. Going forward, funders should consider requiring that educational resources and concomitant data resulting from their sponsorship should be open, as a public good. There are, however, many other forms of open practice that bring value to the GFSP. Nine different open strategies and tactics (Appendix A) are described, including: open content (including OER and open courseware), open data, open access (research), open government, open source software, open standards, open policy, open licensing and open hardware. It is recommended that all stakeholders proactively pursue "openness" as an operating principle. This paper presents an overall GFSP Open Ecosystem Engagement Strategy within which specific local case examples can be situated. Two different case examples, China and Colombia, are presented to show both project-based and crowd-sourced, direct-to-public paths through this ecosystem.

Community building through a public library Minecraft Gaming Day

Minecraft is a popular building block game ubiquitous in the cultural landscape of young people. Noticing a gap in traditional library programs for virtual games such as Minecraft, children and youth services librarians at North Melbourne Library developed a collaborative Minecraft Gaming Day between librarians and young library patrons. The Minecraft Gaming Day was a uniquely creative experience linking traditional library service provision with socialisation, identity and the building of community. It challenged the traditional programming approach for young people and creating a program with young people, allowing young people to have a role in library programming, treating them as valued community members, and giving them the ability to contribute their vision to the future of library services. The combination of digital and real play spaces gave the young community a positive, educational and active way to participate in library programming and demonstrated how young people and librarians can work together to creatively help public libraries support their communities and promote social inclusion and literacy building. This article is based on ethnographic research drawing from empirical data, including staff evaluations and a focus group conducted with five young people involved with the planning and implementation of the program.

The law and ethics of 'self-quantified' health information: an Australian perspective

This exploratory article examines the phenomenon of the ‘Quantified Self’—until recently, a subculture of enthusiasts who aim to discover knowledge about themselves and their bodies through self-tracking, usually using wearable devices to do so—and its implications for laws concerned with regulating and protecting health information. Quantified Self techniques and the ‘wearable devices’ and software that facilitate them—in which large transnational technology corporations are now involved—often involve the gathering of what would be considered ‘health information’ according to legal definitions, yet may occur outside the provision of traditional health services (including ‘e-health’) and the regulatory frameworks that govern them. This article explores the legal and regulatory framework for self-quantified health information and wearable devices in Australia and determines the extent to which this framework addresses privacy and other concerns that these techniques engender, along with suggestions for reform.

A mathematical theory of compressed video buffering: Traffic regulation for end-to-end video network QoS

The recent successes of over-the-top (OTT) video services have intensified the competition between the traditional broadcasting video and OTT video. Such competition has pushed the traditional video service providers to accelerate the transition of their video services from the broadcasting video to the carrier-grade IP video streaming. However, there are significant challenges in providing large-scale carrier-grade IP video streaming services. For a compressed video sequence, central to the guaranteed real-time delivery are the issues of video rate, buffering, and timing as compressed video pictures are transmitted over an IP network from the encoder output to the decoder input. Toward the understanding and eventual resolution of these issues, a mathematical theory of compressed video buffering is developed to address IP video traffic regulation for the end-to-end video network quality of service. In particular, a comprehensive set of theoretical relationships is established for decoder buffer size, network transmission rate, network delay and jitter, and video source characteristics. As an example, the theory is applied to measure and compare the burstiness and delay of video streams coded with MPEG-2, advanced video coding, and high-efficiency video coding standards. The applicability of the theory to IP networks that consist of a specific class of routers is also demonstrated.

Recovery oriented consumer focused practice: Emerging critical success factors in establishing a culture of collaboration to support our most vulnerable community members

Introduction: Consumer focused integrated care requires a whole of system paradigm shift for the myriad of community and government service providers that provide support to individuals who are impacted by severe and complex mental, physical and social health issues. Service providers often work in silos due to narrow and specific contractual obligations, and in competition due to ever diminishing government funding. Increasingly consumers most needing support are further marginalised, bounce between agencies and eventually disengage from a chaotic system. The Partners in Recovery (PIR) initiative provides a consumer centred, integrated, collaborative partnership approach to supporting some of our most marginalised and disadvantaged individuals in being active participants in their own recovery. PIR contracts were awarded in mid 2013 and the current funding concludes in June 2016. While PIR is still in its infancy, ConNetica is providing support to 7 PIR projects across Australia as either a local evaluation coordinator or expert adviser. This has enabled the collation of qualitative and quantitative data with identified critical success factors and key findings related to service collaboration, integration and recovery oriented practices. Description of practice and context: The PIR process supports individuals who have persistent and complex needs that are not being met through the traditional fragmented service provider structure. PIR places the individual consumer, with support from their families and carers, at the centre of a holistic, individualised and flexible process focused on maximizing recovery with the consumer actively participating in the development of their recovery plan. The positive impact of flexible funding available to meet the immediate and personal needs of consumers, usually not available through traditional avenues, cannot be underestimated. Through a collaborative and integrated consumer focused recovery model PIR ultimately encourages whole of system change. World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. International Journal of Integrated Care – Volume 14, 8 December – URN:NBN:NL:UI:10-1-116689– http://www.ijic.org/ Description of change implemented: The PIR initiative is coordinated through a lead agency, providing leadership and coordination to enable strategic partners to work together in the development of the governance structure, directly increasing engagement and collaboration. Consortium partners and stakeholders work together to develop and refine practices while support facilitators are based at host agencies, supervised by team leaders. Support facilitators work directly with consumers, assisting them to identify their current recovery needs and coordinating access to a range of services to ensure needs are met. Support facilitators aim to establish a system of collaborative active partnerships between service providers, extended beyond the traditional boundaries of mental health services. They become the conduit for consumers to take ownership of their own recovery, supporting them to access services, while leading practices that create a cultural shift in understanding of the need for collaboration and innovation within the service sector. Objective of the change and targeted population: The PIR process supports individuals who are experiencing severe and persistent mental health issues and have been unsuccessful in receiving a response from multiple agencies. Key goals of the initiative are to improve and sustain service collaboration and integration, and ensure provision of recovery oriented practice. Stakeholders engaged: Stakeholders include the consumers, their families and carers. Lead agencies include Medicare Locals and NGOs. Additional partners and stakeholders include the broader community sector, government mental health services, primary health care providers (physical and mental health) alcohol and other drug treatment services, income support services, education, housing and employment supports. Theory/Methods used: ConNetica has developed key measurement principles to assist each PIR consortia to develop and implement local evaluation plans. Action learning and a program logic framework enables needs assessment, process evaluation, outcomes evaluation and impact evaluation to be conducted using a range of data collection methods and tools. Service mapping, client experience of care and workforce development needs are part of the local evaluation process. Highlights: While relatively early in the process initial data indicates that consumers are benefiting from the client centred recovery process. A sense of hopefulness, increased confidence, engagement in identifying and achieving current goals and developing plans for the future has characterised consumer feedback. Support facilitators have generally identified greater collaboration across internal and external agencies and partners’ awareness of the PIR paradigm has increased propensity for reflection on alternative options to traditional processes. Challenges remain in engaging clinicians and some mental health services in the initiative, while there is an ongoing need for review of systems and processes, and ongoing education across all stakeholders. In some areas there is also a lack of services for consumers to access. Conclusions: Preliminary findings demonstrate that consumers benefit from the development of recovery focused consumer centric practices that require shared understanding and collaborative systems of practice. As with any change management process time is required to identify, refine and imbed practices across the broader sector that contribute to lasting systemic and cultural change.

Enabling wireless cooperation in delay tolerant networks

This paper presents a credit-based incentive mechanism for delay tolerant networks which enables device-to-device data exchange without the support of traditional Internet service providers. The solution uses a utility function that represents the monetary value of a given data message during its journey in the network, and a buffer management optimization algorithm to prevent selfish behaviour among nodes. Virtual banking relies on an off-line central trusted authority. The paper introduces the concept of isotropic deliveries in delay tolerant networks which uses binary spray and wait forwarding strategy. Simulations with the IEEE 802.15.4 standard show the proposed incentive mechanism preventing selfish behaviour and guaranteeing more extra credits to the end-user.

The Order Effect on Electronic Word of Mouth to Online Religious Service Usage: Using Daoism as an Example in Taiwan

As we known, the continuing improvements in information technology have led to many new and fascinating applications in physics, engineering, and so on. Besides, the innovative information and communication technology (ICT) applications also denote a significant effect on the religion issues. Daoism, a traditional religion being affected with Internet has been mounted steadily for a number of decades. In order to attract the young group, online service will be the possible choice when traditional Daoism service providers consider how to provide the better service model. People choose to use the online service based on recommendations received not only by word of mouth (WOM), but also from cyberspace such as website, electronic bulletin boards, blogs, and facebook. In psychological terms, one result is cognitive bias, i.e., subjects tend to have better recall for the information presented early compared to information presented later, and this research is spawned from this theory. This work explored the relationship between the order effect on electronic word of mouth (eWOM) and online religious service usage. We constructed the research framework and established the hypotheses. In order to study completeness, we investigated the users who used the online religious services including websites, social network sites, blogs and facebook. The e-questionnaire surveys on online worshippers’ data are collected. Totally, 271 valid formal questionnaires were collected and analyzed (N = 271; mean age = 22.1; 56 % male). The SPSS 20.0 software was used for analysis and hypothesis testing. The findings are as follows:

Primary vendor capabilities in a mediated outsourcing model: Can IT service providers leverage crowdsourcing?

Crowdsourcing platforms that attract a large pool of potential workforce allow organizations to reduce permanent staff levels. However managing this “human cloud” requires new management models and skills. Therefore, Information Technology (IT) service providers engaging in crowdsourcing need to develop new capabilities to successfully utilize crowdsourcing in delivering services to their clients. To explore these capabilities we collected qualitative data from focus groups with crowdsourcing leaders at a large multinational technology organization. New capabilities we identified stem from the need of the traditional service provider to assume a “client” role in the crowdsourcing context, while still acting as a “vendor” in providing services to the end-client. This paper expands the research on vendor capabilities and IT outsourcing as well as offers important insights to organizations that are experimenting with, or considering, crowdsourcing.

Exploring the contribution of innovation intermediaries to the new product development (NPD) process: a typology and an empirical study

In the ‘knowledge economy’ upheld by the European Lisbon strategy, knowledge‐intensive services are considered a key driver for innovation and competitiveness. A category of knowledge‐intensive services that has become of utmost importance in the last few decades is new product development (NPD) services, which interconnect distant knowledge domains with the client firms. In addition to NPD service providers, web‐based innovation intermediaries have started to help innovative firms access dispersed bodies of knowledge. Despite the heterogeneity of their characteristics, however, a clear typology of the strategies used by traditional NPD service providers and web‐based intermediaries to interact with their knowledge sources and with their clients is missing. This typology would be very useful for those firms that are willing to collaborate with innovation intermediaries because it could highlight the typologies of NPD problems different intermediaries are apt to address and the managerial challenges that working with them entails. Developing such a classification framework is the main goal of this paper.The typology proposed in this paper suggests that innovation intermediaries should be distinguished based on the following: (1) the way they access their distributed knowledge sources and (2) the way they deliver value to their clients. By combining these two dimensions, four categories of innovation intermediaries are identified, which are named brokers, mediators, collectors and connectors. A multiple case study analysis involving four innovation intermediaries and 12 of their clients is presented in the paper. The analysis provides exploratory insights into (1) the typologies of NPD problems that each class of intermediaries addresses and (2) the managerial challenges that working with each of them entails. These preliminary findings call for further theoretical and empirical research into the complex interaction among innovation intermediaries, their dispersed sources of knowledge and their clients.

The transition of childbirth practices among tribal women in Gujarat, India - a grounded theory approach.

BackgroundUnder the National Rural Health Mission, the current emphasis is on achieving universal institutional births through incentive schemes as part of reforms related to childbirth in India. There has been rapid progress in achieving this goal. To understand the choices made as well as practices and perceptions related to childbirth amongst tribal women in Gujarat and how these have been influenced by modernity in general and modernity brought in through maternal health policies.MethodA model depicting the transition in childbirth practices amongst tribal women was constructed using the grounded theory approach with; 8 focus groups of women, 5 in depth interviews with traditional birth attendants, women, and service providers and field notes on informal discussions and observations.ResultsA transition in childbirth practices across generations was noted, i.e. a shift from home births attended by Traditional Birth Attendants (TBAs) to hospital births. The women and their families both adapted to and shaped this transition through a constant ’trade-off between desirable and essential’- the desirable being a traditional homebirth in secure surroundings and the essential being the survival of mother and baby by going to hospital. This transition was shaped by complex multiple factors: 1) Overall economic growth and access to modern medical care influencing women’s choices, 2) External context in terms of the international maternal health discourses and national policies, especially incentive schemes for promoting institutional deliveries, 3) Socialisation into medical childbirth practices, through exposure to many years of free outreach services for maternal and child health, 4) Loss of self reliance in the community as a consequence of role redefinition and deskilling of the TBAs and 5) Cultural belief that intervention is necessary during childbirth aiding easy acceptance of medical interventions.ConclusionIn resource poor settings where choices are limited and mortality is high, hospital births are perceived as increasing the choices for women, saving lives of mothers and babies, though there is a need for region specific strategies. Modern obstetric technology is utilised and given meanings based on socio-cultural conceptualisations of birth, which need to be considered while designing policies for maternal health.

Analyzing the Behavior of Smartphone Service Users

This paper reports the findings of a study into the behavior of the users of a mobile service. The study analyses the behavior of travelers using a Smartphone application to access real-time transit information and contrasts such user behavior with that of users accessing a transit information service from a website. Previous research in this field has tended to focus upon the perceived benefits of providing real-time transit information and without investigating when and how often passengers would use such real-time transit information services. This paper specifically explores the behavior patterns of travelers using a Smartphone service and those of using a website to provide real-time transit information. Based on empirical data derived from real information services, the impact on user behavior of providing a mobile service is analyzed and contrasted to traditional Web-based service provision. The Smartphone service is furthermore used to conduct a passenger survey to obtain information on the individuals using the mobile service. The results of the analysis presented demonstrate that the demand for information from the website is constant throughout the working week whereas demand for Smartphone information increases during the week peaking during late afternoons and on Fridays. The results of the passenger survey demonstrate that over 80 percent of Smartphone application users are between 18 and 49 years of age and perhaps most importantly, that Smartphone survey questions are twice as likely to be answered compared to the response rates for Web or mail surveys.

Provision of clinical pharmacy education and services by RAK college of pharmaceutical sciences, Ras Al Khaimah, UAE

Objectives: Internationally, the role of pharmacist has now been extended from the provision of traditional services to patient specific care services. Unlike other developed countries, clinical pharmacy services are very rare in the health care settings of United Arab Emirates (UAE). Hence, clinical pharmacy based education and training is the need of the hour. Materials and Methods: RAK College of Pharmaceutical Sciences (RAKCOPS) through its innovative undergraduate pharmacy curriculum with a practice-oriented training, is enabling the students to acquire knowledge, skills, and practice to apply in a healthcare set up. RAKCOPS established a clinical pharmacy department in the year 2009 at Ibrahim Bin Hamad Obaidallah Hospital of Ras Al Khaimah, UAE, which is a 330 bedded tertiary care medical specialty hospital. In the year 2007, RAKCOPS initiated undergraduate pharmacy program of 4.6 years (B. Pharm) with a one semester of practice school training in the last semester. Results: Practice school training as a part of B. Pharm program is mainly designed to help the students to gain confidence in their ability to be an active and useful participant in the healthcare. Clinical pharmacy related services such as drug and poison related information, adverse drug reaction (ADR) monitoring, and reporting are also provided by the department of clinical pharmacy. Conclusion: Pharmacy practice related education and practice-based training provided for the undergraduate pharmacy students will be definitely a major contribution towards bringing up quality clinical pharmacists in UAE, who will be a major asset for the healthcare team.

The provision of human resources and employment advice to small and medium-sized enterprises: The role of small and medium-sized practices of accountants

Small and medium-sized practices (SMPs) are often identified as a main provider of human resources and employment advice to small and medium-sized enterprises (SMEs), but little is known about the nature of this involvement. This article explores this gap in knowledge. It examines the type of support provided and resources used by SMPs and how this support role sits alongside core SMP competencies. Nineteen interviews were carried out. The study found an emphasis upon employment procedures and contracts in the support given. The support offered and the resources used were related to the size of SMP. The trust established during the provision of traditional accountancy services was the main reason that SMEs approached their accountant in search of human resources and employment support. The article provides an important insight into understanding how SMEs are supported in this area and indicates several areas where further research is required.

Sources by Which Students Perceive Professional Counselors’ Effectiveness

Go To DigestUsing qualitative research methods interviews were conducted with college students regarding the sources they used in generating perceptions of professional counselors. Respondents believed that word of mouth, media sources, and personal experiences were responsible for their understandings of professional counselors. The findings have applications for leaders in professional counseling organizations.Perceptions do not equal reality. However, perceptions eventually can lead to what reality becomes in time. All professions possess public perception. When someone refers to doctors, lawyers, dentists, and other specialized occupational groups, images are created in our minds. These percepts possess varying degrees of reality, of course, but the effects of such images are cogent nonetheless. Of particular interest to the present study is the perception of human service personnel, including professional counselors.As a whole, the human service profession has landed itself on the positive side of the public's opinion spectrum (Nunnally & Kittross, 1958). McGuire and Borowy's (1979) research showed a continuum of perceptions held by the lay public regarding a wide range of professionals who worked with mental illness. Those occupying the fields of nursing, physicians, counseling psychologists, social workers, psychiatric nurses, psychiatrists, and clinical psychologists received the highest rankings.Undergraduate students' opinions regarding effectiveness of various human service providers for helping mental health consumers were reported by Tse, Wantz, and Firmin (2010) and Wantz and Firmin (2011). Participants in these studies rated human service providers' effectiveness more positive than negative. Professional counselors and psychologists were rated more effective with providing mental health services than other human service providers.Richardson and Handal (1995) found the general public viewed psychotherapy as a reasonably effective means of treatment for between 25 to 50% of all cases. Most people also recognized that services of less traditional human service providers, such as marriage and family therapists, also could be used effectively in relation to particular disorders. Psychiatrists and psychologists, however, were perceived as having higher levels of competence when addressing mental health issues (Schindler, Berren, Hannah, Beigel, & Santiago, 1987). Educational attainment (Dotson-Blake, Know, & Holman, 2010), chronological maturity (Erikson, 1963; Oliver, Reed, & Smith, 1998), and psychosocial development (Tinsley, Hinson, Holt, & Tinsley, 1990) have been reported to be positively correlated with perceived benefits of counseling.Murstein and Fontaine (1993) found familiarity of the general public to be greater concerning physicians, clergypersons, and psychiatrists than was in their knowledge of psychotherapists and psychologists. Consequently, of the two, psychologists were the source the general public was most likely to use when recommending a human service provider. Also reported, the most common reasons for which clients sought mental health professionals were mild depression, marital problems, and child-rearing issues. A generation ago, Gelso, Brooks, and Karl (1975) reported mental health consumers' overall preferences to be for counseling psychologists and psychiatrists.Sharpley (1986) purported a tendency for mental health consumers to separate human service professionals into two categories, each entailing distinct perspectives. First, private practice and fee-for-service providers, psychologists and psychiatrists being the most prominent, were viewed as those who were most competent in treating mental illnesses. Second, public-utility and non-fee-demanding professionals, of which social workers and counselors prominently emerged, were perceived as being more practical and apt in providing service to the average person when addressing emotional problems. …

Automated self-service modeling: predictive analytics as a service

Research into service provision and innovation is becoming progressively more important as automated service-provision via the web matures as a technology. We describe a web-based targeting platform that uses advanced dynamic model building techniques to conduct intelligent reporting and modeling. The impact of the automated targeting services is realized through a knowledge base that drives the development of predictive model(s). The knowledge base is comprised of a rules engine that guides and evaluates the development of an automated model-building process. The template defines the model classifier (e.g., logistic regression, multinomial logit, ordinary least squares, etc.) in concert with rules for data filling and transformations. Additionally, the template also defines which variables to test ("include" rules) and which variables to retain ("keep" rules). The "final" model emerges from the iterative steps undertaken by the rules engine, and is utilized to target, or rank, the best prospects. This automated modeling approach is designed to cost-effectively assist businesses in their targeting activities--independent of the firm's size and targeting needs. We describe how the service has been utilized to provide "targeting services" for a small to medium business direct marketing campaign, and for direct sales-force targeting in a larger firm. Empirical results suggest that the automated modeling approach provides superior "service" in terms of cost and timing compared to more traditional manual service provision.

Technology mediation in service delivery: A new typology and an agenda for managers and academics

The role of information and communication technology for economic growth has been emphasized repeatedly. Technological breakthroughs have generated new forms of services, such as self-services or remote services. Although these encounters are qualitatively different from traditional service provision, prior service management literature thus far had paid little attention to theory development and the systematization of technology-based service encounters. To fill this research gap, the present study outlines how new types of technology-based services fit into existing service typologies and provides an extension of existing frameworks to capture their unique characteristics. These insights in turn offer managerial implications and highlight open research questions.

Integrated Working in Children's Centres: A User Pathway Analysis

The growth of Children's Centres has seen the development of new ways of working with families by a variety of different workers. In this paper the authors report on a research project which examined how integrated working operates in practice within the different Children's Centres in one local authority in England. The authors explore strengths and difficulties of integrated working, and demonstrate how the opportunities and challenges presented are negotiated by Children's Centre workers and by more traditional service providers and professional groupings. The research project developed the user pathway model as a methodological tool to interrogate practice. Workshops were undertaken in 11 Children's Centres where internal and external partners, comprised of different professional groupings, worked together to map the pathway taken through their services by a virtual user. Findings indicate that whilst examples of integrated ways of working did exist, difficulties were also experienced. These difficulties and successes impact both on the way in which the service user experiences the work of Children's Centres and the outcomes that integrated working achieves. This paper shows how Children's Centres can present new opportunities and integrated ways of working, but may be restrained by more traditional professional working practices and managerial arrangements.

Opportunities and threats in mental health: part 3

Recent growth in the mental healthcare market has led to traditional service providers havingto rethink their conventional approach. The rate at which the current market is changing, as well as the impact of the financial downturn, call for an urgent review of the status quo. This article seeks to highlight the opportunities offered by an integration of the services currently supplied by multiple providers. It is proposed that this will lead to a more efficient mental healthcare service.

Policy-based integration of multiprovider digital home services

The digital home is both the nexus of a new wave of user-centric service integration and the front line of competition between device vendors, connectivity providers, and added-value service providers. Vertical integration of provider offerings via bundled services and devices is no longer sufficient to satisfy customer demands for best of breed elemental services and services composed from traditional service provider offerings, networked consumer devices, Web applications, and social networks. New digital home services spanning these domains must mediate between highly dynamic and overlapping sources of configuration and execution authority, while respecting the desires of the customer and simplifying their interactions with the system. In this article we present a policy-based federated service management architecture that addresses these concerns for digital home devices participating in end-to-end communications services. We also describe an OSGi-based gateway prototype of the architecture and investigate the scalability of our approach via simulation.

Complementary and Alternative Medicine for Mental Disorders Among African Americans, Black Caribbeans, and Whites

This study examined racial and ethnic differences in the use of complementary and alternative medicine (CAM) for the treatment of mental and substance use disorders. Data were from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R). The analytic sample included 631 African Americans and 245 black Caribbeans from the NSAL and 1,393 non-Hispanic whites from the NCS-R who met criteria for a mood, anxiety, or substance use disorder in the past 12 months. Logistic regression was used to examine racial and ethnic differences in the use of any CAM and in the use of CAM only versus the use of CAM plus services in another treatment sector. Thirty-four percent of respondents used some form of CAM. Whites were more likely than blacks to use any CAM, although there was no racial or ethnic difference in CAM use only versus CAM use plus traditional services. A higher proportion of blacks than whites used prayer and other spiritual practices. Among those with a mood disorder, black Caribbeans were less likely than African Americans to use any CAM. Findings of this study were similar to those of previous studies that examined physical illness in relation to CAM use in terms of its overall prevalence, the predominant use of CAM in conjunction with traditional service providers, and racial and ethnic differences in the use of CAM. The use of prayer was a major factor in differences between blacks and whites in CAM use; however, there were also differences among black Americans that warrant further research.