Table 3.
Summary of multivariate analyses of CAM use demographic and health factors
| Study | Sample characteristics and sampling strategy [n] | CAM use variable | Significant predictors | Non-significant predictors |
|---|---|---|---|---|
| Arcury et al. (6) | Adults aged 65+; representative national survey USA (2002 NHIS) 5837 | Use CAM in past year (excluding prayer) | Ethnicity (Hispanic and Asian >White and Black), gender (female), age (>80 less likely than 65–69), education (high school+), number of health conditions, region (Midwest, West) | None |
| Astin (8) | Adults; randomized national sample, USA 1035 | Use alternative therapy in previous year | Education (higher), health status (poorer), health status (urinary tract problems, chronic pain, back problems, anxiety) | Income, age, gender, ethnicity |
| Bair et al. (10) | Women taking part in SWAN study, USA; community-based sample 3307 | Ethnicity (White > African American > Hispanic/Chinese/Japanese), age (younger), language (English only > bilingual/non-English only), income (higher), employed, education (college+), physical activity (higher), not smoking, health-related quality of life (worse), depression (less) | Marital status, menopausal status, perceived stress | |
| Bausell et al. (12) | Adults aged 18+; representative national sample, USA (Medical Expenditure panel survey) 16038 | Visit CAM therapist in 1996 | Age (older, 30+), gender (female), education (higher), race (White > Hispanic/African American), region (Midwest and West > South), physical health (poorer) | Marital status, mental health |
| Bazargan et al. (13) | Adults (African American and Latino); local randomized sample, USA 287 | Use CAM to treat sickness in past 12 months | Financial strain (greater), health status (poorer) | Gender, access to care, availability of information, use of public services, depression |
| Bell et al. (14) | Adults; representative national survey, USA (2002 NHIS) 31044 | Ever use prayer for health | Age (older), gender (female), race (non-Hispanic Black > White; Hispanic > White), income (lower), region (South and Midwest > Northeast), self-rated health (poor), Chronic health conditions (more), use CAMs (biologically based therapies, mind-body medicine, manipulative methods) | Health insurance, education, use alternative medical systems |
| Burke et al. (21) | Adults; representative national survey, USA (2002 NHIS) 30278 | Use acupuncture in past 12 months | Race/gender interaction (Asian women > white women), education (college+), region (Northeast and West > South), self-reported health (worse), smoking status (former > never) | Birth place, age, income, employment, marital status, health insurance, alcohol use, BMI |
| Cherrington et al. (23) | Women aged 30–65; community-based samples, USA (ENDOW study) 833 | Use CAM therapy or practitioner in past 5 years | Education (high school+), self-reported symptoms (painful intercourse) | Health insurance, income, ethnicity, age, study site, hysterectomy, reported symptoms (pelvic pain, intestinal problems, abnormal bleeding) |
| Buono et al. (19) | Adults aged 65+; randomized population-based sample, Italy 655 | Use alternative therapies | Gender (female), depression (higher), No chronic somatic disease, spontaneously report pain or discomfort | None reported |
| Egede et al. (29) | Adults aged 18+; randomized national representative sample, USA (Medical expenditure panel survey) 21571 | Use practitioner-based CAM in 1996 | Gender (female), Ethnicity (Hispanic and Black < White), education (high school+), region (Northeast, Midwest, South < West), physical health (poor), insurance status (private insurance < uninsured), employment status (employed > unemployed), conditions (diabetes alone, diabetes + other chronic conditions) | Age, marital status, mental health, income |
| Fennell (32) | Adults; representative national survey, USA (2000 NHIS) 24834 | Use vitamins or minerals | Ethnicity (non-Latino white), gender (female), age (older), income (higher), education (higher), health insurance, smoking (former smoker > non-smoker, current smoker < non-smoker), drinking (current or former > non drinker), exercise (increasing), weight (decreasing), number of serious medical conditions (increasing), number of functional limitations (increasing), self-rated health (good) | Marital status |
| Garrow et al. (33) | Adults without diabetes; representative national survey, USA (2002 NHIS) 28625 | CAM use | Age (35–49 > 18–34, 65+<18–34), gender (female), race (White/Hispanic < Black), education (higher), income (higher), region (South < Northeast, West > Northeast). employed, co-morbidities (1+), Health status (better than last year), functional limitations | Marital status |
| Goldstein et al. (34) | Adults with and without cancer; randomized local survey, USA (California health interview survey) 9187 | CAM provider use in past 12 months | Gender (female), age (65+<18–35), race (Latino/African American < White), poverty level (300% and above >0–99%), education (higher), health status (chronic illness or cancer) | Insurance status |
| Gollschewski et al. (35) | Women aged 48–67; Randomized local sample, Australia 886 | Use herbal therapies | Good general health, age (<55 years), Previous use of hormone therapy, participate in BSE in past 2 years, not current user of hormone therapy | Employment, menopausal status, social functioning, mental health, pain, professional breast checks, pap smears |
| Graham et al. (38) | Adults; representative national survey, USA (2002 NHIS) 20990 | CAM use (excluding prayer) | Gender (female), education (higher), income (higher), no insurance, self-perceived health status (poorer), region (west), ethnicity (non-Hispanic whites), visited health professional in last 6 months | Usual source of medical care |
| Hanssen et al. (42) | Adults; national representative/randomized samples, Norway 1000 | Ever used practitioner- based CAM | Education (higher), self-reported health (poorer), visits to medical doctor (more) | None reported |
| Adults; national representative/randomized samples, Denmark 18691 | Ever used CAM | Education (higher), self-reported health (poorer), visits to medical doctor (more) | None reported | |
| Adults; national representative/randomized samples, Sweden 1001 | Ever used practitioner- based CAM | Education (higher) | None reported | |
| Harrison et al. (44) | Adults; 5% systematic regional sample, UK 15465 | Taking one or more herbal supplements | Age (45–64 more than younger or older), gender (female), ethnicity (white), SES (living in private household), physical activity (active), psychiatric morbidity (possible case), on prescribed medication | Self-rated general health, smoking status |
| Hogan et al. (46) | Adults aged 65+; National population-based sample (Canadian Study of Health and Aging), Canada 1081 | CAM use | Region (BC/Prairies/Ontario), residence (community > institution), gender (female) | Age, family history of neurodegenerative disorder, education, cognitive status |
| Honda et al. (47) | Adults aged 25–74; National representative survey, USA (MIDUS - Midlife development in the United States survey) 3032 | CAM use in past 12 months | Gender (female), education (higher), psychiatric disorders (yes) | Age, ethnicity, marital status, health insurance coverage, physical disorders |
| Hsiao et al. (48) | South Asians; Randomized local survey, USA (California health interview survey) 109 | CAM use | English proficiency (not proficient in English and do not speak English) | Age, gender, education, income, health status, length of US residence, health insurance status |
| Japanese Americans; Randomized local survey, USA (California health interview survey) 179 | CAM use | Age (51+ > younger) | Gender, education, income, health status, english proficiency, length of US residence, health insurance status | |
| Other Asians; Randomized local survey, USA (California health interview survey) 328 | CAM use | Age (51+ > younger), Health insurance status (uninsured > insured) | Gender, education, income, health status, english proficiency, length of US residence | |
| Chinese Americans; Randomized local survey, USA (California health interview survey) 451 | CAM use | Income (>$50 000), English proficiency (not proficient in English and do not speak English at home), length of US residence (10 years + less likely than US born) | Age, gender, education, health status, health insurance status | |
| Non-Hispanic whites; Randomized local survey, USA (California health interview survey) 3660 | CAM use | Age (65+ < 20–35 years), Education (higher), health status (chronic illness) | Gender, income, health status, english proficiency, length of US residence, health insurance status | |
| Filipino Americans; Randomized local survey, USA (California health interview survey) 269 | CAM use | Gender (male), education (college graduate +), health status (chronic illness, self-rated health very good/excellent), English proficiency (speak English well and English at home) | Age, income, length of US residence, health insurance status | |
| Hsiao et al. (49) | Latino Adults; Randomized local survey, USA (California health interview survey) 2188 | Use of Latino specific CAM (curandero) | Health status (cancer), English proficiency (speak English well) | Age, gender, education, income, self-rated health, length of US residence, health insurance status |
| Asian Adults; Randomized local survey, USA (California health interview survey) 1203 | Use of Asian-specific CAM (acupuncturist, TCM, green tea, soy products) | Age (36–64 > younger), health status (cancer), English proficiency (not proficient in English) | Gender, education, income, self-rated health, length of US residence, health insurance status | |
| American Indian adults; Randomized local survey, USA (California health interview survey) 322 | Use of American Indian specific CAM (native American healers or healing rituals) | Education (increasing), health status (cancer) | Age, gender, income, self-rated health, health insurance status | |
| African American adults; Randomized local survey, USA (California health interview survey) 924 | Use of African American specific CAM (others pray for your health, garlic) | Age (>65 less likely), gender (female), health status (cancer, other chronic illness), length of US residence (US born > 0–9 years residence) | Education, income, self-rated health, health insurance status | |
| White Adults; Randomized local survey, USA (California health interview survey) 3513 | Use of White specific CAM (massage therapist, osteopath) | Gender (female), income (higher), health status (cancer, other chronic illness) | Age, education, self-rated health, English proficiency, length of US residence, health insurance status | |
| Hull et al. (50) | Adults; Randomized regional survey of rural residents, USA 4695 | Use of faith- based healing | Age (18–44 > 75+), self-reported health (poorer) | Ethnicity, education, marital status, gender (female), income (<$50 000), unemployed |
| Keith et al. (52) | Adults aged 18–64; representative national sample, USA (Medical expenditure panel survey) 13208 | CAM-provider use in past year | Ethnicity (African American and Hispanic < White), gender (female), marital status (unmarried), region (West), education (higher), self-reported health status (poorer) | Poverty status |
| MacLennan et al. (60) | Adults aged 15+; representative non- institutionalised population-based survey, Australia (South Australian health omnibus survey 1993) 3004 | Use alternative medicines in past year | Age (15–54 years > older), gender (female), education (post- secondary), work status (employed), drink alcohol at risk level, BMI (overweight/obese < normal), exercise in past 2 weeks (yes) | Country of birth, marital status (never married), SES (high/very high), household income ($20 000+), history of hypertension |
| Mantyranta et al. (62) | Women aged 15–74; randomized representative survey, Finland 1100 | Use alternative drugs | Education (>12 years), smoking status (non-smoker), Reporting psychosomatic symptoms, physician visits | Residence (rural/urban), exercise, self-reported health status, existence of long-standing illness |
| Men aged 15–74; randomized representative survey, Finland 1034 | Use alternative drugs | Education (>12 years), residence (urban>rural), smoking status (non-smoker), exercise weekly (3 h or more), reporting psychosomatic symptoms, physician visits | Self-reported health status, existence of long-standing illness | |
| Matthews et al. (64) | Women; Community sample, USA 829 | Total number of CAM modalities used | Sexual orientation (lesbian), health worry (no), perceived discrimination in healthcare settings (yes) | Age, education, ethnicity, income, Insurance status, chronic illness |
| McCaffrey et al. (65) | Adults aged 18+; nationally representative survey, USA (Eisenberg et al. dataset 30) 2055 | Use of prayer for health | Gender (female), age (34+ years >18–33), education (high school+), religion (Christian non-Roman Catholic), medical conditions (depression, headaches, back and/or neck pain, gastrointestinal problems, allergies) | None reported |
| McFarland et al. (66) | Adults; Medical expenditure panel survey, USA 16400 | Practitioner-based CAM use | Age (20–64 years > older or younger), gender (female), ethnicity (white), education (high school +), region (West), seen conventional physician in last year | Self-reported health, problems with instrumental activities of daily living, problems with activities of daily living |
| Adults; Canadian national population health survey, Canada 70884 | Practitioner-based CAM use | Age (20–64 years > older or younger), gender (female), ethnicity (white), education (high school+), region (West), Self-reported health (excellent < poor-good), problems with instrumental activities of daily living (yes), problems with activities of daily living (no), seen conventional physician in last year | None reported | |
| McKenzie et al. (68) | Adults aged 55+; Convenience sample, Canada 128 | Number of supplements used | BMI (lower) and positive attitudes towards supplements | Age, self-rated health, number of medications, weight change, dietician's rating of nutritional risk, BMI, money spent on groceries |
| McMahan et al. (69) | Adults aged 65–74; National representative survey USA (Midlife development in the United States survey) 335 | CAM use in past 12 months | Gender (female), education (higher), income (higher), spirituality importance (higher), present health status (worse) | Not reported |
| Messerer et al. (70) | Women; Nationally representative randomized survey, Sweden 5826 | Use natural remedies | Age (16–44 years < 45–54 years), physical exercise (heavier), self-reported health status (excellent < good) | Education, marital status, place of residence, smoking status, BMI |
| Men; nationally representative randomized survey, Sweden 5596 | Use natural remedies | Age (65–84 > 45–54 years), physical exercise (heavier), self-reported health status (excellent < good) | Education, marital status, place of residence, smoking status, BMI | |
| Muhajarine et al. (73) | Adults aged 20+; Randomized local sample, Canada 818 | Use of alternative practitioner and physician in past 12 months (compared with use of physician in past 12 months) | Gender (male), chronic back pain, migraine headaches, Psychological distress (higher) | Age, number of chronic conditions, number of disabilities |
| Najm et al. (74) | Non-Hispanic White adults; Convenience sample, USA 176 | CAM use in past year | Insurance (no insurance less likely, medicare more likely) | Age, gender, years in US, born in US, education, perceived health, number of physicians visited |
| Hispanic adults; Convenience sample, USA 167 | CAM use in past year | Years in US (<10), number of physicians visited (higher), Insurance (private insurance and no insurance > managed care or medicare) | Age, gender, education, born in US, perceived health | |
| Asian adults; Convenience sample, USA 182 | CAM use in past year | Gender (female), number of physicians visited (fewer), Insurance status (Medicare more likely, no insurance less likely) | Age, years in US, education, perceived health | |
| Ness et al. (75) | Adults (aged 52+); Randomized subsample from the nationally representative Health and retirement study, USA 1099 | CAM use | Gender (female), ethnicity (Hispanic < Caucasian), Income ($60 000+ > less than $17 000), No current smoking, limitations to activities of daily living (1 limitation > none) | Age, education, no of chronic conditions, insurance, hospitalized in past 2 years, visits to doctor in past 2 years, current alcohol consumption, limitations in instrumental activities of daily living |
| Newton et al. (76) | Women aged 45–64; Local sample of women taking part in a trial, USA 886 | Alternative therapy use | Hot flashes, HRT use (current < never), trouble sleeping, exercise level (higher) | Menopausal status, education, night sweats |
| Ng et al. (77) | Adults aged 65+; Local comprehensive survey of older adults of Chinese ethnicity, Singapore (subsample of Singapore Chinese longitudinal aging cohort study) 2010 | Social support (increasing), arthritis, cancer, disabled in instrumental activities of daily living, current smoker, regular Tai qi, Use sleeping pills, less frequent doctor visits (in those with chronic disease) | Age, education, marital status, living arrangements, gender, payment for healthcare, chronic disease, hypertension, diabetes, heart disease, stroke, other illness, number of concurrent chronic diseases (higher), using hypnotics, disabled in activities of daily living, regular exerciser, current alcohol use, frequency of doctor visits (in those with no chronic disease), number of prescribed medications, life satisfaction (higher), customarily see same doctor, poor compliance with medicines | |
| Nielsen et al. (79) | Men; representative randomized national sample, Denmark (Danish health and morbidity survey 2000) 6963 | Use natural medicines in past 14 days | Age (increasing, but less in 80+years), presence of chronic disease | Self-perceived general health, education, conventional medicine use |
| Women; representative randomized national sample, Denmark (Danish health and morbidity survey 2000) 7312 | Use natural medicines in past 14 days | Age (increasing, but less in 80+years), presence of chronic disease, self-perceived general health (less than good), | Education, conventional medicine use | |
| Nilsson et al. (80) | Women aged 25–74; Randomized regional population-based sample of adults, Sweden 2974 | CAM use | Education (secondary or university+), Age (55–64 years), self-perceived health status (poor) | Medical history |
| Men aged 25–74; Randomized regional population-based sample of adults, Sweden 2820 | CAM use | Education (secondary or university+) | Age, medical history (cardiovascular disorder or diabetes), self-perceived health | |
| O’Connor et al. (82) | Adults aged 40+; Local randomized sample, USA 4404 | Use prayer for health | Gender (female), education (some college or more less likely to pray), employment, marital status (married or widowed) | Age, chronic condition |
| Rafferty et al. (87) | Adults aged 18+; Local population-based survey, USA (Behavioral risk factor surveillance system) 3764 | CAM use | Gender (female), ethnicity (White > Black), education (higher), self-perceived general health status (poorer) | Age, income |
| Raji et al. (88) | Adults aged 77+; Local population-based sample, USA 365 | Current use of herbs | Gender (female) | Ethnicity, age, place of birth, medical condition (diabetes, coronary artery disease), physician visits in past year |
| Saper et al. (89) | Adults aged 18+; nationally representative sample, USA (Eisenberg 1998 dataset30) 2055 | Ever use yoga | Age (34–53 years > 54+years), gender (female), religious preference (none or other > Christian), education (> high school), urbanicity (metropolitan), no children under 18 living in household, CAM use other than yoga (any, relaxation techniques, homeopathy, energy healing, acupuncture), specific health conditions (lung disease) | |
| Shmueli et al. (93) | Adults aged 45–75; representative sample of Israeli Jewish population 4165 | Any CAM use | Survey year (2000), health-related quality of life (poorer), gender (female), age (younger), economic status (good), residence (big city), education (higher), origin (USSR less likely) | Insurance |
| Shmueli et al. (94) | Adults aged 45–75; representative sample of Israeli Jewish population 2003 | Use CAM provider in previous year | Gender (female), education (high school) | Religiosity, age, education, economic status, ethnicity, residential area, marital status, health plan, chronic health problems, health-related quality of life |
| Adults aged 45–75; representative sample of Israeli Jewish population 2505 | Use CAM provider in previous year | Gender (female), age (younger), education (higher), economic status (very good or good), health plan (Meuhdet plan > other three plans), health-related quality of life (worse) | Religiosity, ethnicity, residential area (big city), marital status, chronic health problems | |
| Sturm (99) | Adults; Nationally representative sample, USA (Healthcare for communities) 9154 | Any CAM use | Gender (female), age (young and old less likely), education (higher), insurance (private or none), region (West), number of chronic conditions (higher), mental health (worse) | Income, ethnicity |
| Unutzer et al. (104) | Adults; randomized national representative sample, USA 9585 | CAM use | Mental disorder (major depression, panic disorder more likely, dysthymia less likely), number of chronic medical problems (higher), gender (female), age (60+ < 30–59 years), education (higher), region (West > South), health insurance (private) | Mental disorder (GAD, mania/psychosis), substance abuse, race, work status |
| Upchurch et al. (105) | Women aged 18+; representative national survey, USA (1999 NHIS) 17399 | CAM use | Age (older), ethnicity (Black non-Hispanic, Hispanic and Asian < White), Nativity (US Born), education (higher), income (>$20 000), region (Midwest & West > South; Northeast < South), self-rated health status (worse) | Insurance status |
| Wolsko et al. (109) | Adults aged 18+; randomized national representative sample, USA (Eisenberg et al. 1998 dataset 30) 2055 | Use of a CAM provider among people who used a given CAM therapy | Visits to conventional practitioners (more), gender (female), use of CAM for diabetes, use CAM for cancer, use CAM for back or neck problems | Age, race, region, education, income, presence of psychiatric disorder |
Note. Due to space limitations we have in most cases presented one analysis per article. Where multiple analyses are present in the original studies the analysis pertaining to overall CAM use in the whole sample has been selected. Where multiple analyses pertain to CAM use in different subsamples of participants, all analyses are presented.