TABLE 2-Residual Urine Levels During a 6-Month Observation Period: 9 4 Women Receiving
Ol (ikier, absence of angina anil Lincontrolled
Acupuncture Treatment (A) for Recurrent Lower Urinary Tract Infections or Receiving No
Treatment {C)
Baseline, No,
Residual Urine, m l A ( i i = fi2) C ( i i - 2 7 )
<10 15 5 26
11 30 20 10
31-100 24 9 7
>]00 3 3
, 0 5 {vs a c j o u t i c t u i e g r o u p ) .
\vi-oU' Ehu iiucr, l,,I I" Sord^ii ^iiid S IJ lagci-lifmi pfi--
liripalf'Li 111 llu,' ilala iiruilyws ;IIK1 in jiri'pamlioM ol' liic
bnt't' ,\ l)i^iniic!i I'liiidiKlt'J nnn(ily,''e^ and coniribiiled
111 IIK'sliid\ |ii-oloci)i ,'\ Hoi'rlli'Uil slipi'rvisi.'d till'sludy
and conliihulcd MI ;ill pliaMvs
Acknowledgments
I'lushtiidy v>a,s lliiuli'd liy llie ^l);\v^j!i;ul iicwiinii
l,"i)uncil dud Ihi' ixkiios l,L'g!icy,
W P liianii ,\iiri)frt Cdois. thf [iiii"lici|)al)ni; arapiinr-
liiiisl, and Gn\\ Aiini,' Wiiifeiilsfn, Iht' nurst' whn nir-
nc'd oul iill plnsiciil measurements. We also tliaiil
Hogt;r Manin I'oi" linguistic supporl.
1'his sliiJy was approvi.'d liy tin,' lU'5;iunal Kihical
niitlf'i' am! ilie Norwegian Dal.i liii^pei'torate.
1 VVaii^^l M li.-ad\ |,*\, Sli.iper'Vf; The prevale'ice
01 d\"-iina in wonu'ii in i ondnit, / R Coll Gen Pnhi
li-iHi.; M H -41:")
2 r u v i n a n IS, Hailovs H, 1 ) \ \ , I T M , O i i i r s p i f B,
Sotjcl ] n I niiavv irai'l inf<'rlii)ii, seii-vcpiirtt'il in<'i-
d i ' i K ' r iiml ,iss<icial('d ''osi Ann l-.pideiniol
:iii;!-r>i:i
,i Si'tuK'lh'i' \\ \. niiary iract inleciioiT^- animiirn)-
hial ri;-,Hlan^'i' Gun Opin L'KII 2 0 0 0 , 1 0 2 . S - 2 4 ,
1 \iiru' \ ,'\lrack T, Iliio L, Baerheim A. Acupiinr-
luii' 111 ihc puiphykiM'- 1)1' reaineiU lower u r i n a n irart
iiilcilioi! Ill iidiili vKimi'd Scand I "rim Health Care
I9')H-1B T,"- i')
'' Baerheim \ , l,drsi;n I',, I,")i^vaiies :\. Vagmal ap|ili-
i-aliuii 1)1 lai'iubauJli ui ihe pro|)hylaxis ol reniiTent
lnv\er urinary lrai;l inl'erlioii in uosTten Scand/
Health Car/' 1494-li^,2"i9-24,"!
Is ( J ' l i u d y I , Catiell Wii Ki[ii*lics ul nrinai-v' I n u t
MtliTlion II' Ih.- [)la<ldi'r ISrI i-rol \'-)My3H
'i Hil/ i!, Gi'tinesKi V Wasser |, ct ai, [(eriuTeiit uri-
nary inicl iitirriiiin-, in |)i)slnicn()piinsal wiirnen, Gh'i
Infect Dr-. :?U00; iO \'<l --t i l i
I-'' Sljinini \ \ r \<;w R i'aclois conlnbutinjr to sus-
ceptibililv ul |>n;iLnu'ni)paii,sai women Id rentrrent iiri-
na:v Irarl ml'iTltons Chn Infeci Ih^ 1 9 9 9 , 2 8 "
7 2 3 72:*
Qctobei 2(!O2, 92. No, 10 ; Aniericiin JournnI of Public Health
2 Months. No. 4 Months, No, 6 Months, No,
A(1-64) C(n =25) A ( r = 5.3) C ( n = 18) A(n =61)
9 25 8 32
1/ 7 17 2 14
14 7 14
10
7 2 1 1 1 2
Yoga for Women With
Hyperkyphosis: Results
of a Pilot Study
Gail A. Greendale, MD. Anna McDivit, BS,
Annie Carpenter, MS, Leanne Seeger. MD.
and Mei-Hua Huang, DrPH
The Lhoradc region of llie spine is normally
kyphotic. or aiitenoi^iy concave?, I-Iypcrkypho-
sis, colloquially called ^'dowajjer's hump." re-
fers tcj excessive kyphotic ciuTaturc'; however,
there is no cntcrion standard, nor arc there
any outcome-based definitions oi the condi-
tion, A kypho.sis angle > 40"tlie 95th per-
ceiitile value for young adultsis currently
used to define hyperkyphosis,' "
1 lyp('rkyphosis may be as.sf)ciatr;d with
200(1,HI' physical and cniotiotial limitations' " and
may have multiple precipitants,"*' ""'"' Yoga
couki be an optimal intervention tor hyper-
kyphosis in that it may improve physical and
emotional fimctiomng as well as combat .some
of the underlying muscular and biomochani-
cal causes. We conducted a single-arm, non-
masked intevTention trial to asse,ss the effects
on anthropometric ajid phy.sieai fimetion of
Prim
yoga among women with hyperkyphosis.
l5(i-1tS:i,
Ib be included in the study, which was
conducted in Los Angeles dunng September
2000 to Sej){ember 2001. women had to
meet the (ollowing criteria: presence of physi-
cian-diagnosed hy perky pho.sis, age 60 years
lung disease, cleared (or participation by pn-
riiiuy care physician, and able to pass pbysical
safety' tests (e,g,, able to rise from the lloor to
a standing position safely and independently),
C(n-23) ITie inter\'enLioii involved hallia yoga, a type
of yoga incoiporating a eombination of
5'
breathing and movement.
9
7
As a means of ensuring the .safety of the
participants, the study took place in a closeh
monitored environment involving one-on-one
supervision and bands-on adjustments and
connections. The womc'ii wi-rv, divided into 2
separate small classes {n= 11 and n= 10),
each of which involved 12 weeks of yoga con-
sisting of twice-weekly 1 -hour se.ssions.
The program included 4 series of poses
modified from the clas.sical lomis of yoga to
accommodate t,he physical constraints of
kyphotic women. More challenging poses
wc.YQ. inh'Ofluced eveiy "J weeks, and muscles
and joints pariicularly affected by hyper-
kyjihosis (sboulders, spinal erectors, abdomi-
nals, neck) were targeted. Figure 1 briefly
summarizes the 4 series and illustrates an ex-
ample of 1 pose from eadi.
Anlhropometric outcomes. as.se,ssd at
hasfdine and follow-up by 1 of tlie investiga-
tors (A,M,) by means of standard protocols,
were (1) height without shoes (measured with
a stadiomctcr), (2) distance from tragus to
wall (a itieasure oi' IbrwarLl curvature), and (.3)
Dehninner kyphometer angle (an estimate of
dcgrt;e of thoracic spinal curvature; higber
values indicate more curvature),'' At baseline,
this investigator perfonned same-day re-
pealed measurements of each anthropomelric
cbaractenshe for 6 (;f the participants. Intra-
clas,s correlation coclllcients were ,98, ,61.
and ,34. respectively,
limed physical performance measures
v.x^re cliair stands (standing up and sitting
(iown. witb arms folded acniss chest, using an
aimless chair)/' functional reach.'' the
"|H:nny test" (picking up a |,)enny from Uie
lioor).''"* the "book test" (placing a book on a
liigb shein.''^ ami an 8-ft (2,4-m) w-alk,''* At
iTiaseline. all participants undtM-went spinal ra-
ciiogT-aphs; radiographs were read by a skele-
tal radiologist,'"
We used pretest-posttest si'ores to com-
piute changes in each antbropometiic and pei-
fonnance outcome. Because our sample size
Greendale et al. j Peer Reviewed , Research and Practice ! 1611
 (a) Recumbent upper extremity stretch (h) s afl1^ knee?

Note.llie program coniamet! 4 progressive sefie,'; of poses that buiiton one another. One example from each seriesisslio'i*-n {ajTIic'iiitsfincswas recuinbent.wh'^n p^ecnicled sailing. Yoga
ijrwthingwastajghLHnd movHment^ inciit(ied"rDllingihe:^houl()ers biii;k"anii Lwlateii rnovemeiilsof tlieariis, le^^s, and abrio!"'ion (bi it! thesmii'd senos,worKor hands and knees was aimed
at buiidint* balance (Miely. (Jo^e !Q the floor), core sireitgiti, ami cdordinaled inoveiTienls ol extremities (c) hi the thini series, women De^dn back bends in Irn prone position on the floor to
strengthen the spinal electors and to stretch the shuifider and hip gndics, (d) Thi: iourth series sntroduced standing poses, [[-'.loiving a"' iniscie 0O!jps, thai trained 'ar sienglii, fiexibiirty and
fiaiance.

FIGURE 1Overview of yoga series and examples of poses.

was ,sniall, we roinputt'd mean rhaiigr scores
(niaidieil t tests) as well BS iiieiiian scores
(WMcoxoii Icsis), We also condiiekxl arlaly.s(^s
Oiat stiatified hy presence or absence of vej--
teiiral fracture (n - 12 women) and l>y yo^a
r;iass, licsulLs were not substajitiveiy diflcrent;
tlnis, we present poiili;d resulLs,
['ardCipaiiLs cdnipk^tf^d daily diark^s Lliai
wei^e independenth coLled b> 2 of the re-
.searchei^s. In making entries in their diar-ies,
tlie women provi(ied r-es[iorrses to serni,sli'iic-
Uivvd qnestions and iiiided comments
u\^ ihe jirograni We corjdticted cimleni
analyses nf diarv entries,"'
\ t haseline, ilie mean age of Ihe 21 partici-
ii.'^ 75,0 years (niiitse: (>,i;!-- iS(i,l i
\'<'ai's), ,\!eaii heijihl and riH^an weiglii were
13(19 cm and <TI.5 kg, respectively Xinc
women i4'A"'i>} hafi no thoracic ov liinibar \ c r
tebi-al fVacturc', 7 (33"u) had at leasl 1 llio-
fractiirv (niedian = 2), and 5 (21"i)) had
hoih thoracic and lumbar frai'Uir{;s (all of ihe
women with hinibar fradtires had a( least 1
Ihoracic IVadnrc!
Xiiieteen woiiien ('->(}"(i) completed tbe
smdy, lovsi's were due Id unrriaied medical
prubicrns .Among lliit.se who mnipleted ihc
siudv- ,se,'-,,sioii atlendi"uice avi'raged 8l)"ii
ffaiifi'e, 52"iH-9li",,j), antl Ihi' daily diary coni-
j^letioii rale was illO"ii, There were no ad-
V!-rsi' evr^nts
Meastfred height increasetl and dislance
from [ragus to wall diminish(,'d: nn changes in

161? R(;searcl! anci Pr.-iclicc' Poor Health Oclober 200?, Vol 92, No 10
 ment ol pariinpanii, coiiductrd biiscliiic mid toMow up
TABLE 1-Baseline and Follow-Up Physical Characteristics and Physical Performance
visits, and contrihuLcd to liu* data aiialvsis, ,\, Caqwiiicr
Measures designed the yojia inl erven I inn and lauglil <itl of the
rlas^es 1, Sefger was ri'spoiisible lor the x-ray |iro(tifi>l,
Baseline Fnlli)w-Up Mean Median Wilcoxor n;ndm}i ai '^pine tllms, and iiiterpretalion of kyphn,':is
MeanValiiE! Mean Value Change t Charge test angles M I liiaiig perfornicd tiic d;itn an;iK";e^,

'ttysiCiil ch;imrteri?itir
lleiglit, cm 156 28 156,81 0,52 0,039 0,30 0,058
Thi^: study wa,'^ funded by ihe CUnide I), Peppfv Oider
Traj;us to WHII, ens 17,43 15,41 -2,02 0,000 -2,00 0.001 :\nn;neaiis lndependeni'c (~fnier anul Ihe ,\aLioLuil (,'eii-
Kypiiometer angle degree 60,89 59,79 1,11 0,748 -2,00 0,111 Icr (il rAccllfnire in Women's Health al IK'I ,\,
'l'iie a.ssisranrn of the stiidi^nLs and slaif ill Ihe Ins
Physical iierf(ifmani:e
C;iiit(pr-['Ci \ Women's Ileailh I-,diu'alion and Ke
Chan itaiid.s 16,54 i:.,23 -1,317 0,034 -1,32 0,033 soiira' ('I'lllcr w giateHilly i'knowled!;<:d.
Penny le,A. s 2,78 2,47 -0.350 0,037 -0,46 0,039
Ftinctioiiil reach, um 28,23 33,09 4,863 0,002 5,60 0,005
BQoktcst,s 3,24 2,87 0,345 0,129 -0,52 0,102 l-^Lliical ck'araiu'L' l'oi lhe study wat; obtained hnni Ihe
in,stiliilioiial levieu hoard ofllif l,rMversM\ iil Caliloi-
8-ft walk,:; 2,60 2,38 -0 222 0,116 -0,21 0 073
nia, I,OS Angeles,

Note. Five participants were missiiii; cata c i one test each, results were unaltered when the analysis oxlcuded these

1, Ion G I , rill M| 'lilies , \ ( ' fiioracie kypliosis:

range in nomial siihjecLs \in / Roentgenol. l9H(l'l,-i4,
979--i;8'i,

kyphometer ariglr weir apparent. Improve- "norifraeture" lij'pcrkyphosis include poor 2 VonLsma'; SA, Mai'Lvvan CA). Sagittal [iroliies of
ments were evident in the case of timed eh;ii!" posture and muscular weakness, laetors tar- Ihe si>ine, C'/f/i ()rt/^;) 19l>,^U)'2:!n 2 4 2 ,

staiuis (fasirr). tlic penny test (Ikster), and
limctioiial reaiih (longer) {Tal)ie I),
in terms nC diary entries, (S3'*(i r)f tlie
wiiineri repiiiled iucrea.'sed postural aware-
ness/imp rovenient (e,ti,, "1 leel I airi standing
geted by the yoga intei"vention,"^''''
The present intervention was not random-
ized, and uivestigatore assessing outcomes
were aware oi the study hypotheses, limita-
tions thai must be acknowledged, \onel!ie-
I I,.-'e<-h J,\, Duihi^rf. (', Kellie S, ei al. Relationship
ol' luiiy; fiiiirUon lo severity ol osieoporosis in vv<im<;n
,\n: Rev Respir Dis 1(-19O; l-t 1 , i ) S - 7 i
1 Cliou liK, I lariisini JI', Helalioiiship ol kyphosis
lo jihvsirnl J'lliHiss and hone mass In |)osl-irit;nopiUisal
women, .\nij Phtis Med !!-)87;liH:219-22'/,

.straighter, because Im mow. aware of my
p<i,stiire !h(^ more I do yoga, the nir)n^ I re-
inenibei" lo ,stariii and sit eoiTeetly" arid "1 slill
b( nd over, Init I am catehing it more olten"),
(i''i'"o re[)(>rteii lrnprovc;d vvell-br'mg (e,g,,
"AIUT riass I leel relaxed and j,)i;acerul" and "I
find [the eiassesj making me feel better in
every way") and 58"(i perceived iniprove-
inenLs in ihcir physical ['unctioiiing (e.g,, "1 re-
ally think all the classes that I have attended
ha\e heip(^d me with my balance" and "1 am
reeling more energy. 1 helicv*', Ix'causc of the
class").
Some clinicians |X'iTeive hypc;rkyphosis as
the irreversible product ol vertebral rraetiires.
leading lo giijatcr ^interior convexity^ Ilrnv-
evcr, in ) study involving 5 0 0 participants,
only i2"-h iii'\anaiice in kyphosis was ex-
plained by v(;ilebral wedging," Similarly, an-
otlier stiiiiy shovvi'd (hal only SO^A) of 132
women with hyperkyphosis had vertebral
Iraetiires;' aboul lhe same perc'entage as ni
Ihi^ prcseiiL pilot study. Postulated eauses of
less. this pilot stud}- sugg<;sts that the nse of
yoga among women wilii hyperkyphosis is
sale and acceptable and may produce belter
posture. The mechanisms by which postiiral
improvements occurred among our pailir-i-
panis may have included increased strength
and flexibility (attested to by improvements m
physical funelion rne;isures) and b(^ightened
attention to alignnK^nt {as reflc^rted in
womens diaiT entries), The contemplative
state cricoiiragci:] by yoga's mind-)jody ap-
proach may also lead to enhanced well-
being,"" a benefit noted by tiie majority of
our partieipanLs,
About Uie Author:^
Ilie author}: are with the School of Medicine L:'niven^ity of
Calilonda at Los .Angeles,
Requests for reprint'^ should be sent to Gail A. dreeii-
dale. Ml). I 'CF.A School oj Medidne. Division of Geri-
atric:^. 10943 Le Conte Are, Suite 2:i'^9. /,.,, Angeles, CA
90095-1687 fe-inad: ggrceiidaUi'rnednet.urta.edu/
Iltis brie! irci': accepted May :~>. 20(12
Contributors
G,A, (ireendale dtisigned the sindy, ohtained funding,
developed lhe sludy proeedtsres, and ,snpi-rvised thr:
data ana!v,sis A, Mrnivii was responsible I'or eiiroQ-
:") RDSS P D , IJIinj^tT B, Davis j \ \ ' , el al, Kvalnalion
ot adverse health oiilromes assoeialcd \sMh vrrlehral
l'raclnn;s, 0-^leoporo-. Im. 1941:1,134-141)
(i, I Iliiijier B, Bkiek DM, \eviil MT, el al CoiiU-ibii-
tion (if \crlebral dflormilit's to elii-oiiie back pani and
(.WwAhMy. j Hone Miner Re-<. l!-!92;7-4 4M-4')(i
7 lutiugfr B, Hlack DM, Paicniui I , el al Kvphows
in older women and its reUilion lo back pam, dfsabilily
and osieopenia: the Sitidy of Osleoporotic h'rarlures,
CMeoporos Int. 1994:4,55-60,
8, O.ok DJ, Guyalt GI 1, A(iaelH Jl>, el al Quality oi'
lite issues in women wiih vertebral traelures due Lo {<;-
[eoDorosis, Arthritis Rhimni. 199:i;3(i:730-7,i(i,
9, i.yles K\V, (^.old DT, Slii]))* KM, el al Associalioii
of osteoporolie vertehra.1 eomjiressiori fractures with
impairi;d functional status. Am j Med. 1993,94:
5 9 i ^{lOl,
10, (ireendale UA, HanvtI-Coniioi ! Ingles S, el a!
I,ate physical anil fuii<1ional dicers of osle()(ioro!ie
Irartiircs m women Ihe Kiincho Bcniiiiilo Sliidy, //Uii
(U'l-iatr Soi 199:1,43,9:"i[i-9(U
I1 Ryaii SI) I'lied 1,P The impael o1 kyphosfs on
daily lunrlioiitiig,/,UJ/ Genali Sin 1997,-t'l
1479-148(1,
12, llendry N(j, 1 he hydration ol the nticleus pulpo
siis and its rclalion lo iiUerveriehnil dise hydration
Jllmefotni Surg 19ri8:4ll:l,?2- 144
K5 Milne JS, i.audei" ij, I'he relai!on,slii|i ol'ky|ihosis
lo lhe shape oi vertebral bodies, Ann Hum Biol. 197(">,
,"i 17,V-I79
14 Sinaki M lloi L, iioifers |\V, el al, Coirelation oi

October ?0()2, Vol 92, No, 10 American Journal uf Public Health Gieendale et al, i Peer Reviewed ' Research and Practice 1613
h^K'k cKieiksor strt^ngtli wilti ihoi'acic kyplKWLS and luni come and education.'"'' However, TABLE 1-Complenientary and
liar kirdiisis in fstrogi'ii-ilcfiris^ni wonipn .-lin / PhiiS re[)orted Ihat many low-inconie Latinos use
\kd R:'hahil l9y(v7Li::i7O-'i74 Altemative Medicine Use by 575
folk practitioners such as the iimuulero Patients Surveyed: South Texas, 1998
IT) I'rihnid K(., IllHii !)\l, [ianis \\ vl al. (\iiTi-bt.'^
(hcaier), the yerhera (herbalist), tiie sobudin
ot kvpliosis tn iilijei" women f ,'\m Gcriatr Sac 1997:
(masseur), or [iracticcs such as spintiiai heal- Treatment = 575
4:T Ii82-fia7.
U) Csiika .M. M('C'ai1_^ i>J. Simple mrihod hit iiwd- iiig rather Ihan trealmenis olVerf^l by health
Msiitl body
sui'i'mi'nl <if lowiT r'>:rrrmiu imii^clc .Wi'iiglh Am/ clubs fir health fb(xi slores.'"'Th<'se |)atlenis of
Rela/atinn 28%
.Med 198[i,78.77-81 ( .\M use are diiterent than those of the niH-
Meiiitatiori 1^\
17 [)iiiii;an \'\\, Studt'iiski S, Chandlt-r J. I'rcscott Ii. jority population and deserve closer scriilin}.
l-'imrlion.il rfari): |)re(iictive viilidiLy in n ."^iimpli; ot cl- Yoga 2%
dfi-lv mail- vfteraiis. / Gemn:ol 1992-47 M9:i-M98.
Thf purpose of this brief WHS ID under- imagery 6%
stand CAM use hv family piacticc paticnLs in Biofecdback 2%
18, Kfniiicn HB, ,Siji AL. \n iiliji'i-ltvr riii'ii.siiir ol
|ihy.siral function of I'Idi'fK (nitpaticnts the pinsical tlie unique CLildiral sediiig of soulli lexai. Hypiiosi'j i%
|!('i'foi'ni:iii('i'lisl / \m f.k;r-i(ilr Soc. 1990..!8' "rhi,s brief estimates C.'\M use prcvBlcnrc am!
Self heip group 4%
Uri-Ill'-). assesses the influence ol paliciil (haracl(;ris-
Sfiirituai tieaimf! 8%
19 (iiiralnik jM. Simiinsick I'.M. ["I'rntrri !, cl ill. A tias, including measures ofethnieitv and ac
y^jnudl hedling
sliorl pliysiciil iTti)rmH(in* h^iit.ciy as.si^ssing iowei' cx-
culturation, on CAM u,se.
Ireinity funrlioii. associaiidii with sclf-rcpoitc<l dwahil- Ma,Hsage 14%
iiy and predirlioH DC tnorliilily iind niirsiiij; lionii' w\- Acupressure 2%
misMon. / GeionUil l994:49:\IHi)-M94
nif'iHpeiilii: loiicn 7%
20. \elsoii DA, Kiei;rko!)er .M. What i^ a v(;nebra]
Cniropractic b%
rnii'lure'' 111 \tarciLS R. Ivliiman I), Keisey J ed'; (h-
liivestigatoi~s conducted a cross-sect ion a I ReflexolDgy 2%
leopimiMS Sail Dicgn, Caiif' Ataili'mic Tn'ss Inc, 1996.
Iii3-K:i.l suiTey in the Residency Research Network of Herbal 'crneiiies
2\. Willms IX;. Bi-,s1 JA, I^iyior \)\\. <-\ id A sy.sit-m-
Sotitli 'lexas (HRNcSTj, a network of (i faniilv <!%
Aromatlierapv
:itir approach tor using qualitative nu'thnds m pHinaiT |)ractice residency progi'ains located in ,Saii Hprbs 24%
pri'vi'iilinti research .\-leii ,-\iithropol (J t99n,4 Anloiiio, Cotpus ('hristi, McAlIen, Harlitigen,
:t9l- iO9 falk iirarticeK
and I,<ir('do. (.'linic slaff sur\eyed KK) ctinsec-
Home remedy 13%
22. I.Li Forge H Mind iiody tiiiicss: enconragiiig ulivc adiiit piitienLs at each clinic siie in fall
prospects I'lir pnmary and secondaiy previ'iition / Cai- Folk healer 2%
1998: 575 iLsablc surveys were rctunied. CuiHDiiejo 1%
I he n^l'iisal rate was 22"'(i, refusers were Olher practices
older than participants. A(.:)Jiitiii(:1[)re 1%
The self-administercd survey elicited the Homeopalliv 1%
reason lor a patient's visit, medication use. de Bioelectromagnellc 1%
mogrnphic informatmn, and measures of elh- 1 ighl therspy 1%
nic backgrotind and accuitiiratii)ii,"' as well as
Use of Complementary CAM use during tlie 12 months pnor to the
Coloiiic tirigation
Aoy complemeiUary/altemative
O.b%
b8%
sun'ey. The CAM I'becklist inckided 2 3 items
and Alternative Medicine that addressed miiid/body trcatmenrs, man-
medicine treatment

ual healing, herbal remedies, lolk practices,

Among Family Practice and other treatments. ()j)en-eiided questions

Patients in South Texas assessed sjiecifu- pioducls used. Surveys v\ere

Sandra K. Burge, PhD. leresa L. Albright,
MD, and the Residency Research Network of
South Texas (RRNeST) Investigators
Americans spctui S27 billioti nui ol pocket
eveiy year on complementaiy and alternative
medicme (CAM).' Nearly all CAM users see
physicians f(ir healUi care." "' but few mention
their iise ol" <1'\M lo their doctors.'"' The
"typical" CAM user is a yoitng woman of Eu-
ropean descent with higher than average in-
available in both Spanish and hJigiish
Bivariatc and multivariate analyses exam-
ined charactenstics of C.'\M users, ctimparing
them with tJiose who used no CAM whatso-
<^v('r. Logistic rcg^^ssion analyses with Ibnvard
stepvvise inclusion detcnniiied the strongest
predictors ol CAM use while controlling Ibr
mul[icollin<'arilv anmng Uic
Of tiie r)/5 res[)ondenls, most vvirc Laliiio
(80%), women (74"'ii), high school gi-aduales
((i9"n), and mameil (57<'n), (i9"<i of ail n--
spoiulcnts had [iri\atc or government health
iiisui'aiicc. She mean age ol'irsponileiits was
11.5 years
Table I tlisplays ]"es[x.inses to CAM san'ey
items. Overall. 332 respondents (3y"'(i) used
a( least I of tlu' trciitmciiLs on Qiis list. On a\
erage. CAM users checked 2 4 CAM items iu
Ihc .survey. .Xuiong C.\M users, only 43"li rc-
porlcd that thev told their lioctor about CAM
use; 13"li left ihis item blanl;.
VV'liai C.AM products diii rcspondciiLs u,s{'?
Fhc most popular remedy was tea. especially
manzanitia Ichamomile). Only 12 (2"ii) re-
pojled use of popular health store produi'ls
such as St. )ohn"s worl, aloe vera, and Cinkgii

1614 1 Research anJ Practice Peer Reviewed Burge el a/. American Journal of Pubirc Healtli Oclobei 2002, Voi 92. No. 10