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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Do Attitudes and Beliefs About Complementary and Alternative Medicine Impact Utilization Among Patients with Cancer? A Cross-Sectional Survey</title>
<author><name sortKey="Bauml, Joshua" sort="Bauml, Joshua" uniqKey="Bauml J" first="Joshua" last="Bauml">Joshua Bauml</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Medicine, Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chokshi, Sagar" sort="Chokshi, Sagar" uniqKey="Chokshi S" first="Sagar" last="Chokshi">Sagar Chokshi</name>
</author>
<author><name sortKey="Schapira, Marilyn M" sort="Schapira, Marilyn M" uniqKey="Schapira M" first="Marilyn M." last="Schapira">Marilyn M. Schapira</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">Department of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Im, Eun Ok" sort="Im, Eun Ok" uniqKey="Im E" first="Eun-Ok" last="Im">Eun-Ok Im</name>
<affiliation><nlm:aff id="A6">University of Pennsylvania School of Nursing, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Li, Susan Q" sort="Li, Susan Q" uniqKey="Li S" first="Susan Q." last="Li">Susan Q. Li</name>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Langer, Corey" sort="Langer, Corey" uniqKey="Langer C" first="Corey" last="Langer">Corey Langer</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Medicine, Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ibrahim, Said" sort="Ibrahim, Said" uniqKey="Ibrahim S" first="Said" last="Ibrahim">Said Ibrahim</name>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">Department of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">26011157</idno>
<idno type="pmc">5589132</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589132</idno>
<idno type="RBID">PMC:5589132</idno>
<idno type="doi">10.1002/cncr.29173</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">003379</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003379</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Do Attitudes and Beliefs About Complementary and Alternative Medicine Impact Utilization Among Patients with Cancer? A Cross-Sectional Survey</title>
<author><name sortKey="Bauml, Joshua" sort="Bauml, Joshua" uniqKey="Bauml J" first="Joshua" last="Bauml">Joshua Bauml</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Medicine, Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Chokshi, Sagar" sort="Chokshi, Sagar" uniqKey="Chokshi S" first="Sagar" last="Chokshi">Sagar Chokshi</name>
</author>
<author><name sortKey="Schapira, Marilyn M" sort="Schapira, Marilyn M" uniqKey="Schapira M" first="Marilyn M." last="Schapira">Marilyn M. Schapira</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">Department of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Im, Eun Ok" sort="Im, Eun Ok" uniqKey="Im E" first="Eun-Ok" last="Im">Eun-Ok Im</name>
<affiliation><nlm:aff id="A6">University of Pennsylvania School of Nursing, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Li, Susan Q" sort="Li, Susan Q" uniqKey="Li S" first="Susan Q." last="Li">Susan Q. Li</name>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Langer, Corey" sort="Langer, Corey" uniqKey="Langer C" first="Corey" last="Langer">Corey Langer</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Department of Medicine, Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ibrahim, Said" sort="Ibrahim, Said" uniqKey="Ibrahim S" first="Said" last="Ibrahim">Said Ibrahim</name>
<affiliation><nlm:aff id="A3">Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">Department of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mao, Jun J" sort="Mao, Jun J" uniqKey="Mao J" first="Jun J." last="Mao">Jun J. Mao</name>
<affiliation><nlm:aff id="A1">Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A7">Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Cancer</title>
<idno type="ISSN">0008-543X</idno>
<idno type="eISSN">1097-0142</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Complementary and Alternative Medicine (CAM) incorporates treatments used by cancer survivors in the attempt to improve quality of life. While population studies have identified factors associated with use, assessment of why patients use CAM or the barriers against utilization have not been examined.</p>
</sec>
<sec id="S2"><title>Patients and Methods</title>
<p id="P2">We conducted a cross-sectional survey study in the thoracic, breast, and gastrointestinal medical oncology clinics at an academic cancer center. Clinical and demographic variables were collected by self-report and chart abstraction. Attitudes and beliefs were measured using the validated Attitudes and Beliefs about CAM (ABCAM) instrument. This instrument divides attitudes and beliefs into three domains: expected benefits, perceived barriers, and subjective norms.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among 969 participants (response rate 82.7%) surveyed between June 2010 and September 2011, patient age≤65, female gender and college education were associated with significantly greater expected benefit from CAM (p < 0.0001 for all). Non-white patients reported more perceived barriers to CAM use than white patients (p<0.0001), but had a similar degree of expected benefit (p=0.76). In a multivariate logistic regression analysis, all domains of the ABCAM instrument were significantly associated with CAM use (p<0.01 for all) among patients with cancer. Attitudes and beliefs about CAM explained much more variance in CAM use than clinical and demographic variables alone.</p>
</sec>
<sec id="S4"><title>Conclusion(s)</title>
<p id="P4">Attitudes and beliefs varied by key clinical and demographic characteristics, and predicted CAM utilization. By developing CAM programs based upon attitudes and beliefs, we may be able to remove barriers among underserved patient populations and provide more patient centered care.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0374236</journal-id>
<journal-id journal-id-type="pubmed-jr-id">2771</journal-id>
<journal-id journal-id-type="nlm-ta">Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">Cancer</journal-id>
<journal-title-group><journal-title>Cancer</journal-title>
</journal-title-group>
<issn pub-type="ppub">0008-543X</issn>
<issn pub-type="epub">1097-0142</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26011157</article-id>
<article-id pub-id-type="pmc">5589132</article-id>
<article-id pub-id-type="doi">10.1002/cncr.29173</article-id>
<article-id pub-id-type="manuscript">NIHMS652845</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Do Attitudes and Beliefs About Complementary and Alternative Medicine Impact Utilization Among Patients with Cancer? A Cross-Sectional Survey</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bauml</surname>
<given-names>Joshua</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chokshi</surname>
<given-names>Sagar</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Schapira</surname>
<given-names>Marilyn M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Im</surname>
<given-names>Eun-Ok</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Li</surname>
<given-names>Susan Q.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Langer</surname>
<given-names>Corey</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ibrahim</surname>
<given-names>Said</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mao</surname>
<given-names>Jun J.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA</aff>
<aff id="A2"><label>2</label>
Department of Medicine, Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</aff>
<aff id="A3"><label>3</label>
Center for Health Equity Research and Promotion (CHERP), Philadelphia VA Medical Center, Department of Medicine, Division of GIM, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</aff>
<aff id="A4"><label>4</label>
Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</aff>
<aff id="A5"><label>5</label>
Department of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</aff>
<aff id="A6"><label>6</label>
University of Pennsylvania School of Nursing, Philadelphia, PA, USA</aff>
<aff id="A7"><label>7</label>
Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA</aff>
<author-notes><corresp id="FN1"><bold>CORRESPONDING AUTHOR:</bold>
Jun J. Mao, M.D., M.S.C.E., Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street/2 Gates, Philadelphia, Pennsylvania 19104, Phone: 215-746-2481; Fax: 215-662-3591, <email>jun.mao@uphs.upenn.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>5</day>
<month>3</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>26</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><day>15</day>
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>07</day>
<month>9</month>
<year>2017</year>
</pub-date>
<volume>121</volume>
<issue>14</issue>
<fpage>2431</fpage>
<lpage>2438</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/cncr.29173</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Complementary and Alternative Medicine (CAM) incorporates treatments used by cancer survivors in the attempt to improve quality of life. While population studies have identified factors associated with use, assessment of why patients use CAM or the barriers against utilization have not been examined.</p>
</sec>
<sec id="S2"><title>Patients and Methods</title>
<p id="P2">We conducted a cross-sectional survey study in the thoracic, breast, and gastrointestinal medical oncology clinics at an academic cancer center. Clinical and demographic variables were collected by self-report and chart abstraction. Attitudes and beliefs were measured using the validated Attitudes and Beliefs about CAM (ABCAM) instrument. This instrument divides attitudes and beliefs into three domains: expected benefits, perceived barriers, and subjective norms.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among 969 participants (response rate 82.7%) surveyed between June 2010 and September 2011, patient age≤65, female gender and college education were associated with significantly greater expected benefit from CAM (p < 0.0001 for all). Non-white patients reported more perceived barriers to CAM use than white patients (p<0.0001), but had a similar degree of expected benefit (p=0.76). In a multivariate logistic regression analysis, all domains of the ABCAM instrument were significantly associated with CAM use (p<0.01 for all) among patients with cancer. Attitudes and beliefs about CAM explained much more variance in CAM use than clinical and demographic variables alone.</p>
</sec>
<sec id="S4"><title>Conclusion(s)</title>
<p id="P4">Attitudes and beliefs varied by key clinical and demographic characteristics, and predicted CAM utilization. By developing CAM programs based upon attitudes and beliefs, we may be able to remove barriers among underserved patient populations and provide more patient centered care.</p>
</sec>
</abstract>
<kwd-group><kwd>Complementary and alternative medicine</kwd>
<kwd>cancer</kwd>
<kwd>attitudes and beliefs</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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