Complementary and Integrated Health Approaches: What Do Veterans Use and Want

Abstract

OBJECTIVES: Non-pharmacological treatment options for common conditions such as chronic pain, anxiety, and depression are being given increased consideration in healthcare, especially given the recent emphasis to address the opioid crisis. One set of non-pharmacological treatment options are evidence-based complementary and integrative health (CIH) approaches, such as yoga, acupuncture, and meditation. The Veterans Health Administration (VHA), the nation's largest healthcare system, has been at the forefront of implementing CIH approaches, given their patients' high prevalence of pain, anxiety, and depression. We aimed to conduct the first national survey of veterans' interest in and use of CIH approaches. METHODS: Using a large national convenience sample of veterans who regularly use the VHA, we conducted the first national survey of veterans' interest in, frequency of and reasons for use of, and satisfaction with 26 CIH approaches (n = 3346, 37% response rate) in July 2017. RESULTS: In the past year, 52% used any CIH approach, with 44% using massage therapy, 37% using chiropractic, 34% using mindfulness, 24% using other meditation, and 25% using yoga. For nine CIH approaches, pain and stress reduction/relaxation were the two most frequent reasons veterans gave for using them. Overall, 84% said they were interested in trying/learning more about at least one CIH approach, with about half being interested in six individual CIH approaches (e.g., massage therapy, chiropractic, acupuncture, acupressure, reflexology, and progressive relaxation). Veterans appeared to be much more likely to use each CIH approach outside the VHA vs. within the VHA. CONCLUSIONS: Veterans report relatively high past-year use of CIH approaches and many more report interest in CIH approaches. To address this gap between patients' level of interest in and use of CIH approaches, primary care providers might want to discuss evidence-based CIH options to their patients for relevant health conditions, given most CIH approaches are safe.

Reducing veterans' risk for suicidal behaviors: A qualitative study to inform development of the RECLAIM health promotion program

“…Mindfulness-based interventions are among the most commonly used complementary and integrated health (CIH) approaches within the VA. 27 However, participants in this study repeatedly emphasized the importance of providing clarity and a sense of familiarity when promoting RECLAIM. This indicates that even though the popularity of mindfulness-based interventions has increased, veterans may still have some uncertainty about these types of interventions.…”

“…The use of peers has been suggested in other studies to generate veteran buy-in and trust. [27][28][29] The use of fellow veterans to promote health care or a speci c program or treatment is a strategy that has been previously suggested considering that peers can be viewed as allies. 27 Using peer-to-peer outreach may also help overcome stigma associated with receiving care and can improve treatment entry and adherence.…”

“…While efforts have been made to prevent and reduce veteran suicide, the rate of suicide among post-9/11 veterans (ages [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] remains the highest of all veteran cohorts and has increased by 76% from 2005-2017, 6 indicating that more work is needed to effectively reduce the rate of suicide among this veteran cohort. Current suicide reduction and prevention strategies often narrowly focus on extreme psychopathology (e.g., post-traumatic stress disorder) and are frequently directed at veterans who have already indicated intent to harm.…”

Reducing Veterans' Risk for Suicidal Behaviors: A Qualitative Study to Inform Development of the RECLAIM Health Promotion Program

“…The use of peers has been suggested in other studies to generate veteran buy-in and trust. [14][15][16] The use of fellow veterans to promote health care or a specific program or treatment is a strategy that has been previously suggested considering that peers can be viewed as allies. 14 Participants frequently discussed how RECLAIM would proactively address veterans' health and wellness.…”

“…[14][15][16] The use of fellow veterans to promote health care or a specific program or treatment is a strategy that has been previously suggested considering that peers can be viewed as allies. 14 Participants frequently discussed how RECLAIM would proactively address veterans' health and wellness. Several participants considered RECLAIM to be an opportunity to help veterans connect to and understand available services at the VA. Access to VA services, such as nutrition and weight loss (MOVE!…”