Providers' and Administrators' Perceptions of Complementary and Integrative Health Practices Across the Veterans Health Administration

Abstract

Objectives: Use of complementary and integrative health (CIH) therapies is being promoted by the Veterans Health Administration (VA), but promotion may not equate to adoption. The purpose of this study was to explore whether perceptions regarding CIH at one VA medical center (VAMC) were similar to perceptions from a sample of other VAMCs.Design: This article reports a subset of qualitative findings from a mixed-methods study. Setting/Participants: Sites were recruited through a VA-wide CIH listserver. On the basis of site description (e.g., therapies offered, interest in CIH), sustained site interest, and geographic location, recorded interviews of 22 persons were conducted at 6 sites across the country.Outcome measures: Interviewees were asked the same questions as the single-site VAMC study respondents.Results: Variable access to CIH services across the VA created the need for workarounds. Multiple barriers (e.g., limited space and challenging credentialing) and facilitators (e.g., strong champion and high veteran demand) were cited. Respondents described nonpharmacologic pain control, the usefulness in treating mental health and/or post-traumatic stress disorder issues, and improvement of staff morale as additional reasons to promote CIH. Findings confirmed those from the earlier single-site VAMC phase of the study. Even the highestperforming sites reported struggling to meet veterans' demands for delivery of CIH.Conclusions: Almost half of active-duty military personnel report the use of at least one type of CIH therapy. As active-duty personnel transition to veteran status, both their physical and mental healthcare needs can potentially benefit from CIH therapies. The VA must actively support local enthusiastic CIH proponents and receive congressional support if it is to actually meet its stated goal of providing personalized, proactive, patient-driven healthcare through the promotion of comprehensive CIH services to veterans.

A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury

“…These common complaints are consistent with already identified barriers to treatments within the scientific literature. 47,54,55,57,58,72–74…”

Perceptions of traditional Chinese medicine for chronic disease care and prevention: a cross-sectional study of Chinese hospital-based health care professionals

“…Furthermore, perhaps the disadvantages of Western medicine in the treatment of chronic diseases have fuelled health care professionals’ optimism about TCM [ 19 ]. According to patients, CAM may not only cure [ 20 ] but also may counterbalance the adverse effects of Western medicine [ 21 – 23 ], improve physical and mental health, promote positive medical outcomes and wellness [ 24 – 27 ], etc. TCM may also enhance the comprehensive outcomes of preventive and treatment efforts and heighten the effectiveness of health interventions and assessments [ 28 ].…”

Garnering Support for Complementary and Integrative Health Implementation: A Qualitative Study of VA Healthcare Organization Leaders

“…26,27 Healthcare leaders' support for CIH therapies is instrumental for successful implementation. [28][29][30][31][32] However, little is known about how to garner such support and what motivates leaders' provision or withholding of support. In two prior studies, leaders identified individual knowledge/ attitudes toward CIH, perceptions of patients, traditional medical culture, champions, and organizational issues as barriers or facilitators to CIH implementation.…”

“…In two prior studies, leaders identified individual knowledge/ attitudes toward CIH, perceptions of patients, traditional medical culture, champions, and organizational issues as barriers or facilitators to CIH implementation. 28,32 Yet how these barriers/facilitators may influence leaders' decisionmaking has not been fully explored. Therefore, we sought to examine leaders' reasons for providing or withholding concrete support for CIH in early adopting VAMCs.…”