How well do participants in clinical trials represent the U.S. population with chronic neck or back pain?

Background: Randomized clinical trials (RCTs) are the gold standard for assessing treatment effectiveness; however, they have been criticized for generalizability issues such as how well trial participants represent those who receive the treatments in clinical practice. We assessed the representativeness of participants from eight RCTs for chronic spine pain in the U.S.

Delay and nonreceipt of needed healthcare in U.S. adults with household family members with serious health needs.

Introduction: Households may be primary settings for developing noncommunicable and infectious diseases due to shared lifestyle factors and ease of transmission, rendering multiple family members within a household in simultaneous need of health services. Limited resources may force families to prioritize healthcare for individuals with serious health needs over other family members; however, few studies have examined unmet healthcare needs within family contexts. This study examines the odds of U.

A Matched Cohort Analysis for Examining the Association Between Slow Gait Speed and Shortened Longevity in Older Americans.

This investigation examined the association between slow gait speed, as defined with newly established cut-points, and all-cause mortality in older Americans with a matched cohort analysis. The analytic sample included 10,259 Americans aged ≥65 years from the 2006-2014 waves of the Health and Retirement Study. Walking speed was measured in participant residences.

Unmet healthcare needs among midlife adults with mental distress and multiple chronic conditions.

Background: Limited attention has focused on midlife health. Yet, this is a time of great change, including onset of chronic conditions and changes in mental health.

Objective: To examine unmet healthcare needs among midlife adults (50-64 years) in the US with severe psychological distress (SPD) and/or multiple chronic conditions (MCC).

Health Care Disparities Among U.S. Women of Reproductive Age by Level of Psychological Distress.

Reproductive-age women have a high rate of contact with the health care system for reproductive health care. Yet, beyond pregnancy, little is known about psychological distress and unmet health care needs among these women. We examined reasons for delayed medical care and types of foregone care by level of psychological distress.

Psychological Distress and Access to Care Among Midlife Women.

The objective of this study is to examine unmet health care needs among midlife women (ages 50-64 years) in the United States by level of psychological distress. Using data for a nationally representative sample of midlife women ( = 8,838) from the 2015-2016 National Health Interview Survey, we estimated odds ratios of reasons for delayed care and types of care foregone by level of psychological distress-none, moderate (moderate psychological distress [MPD], and severe (severe psychological distress [SPD]). More than one in five midlife women had MPD (15.

Gender Differences in Prevalence, Patterns, Purposes, and Perceived Benefits of Meditation Practices in the United States.

Introduction: Meditation is a common type of complementary and alternative medicine (CAM), and the evidence for its usefulness for health promotion is growing. Women have higher rates of overall CAM use than men do, but little is known about gender differences in meditation practices, reasons for use, or perceived benefits.

Methods: Data from the 2012 National Health Interview Survey (NHIS) were used.

Perceived Benefits of Using Complementary and Alternative Medicine by Race/Ethnicity Among Midlife and Older Adults in the United States.

To describe, for a national sample of midlife and older adults, the types of complementary and alternative medicine (CAM) used for health and wellness and the perceived benefits of CAM use by race/ethnicity. Using data from the 2012 National Health Interview Survey, we ran multiple logistic regression models to estimate the odds of each perceived benefit among adults ages 50 and older. More than 38% of midlife and older adults used CAM in the past year.

Acupuncture 'dose' (number of treatments) and insurance benefits in the USA.

Background: An adequate treatment dose, including a sufficient number of acupuncture treatments, is important for the clinical effectiveness of acupuncture treatment for common conditions.

Objective: To examine the characteristics of US adults who used a full course of acupuncture (≥6 treatments), a short course (1-5 treatments) or no acupuncture, including use of insurance benefits for acupuncture among users.

Methods: We used population-based survey data from the 2012 National Health Interview Survey (NHIS), the most current nationally representative data including use of acupuncture.

Racial/Ethnic Differences in the Use of Complementary and Alternative Medicine in US Adults With Moderate Mental Distress.

Objectives: To examine the prevalence of complementary and alternative medicine (CAM) use by race/ethnicity and to identify sociodemographic and health-related factors associated with CAM use among US adults with moderate mental distress (MMD).

Methods: We analyzed data from the 2012 National Health Interview Survey (NHIS). We used data for 6016 noninstitutionalized US adults with MMD (3492 non-Hispanic whites, 953 non-Hispanic blacks, 1078 Hispanics, 268 Asians, and 225 others consisted of American Indian, Alaska Native, and those reporting multiple races).

Barriers to Care and Health Care Utilization Among the Publicly Insured.

Background: Although the Affordable Care Act has been successful in expanding Medicaid to >17 million people, insurance alone may not translate into access to health care. Even among the insured, substantial barriers to accessing services inhibit health care utilization.

Objectives: We examined the effect of selected barriers to health care access and the magnitude of those barriers on health care utilization.

Complementary health approaches for health and wellness in midlife and older US adults.

Objectives: To characterize the use of complementary health approaches (CHA) and examine the perceived benefits of using CHA by reason for use among midlife and older adults.

Study Design: Analysis of 2012 National Health Interview Survey data, a nationally representative US sample using cross-tabulations with design-based F-tests and multiple logistic regression. The analytic sample included adults aged over 50 years (N=14,849).

Complementary and Alternative Medicine Use in the US Adult Low Back Pain Population.

Background: Many people suffering from low back pain (LBP) have found conventional medical treatments to be ineffective for managing their LBP and are increasingly turning to complementary and alternative medicine (CAM) to find pain relief. A comprehensive picture of CAM use in the LBP population, including all of the most commonly used modalities, is needed.

Study Objective: To examine prevalence and perceived benefit of CAM use within the US LBP population by limiting vs nonlimiting LBP and to evaluate the odds of past year CAM use within the LBP population.

Complementary and integrative healthcare for patients with mechanical low back pain in a U.S. hospital setting.

Objectives: Complementary and integrative healthcare (CIH) is commonly used to treat low back pain (LBP). While the use of CIH within hospitals is increasing, little is known regarding the delivery of these services within inpatient settings. We examine the patterns of CIH services among inpatients with mechanical LBP in a hospital setting.

Complementary and Alternative Medicine Use among Women of Reproductive Age in the United States.

Background: The purpose of this study was to examine the prevalence of complementary and alternative medicine (CAM) use, types of CAM used, and reasons for CAM use among reproductive-age women in the United States.

Methods: Data are from the 2007 National Health Interview Survey. We examined a nationally representative sample of U.

Propensity score matching to measure the effect of survey mode on reports of racial and ethnic discrimination in health care.

Objective: To examine the effect of survey mode (mail vs. telephone) on the likelihood of reporting health care-related discrimination based on race, ethnicity, or nationality.

Methods: We use data from a mixed-mode, mail and telephone survey of public health care program enrollees (N=2807), including Somali, Hmong, African American, American Indian, and Latino populations.

Assessing Diabetes Care Disparities with Ambulatory Care Quality Measures.

Objective: To identify and describe racial/ethnic disparities in overall diabetes management.

Data Source/study Setting: Electronic health record data from calendar year 2010 were obtained from all primary care clinics at one large health system in Minnesota (n = 22,633).

Study Design: We used multivariate logistic regression to estimate the odds of achieving the following diabetes management goals: A1C <8 percent, LDL cholesterol <100 mg/dl, blood pressure <140/90 mmHg, tobacco-free, and daily aspirin.

Potential benefits of increased access to doula support during childbirth.

Objectives: The annual costs of US maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between doula support, desire for doula support, and cesarean delivery, distinguishing cesarean deliveries without a definitive medical indication.

Exploring electronic health records as a population health surveillance tool of cardiovascular disease risk factors.

The objective of this study was to examine the utility of using electronic health record (EHR) data for periodic community health surveillance of cardiovascular disease (CVD) risk factors through 2 research questions. First, how many years of EHR data are needed to produce reliable estimates of key population-level CVD health indicators for a community? Second, how comparable are the EHR estimates relative to those from community screenings? The study takes place in the context of the Heart of New Ulm Project, a 10-year population health initiative designed to reduce myocardial infarctions and CVD risk factor burden in a rural community. The community is served by 1 medical center that includes a clinic and hospital.

Differences in diabetes self-care activities by race/ethnicity and insulin use.

Purpose: The purpose of this study is to examine differences in diabetes self-care activities by race/ethnicity and insulin use.

Methods: Data were from the 2011 Behavioral Risk Factor Surveillance System for adults with diabetes. Outcomes included 5 diabetes self-care activities (blood glucose monitoring, foot checks, nonsmoking, physical activity, healthy eating) and 3 levels of diabetes self-care (high, moderate, low).

Patient-Perceived Pressure from Clinicians for Labor Induction and Cesarean Delivery: A Population-Based Survey of U.S. Women.

Objective: To determine whether patient-perceived pressure from clinicians for labor induction or cesarean delivery is significantly associated with having these procedures.

Data Sources/study Setting: Listening to Mothers III, a nationally representative survey of women 18-45 years who delivered a singleton infant in a U.S.

Employment during pregnancy and obstetric intervention without medical reason: labor induction and cesarean delivery.

Background: Rising rates of labor induction and cesarean delivery, especially when used without a medical reason, have generated concern among clinicians, women, and policymakers. Whether employment status affects pregnant women's childbirth-related care is not known. We estimated the relationship between prenatal employment and obstetric procedures, distinguishing whether women reported that the induction or cesarean was performed for medical reasons.

Maternal depressive symptoms, employment, and social support.

Objective: The purpose of this study was to characterize the relationship between maternal depressive symptoms and employment and whether it is mediated by social support.

Methods: We used data from a nationally representative sample of 700 US women who gave birth in 2005 and completed 2 surveys in the Listening to Mothers series, the first in early 2006, an average of 7.3 months postpartum, and the second an average of 13.