Use of traditional health practices among native Americans in a primary care setting

BACKGROUND. This study was undertaken to ascertain the extent that traditio nal health practices are used by urban American Indian/Alaska Native (AI/AN ) primary care patients, to identify related patient characteristics, to de termine associations with health status and functioning, and to describe at titudes about care received. METHODS. This study used a brief self-report survey of 869 adult AI/AN pati ents randomly sampled over a 14-month period from a comprehensive urban pri mary care program. Current medications were determined by follow-up medical record review. RESULTS. Seventy percent of urban AI/AN patients in primary care often used traditional health practices; use was strongly associated with cultural af filiation In bivariate analyses, use was significantly associated with male gender, cultural affiliation, poor functional status, alcohol abuse, and t rauma and, except for musculoskeletal pain, not with specific medical probl ems. The multiple logistic regression model for any use versus no use was s ignificant (P less than or equal to 0.001). Being of male gender (P less th an or equal to 0.001), having more than a high school education (P less tha n or equal to 0.05), visiting friends/relatives on a reservation (P less th an or equal to 0.01), living the Native way of life (P less than or equal t o 0.001) and not the white way (P less than or equal to 0.05), experiencing back pain (P less than or equal to 0.01), and having a physical injury inf licted by a family member (P less than or equal to 0.001) were predictive o f use. CONCLUSIONS. The results in this clinical setting suggest that health care providers should anticipate use of traditional health practices among urban AI/AN patients. Use was predicted by important demographic, clinical, and cultural characteristics.