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

BACKGROUND. This study was undertaken to ascertain the extent that traditional health practices are used by urban American Indian/Alaska Native (AI/AN) primary care patients, to identify related patient characteristics, to determine associations with health status and functioning, and to describe attitudes about care received. METHODS. This study used a brief self-report survey of 869 adult AI/AN patients randomly sampled over a 14-month period from a comprehensive urban primary 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 affiliation In bivariate analyses, use was significantly associated with male gender, cultural affiliation, poor functional status, alcohol abuse, and trauma and, except for musculoskeletal pain, not with specific medical problems. The multiple logistic regression model for any use versus no use was significant (P less than or equal to 0.001). Being of male gender (P less than or equal to 0.001), having more than a high school education (P less than or equal to 0.05), visiting friends/relatives on a reservation (P less than or equal to 0.01), living the Native way of life (P less than or equal to 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 inflicted by a family member (P less than or equal to 0.001) were predictive of 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.