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Introduction: Pain catastrophizing describes helplessness, rumination, and magnification of a pain experience. High pain catastrophizing is an independent risk factor for disability, pain severity, inadequate treatment response, chronicity, and opioid misuse. Interdisciplinary pain programs (IPPs) are beneficial and cost-effective for individuals with chronic pain, but their functional impact on individuals with high pain catastrophizing is not well established. The emerging field of placebo studies suggests that patient-provider relationships, positive treatment expectations, and sociobiologically informed care trigger physiological responses that may enhance therapeutic interventions. Methods: In this retrospective observational cohort study, we compared admission and discharge data for 428 adults with high-impact chronic pain (mean 8.5 years) who completed the Spaulding-Medford Functional Restoration Program (FRP). The interdisciplinary FRP team of physiatrists, behavioral health clinicians, physical therapists, and occupational therapists specializes in evidenced-based conventional rehabilitation, integrative health, and pain psychoeducation via enriched therapeutic encounters, fostering collaboration, validation, trust, self-efficacy, and positive expectations. Clinical outcome measures included the Canadian Occupational Performance Measure (COPM) assessing functional performance (COPM-PS) and satisfaction with function (COPM-SS), the Pain Numeric Rating Scale (NRS), the Pain Catastrophizing Scale (PCS), and the Patient Health Questionnaire-9 (PHQ-9). Results: FRP participants with clinically elevated catastrophizing at baseline (PCS =30, mean PCS 39) achieved statistically significant improvements in function (mean delta -2.09, CHI2 = 15.56, p < 0.001), satisfaction with function (COPM-SS mean delta -2.50, CHI2 = 7.42, p = 0.007), pain (NRS mean delta 2.7), mood (PHQ-9 mean delta 1.87, p = 0.002), and catastrophizing (PCS mean delta 4.16, p < 0.001). Subgroup analysis revealed racial disparities in pain scores, and exploratory analysis showed a trend toward reducing opiate consumption. Discussion: Despite the known association of adverse outcomes with high catastrophizing, FRP participation was associated with increased productive engagement, reduced pain, reduced maladaptive thought processes, and improved mood. Although causation and efficacy cannot be established from a retrospective design, this is the first study to identify functional improvement in patients with high-impact chronic pain and clinically relevant high pain catastrophizing who participate in an IPP combining conventional and complementary rehabilitation with psychoeducation. These enriched therapeutic encounters may enhance the treatment process by promoting trust, empathy, collaboration, and beneficial reframing of patients' experiences, expectations, and goals. [ABSTRACT FROM AUTHOR]

Large-scale implementation of interprofessional education across the United States Veterans Health Administration has supported advancement of a new model of collaborative practice, the Whole Health System, centering on the patient and what matters most to them. Other health care systems can consider similar educational efforts for health care transformation. [ABSTRACT FROM AUTHOR]

Clasina Leslie Smith,1,2,&ast; Bill Reddy,3,&ast; Charis M Wolf,4,5,&ast; Rosa N Schnyer,6,7,&ast; Korina St John,8,&ast; Lisa Conboy,4,7,9– 14,&ast; Jen Stone,15 Lixing Lao16– 18 1Chicago Healing Center, Chicago, IL, USA; 2School of Medicine, Southern Illinois University, Springfield, IL, USA; 3Vital Point Acupuncture, Annandale, VA, USA; 4Seattle Institute of East Asian Medicine, Seattle, WA, USA; 5Middle Way Acupuncture Institute, Seattle, WA, USA; 6School of Nursing, University of Texas, Austin, TX, USA; 7Oregon College of Oriental Medicine, Portland, OR, USA; 8Modern Medicine Woman, LLC, Palmer, AK, USA; 9Beth Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 10California Institute of Integral Studies, San Francisco, CA, USA; 11Pacific College of Oriental Medicine, San Diego, CA, USA; 12YoSan University, Los Angeles, CA, USA; 13Five Branches University, Santa Cruz, CA, USA; 14American Academy of Health and Wellness, Roseville, MN, USA; 15CTSI, Indiana University School of Medicine, Indianapolis, IN, USA; 16Virginia University of Integrative Medicine, Vienna, VA, USA; 17School of Medicine, University of Maryland, Baltimore, MD, USA; 18School of Chinese Medicine, University of Hong Kong, Pokfulam, Hong Kong&ast;These authors contributed equally to this workCorrespondence: Clasina Leslie Smith, Chicago Healing Center, 1560 N Sandburg Ter, Unit 3215, Chicago, IL, 60610, USA, Tel +1-773-217-0567, Email LeslieTCM@gmail.comAbstract: The term “acupuncture” commonly refers to a non-pharmacologic therapy that is increasingly employed by diverse segments of the population for a wide variety of complaints including pain, insomnia, anxiety, depression, frozen shoulder, and other issues. The term is also used as a short-hand for the wider medical system from which the placement of needles into the skin for therapeutic benefit and related techniques evolved. Thus “acupuncture” refers both to the therapeutic technique and the therapeutic system of Acupuncture and Herbal Medicine (AHM). The other modalities included within AHM include a wide variety of physical and mechanical manipulations, herbal medicines, dietary recommendations, and lifestyle modifications. Clinically, acupuncture is increasingly offered in a variety of conventional medical settings such as hospitals, medical school clinics, veterans’ healthcare centers, oncology facilities, and rehabilitation centers, and its safety profile is excellent overall. Barriers to further incorporation of acupuncture into biomedical sites include insurance coverage of acupuncture, education of conventional medical practitioners and other stakeholders about the utility, efficacy, and evidence base of acupuncture. Acupuncturists in the United States are skilled practitioners who are highly educated in the complex therapeutic system from which acupuncture arose and in the technical aspects of its utility as a treatment modality. The training, certification, licensure, and regulation of acupuncturists is similar to that of conventional providers such has physician’s assistants, advanced practice nurses, and medical and osteopathic doctors. While clinical use and acceptance of acupuncture continues to grow, there is to date no definitive composite document explaining the utility of acupuncture in various healthcare settings, the current understanding of how acupuncture works, and the training, professional regulation, and certification of acupuncture practitioners. This article will address these topics and strive to create a reference for practitioners, administrators, legislators, insurance providers, patients and their families, and other stakeholders.Plain Language Summary: Acupuncture refers to the placement of thin, sterile needles into the skin to stimulate healing effects, and, in the United States, it also refers to the medical system from which the technique of acupuncture evolved. That system, Acupuncture and Herbal Medicine (AHM), uses acupuncture, dietary and lifestyle advice, herbal medicines, and other therapies to facilitate health and healing. Acupuncture is increasingly being used for a wide variety of medical problems including pain, difficulty sleeping, mental health concerns, and other issues in a wide variety of settings and is supported by a growing scientific basis for understanding why and how it works. Training and licensure of acupuncturists are similar to many conventional practitioners, and the process is accredited and overseen by various governmental and regulatory bodies. This paper aims to provide an overview of the use of acupuncture in the United States, the scientific basis for acupuncture, the training and licensure of acupuncturists, and the ways in which acupuncture is and might be incorporated into conventional medical settings.Keywords: acupuncture, herbal medicine, traditional Chinese medicine, integrative medicine, integrative health, medical policy

Background: Few studies have examined the menopausal transition in American Indian and Alaska Native (AI/AN) women; these reports indicate they are the most likely group to report bothersome vasomotor symptoms (VMS). Evidence demonstrates VMS may be a biomarker for chronic diseases. Thus, evidence-based interventions to improve VMS and other symptoms and health-screening rates for urban midlife AI/AN women are needed. Objective: The objectives of this community-based project were to form a Community Advisory Board (CAB) with whom to: 1) conduct CAB meetings (similar to a focus group) with midlife AI/AN women to understand their lived health care experiences and needs during the menopausal transition; and 2) obtain guidance in creating a tailored intervention. Methods: Eligible participants indicated they were registered members of American Indian Tribes, self-identified as a woman, aged 35 or older, and were recruited through the Urban Indian Center of Salt Lake and community outreach. Three CAB meetings were conducted via Zoom. A qualitative-descriptive approach was used for analysis, with the aim of staying close to the data to understand AI/AN women's experiences and needs. Transcripts were iteratively coded using content/thematic analysis. Results: Four themes emerged: 1) lack of and desire for information about the menopause transition; 2) barriers to accessing care; 3) matriarchal priorities impacting personal health outcomes; and 4) preferences for Indigenous and integrative medicine as first-line interventions, followed by conventional medicine. Conclusions: Among this sample of urban AI/AN women, there was a great need for and interest in information about menopause, both for themselves and for their daughters and family. Integrative and Indigenous approaches were preferred. Proposed next steps include developing and pilot-testing a nurse-delivered health-education intervention with Indigenous, integrative, and conventional medical content. [ABSTRACT FROM AUTHOR]

Background: Individuals with a uterus experience menopause, the cessation of menses, on average at age 51 years in the United States. While menopause is a natural occurrence for most, over 85% of women experience multiple interfering symptoms. Menopausal women face health disparities, including a lack of access to high-quality healthcare and greater disparities are experienced by women who are black, indigenous, and people of color. Some women are turning away from hormone therapy, and some seek integrative health interventions. Objective: Some menopausal women who seek healthcare do not receive it as they lack access to medical and integrative healthcare providers. A potential solution to this problem is a medical group visit (MGV), during which a provider sees multiple patients at once. The aims of this study were to gather women's opinions about the menopause, provider access, and conventional and integrative health interventions for later use to develop a menopause MGV. Methods: We conducted a Community Engagement Session and a Return of Results (RoR) with midlife women to learn about their menopause experiences, barriers and facilitators to accessing health providers, and their interest in and suggestions for designing a future integrative MGV (IMGV). Thematic qualitative research methods were used to summarize session results. Results: Nine women participated in the Session and six attended the RoR. Participants were well-educated and diverse in race and ethnicity. Themes included: an interest in this topic; unfamiliar medical terms; relevant social factors; desired whole person care; interest in integrative health; barriers and facilitators to accessing healthcare. The group expressed interest in ongoing participation in the future process of adapting an IMGV, naming it MENOGAP. Conclusion: These findings highlight the importance of stakeholder engagement before designing and implementing MENOGAP and the great need among midlife women for education about the menopausal transition, integrative self-care, and healthcare. [ABSTRACT FROM AUTHOR]

Objective: The Non-Opioid Pain Alleviation Information Network (NOPAINMN) project was designed to identify, consolidate, and map evidence-based non-opioid and non-pharmacological pain management complementary and integrative health (CIH) modalities for chronic pain management across Minnesota into a searchable and informational website (www.nopainmn.org ). Methods: The Academic Consortium for Integrative Medicine & Health's Pain Task Force White Paper identifying evidence-based research of non-pharmacological pain practice (NPPC) was reviewed and referenced. National and state certifying boards and accrediting organizations for NPPC modalities were accessed to identify Minnesota-based NPPC providers' name, business/health-system affiliation, address, contact information, and credentials. The NOPAINMN website displays these data in a consumer-facing website with searchable fields such as NPPC modality type, and location with varying distances. The website was β-tested by practitioners and stakeholders for optimization. Eight main NPPC modalities and their respective subcategories were identified and mapped: Acupuncture; Integrative Medical Care (Functional medicine consultation and Integrative medicine consultation); Massage Therapy; Mind–Body Therapies (Biofeedback, Clinical Hypnosis, Mindfulness-Based Stress Reduction, and Music Therapy); Movement Therapies (Tai Chi, qigong, and Yoga Therapy); Psychology (Cognitive Behavioral Therapy); Rehabilitative Therapies (Physical and Occupational Therapy); and Spinal Manipulation. Results: All information compiled resulted in 17,155 providers/practitioners. Physical Therapy had the greatest number of reported providers (n = 5224), followed by Occupational Therapy (n = 3792), Psychology (n = 3324), Chiropractic (n = 3033), Acupuncture (n = 591), and Massage Therapy (n = 544). The Resource Map included 56 major health systems, 686 facilities, 2651 solo or private group practices, and 14 academic training schools. With web-based cross-referencing, providers and facilities were affiliated and linked with health systems to produce an interconnected mapping system. β-Testing with patients found that the website was reported as relatively easy to use and informative. Conclusion: The website was created to assist individuals, health care providers, insurance carriers, and health care facilities in finding evidence-based information and resources on NPPC to guide, support, and proactively manage and engage chronic pain patients across Minnesota. [ABSTRACT FROM AUTHOR]

This Opinion piece discusses several key research questions in health neuroscience, a new interdisciplinary field that investigates how the brain and body interact to affect our health behavior such as health mindsets, decision-making, actions, and health outcomes across the lifespan. To achieve physical, mental, and cognitive health, and promote health behavior change, we propose that the prevention and treatment of diseases should target the root causes--the dysfunction and imbalance of brain-body biomarkers, through evidence-based body-mind interventions such as mindfulness meditation and Tai Chi, rather than dealing with each symptom or disorder in isolation through various treatment approaches. [ABSTRACT FROM AUTHOR]

IntroductionPain catastrophizing describes helplessness, rumination, and magnification of a pain experience. High pain catastrophizing is an independent risk factor for disability, pain severity, inadequate treatment response, chronicity, and opioid misuse. Interdisciplinary pain programs (IPPs) are beneficial and cost-effective for individuals with chronic pain, but their functional impact on individuals with high pain catastrophizing is not well established. The emerging field of placebo studies suggests that patient-provider relationships, positive treatment expectations, and sociobiologically informed care trigger physiological responses that may enhance therapeutic interventions.MethodsIn this retrospective observational cohort study, we compared admission and discharge data for 428 adults with high-impact chronic pain (mean 8.5 years) who completed the Spaulding-Medford Functional Restoration Program (FRP). The interdisciplinary FRP team of physiatrists, behavioral health clinicians, physical therapists, and occupational therapists specializes in evidenced-based conventional rehabilitation, integrative health, and pain psychoeducation via enriched therapeutic encounters, fostering collaboration, validation, trust, self-efficacy, and positive expectations. Clinical outcome measures included the Canadian Occupational Performance Measure (COPM) assessing functional performance (COPM-PS) and satisfaction with function (COPM-SS), the Pain Numeric Rating Scale (NRS), the Pain Catastrophizing Scale (PCS), and the Patient Health Questionnaire-9 (PHQ-9).ResultsFRP participants with clinically elevated catastrophizing at baseline (PCS ≥30, mean PCS 39) achieved statistically significant improvements in function (mean delta -2.09, CHI2 = 15.56, p

ObjectiveChinese-American patients use CIH at high rates but disclosure of CIH use to clinicians is low. Further, the content of CIH talk between patients and their clinicians is not well described. We aimed to characterize CIH talk between Chinese-American patients and their primary care clinicians.MethodsDiscourse analysis of 70 audio-recordings of language concordant and discordant-interpreted visits.ResultsNearly half of all visits (48.6%) had some form of CIH communication. 'Simple CIH talk' focused on a single CIH topic resulting in a positive, neutral, or negative response by clinicians. 'CIH-furthering talk' was characterized by clinicians and patients addressing more than one CIH topic or including a combination of orientations to CIH by both clinicians and patients. CIH-furthering talk characterized by clinician humility could enhance rapport, cultural understanding, and open communication. CIH-furthering talk also led to miscommunication and retreat toward biomedicine.ConclusionCIH communication occurred frequently during language concordant and discordant-interpreted visits with Chinese-American patients. Both patients and clinicians used CIH-furthering talk as a conversational resource for managing care.InnovationThis discourse analysis of visits between Chinese-American patients and their clinicians advances understanding of CIH communication beyond disclosure, illustrating the complexity of linguistic and cultural nuances that affect patient care.

The ideal future state of health for the world's populations requires a cohesive model that considers the synergistic roles of communities, public health and healthcare. This future state reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing. This is the definition of Integrative Medicine. We are far from this idealistic future. Healthcare costs continue to escalate while life expectancy declines. We train our future healthcare professionals in our current disease-based model that prioritizes siloed pharmaceutical and interventional approaches over whole person prevention focused care. As healthcare professionals, we disregard our capacity to influence the leading risk factors for disease-related death and disability which include health behaviors, social, economic and environmental drivers. Burnout is high and rising. Rapid shifts are expected in the coming years as the current system's cost becomes untenable. We need a sustainable future for healthcare. That means we must figure out how to re-center on the patient, on a full spectrum of prevention and treatment, and how to influence public and community health. The future model must focus on health behaviors at its foundation, use systems thinking, be environmentally sustainable, and approach health from a population lens. The future will require an ability to consider complex systems approaches to health and wellbeing that include a focus on both the patient and the healthcare team. Research strategies must not only consider effectiveness but also reach, implementation and institutionalization in a multi-dimensional capacity that looks at whole person health as an outcome while looking at individuals in the context of where they live and work. The Integrative Medicine community has an opportunity to help lead the way to a sustainable and health focused future. [ABSTRACT FROM AUTHOR]

Health and wellness coaching (HWC) is an effective intervention for many chronic lifestyle diseases. Chronic diseases represent a majority of our severe national healthcare burden. Yet, HWC certification programs vary in delivery method and degree awarded. The purpose of this paper is to provide an evidence based rationale for HWC as a complementary area of study to non-licensure granting, undergraduate health degrees in higher education. A comprehensive review of the literature related to the efficacy of HWC was completed. In addition, the national program directory was mined for descriptive data for approved HWC programs. Given the growing body of support for HWC as an effective intervention, we recommend that institutions deliver HWC curricula as an academic minor for undergraduate students in non-licensure granting health-related degrees to position graduates for entry level careers in HWC. Evidence from the successful deployment of an undergraduate program in HWC supports our contention that HWC be delivered as an academic minor in support of lifestyle health and wellness education. In doing so, the field can offer HWC in a way that is widely accessible to the undergraduate population, while providing a mechanism for direct employment as a professional health and wellness coach. [ABSTRACT FROM AUTHOR]

Healthy aging is an integrated "whole person" process that involves an individual's biology, behavior, and social/physical environment. With the recent development of antiaging drugs, careful consideration of the respective roles of pharmacologic and nonpharmacologic approaches to both health and aging is in order. Recent advances in understanding the cellular and molecular mechanisms of aging are providing new measures that can be used as clinical outcomes in studying the impact of antiaging interventions in humans. This paper outlines the strategic interest of the National Center for Complementary and Integrative Health (NCCIH) in supporting the development, testing, and implementation of effective, scalable, and integrated multicomponent interventions to support healthy aging of the whole person. [ABSTRACT FROM AUTHOR]

Integrative health is an emerging specialty inside multiple disciplines within the medical community, yet the practice of integrative physical therapy remains undefined. This perspective paper suggests a set of guiding principles to support the role of physical therapy in integrative health. These guiding principles, including therapeutic partnership, whole person health, living systems, movement as an integrative experience, and salutogenesis, are described and explored in-depth as they relate to all aspects of patient care and clinician experience. These guiding principles are articulated within the context of social determinants of health and the interrelated roles that environment, trauma, stress, and lifestyle all play within an integrative physical therapy plan of care. Examples of current integrative physical therapy practices that embody these principles are described. The 5 guiding principles are designed to elicit interprofessional inquiry into how integrative health models can be applied to the art and science of physical therapy practice. The expansion of integrative health into the field of physical therapy has the potential to improve individual and population health, as integrative physical therapy can be used to address prevention, health promotion, primary care, and wellness while acknowledging the complex, dynamic, and interconnected nature of the human condition. Impact This perspective article presents 5 guiding principles to establish a framework to define and shape the growing application of an integrative health model to physical therapy practice. These integrative physical therapy guiding principles aim to improve the quality of whole-person, patient-centered care. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the feasibility, acceptability, and preliminary efficacy of a 6-session music therapy protocol on self-efficacy, quality of life, and coping skills in adults with sickle cell disease (SCD). PATIENTS AND METHODS: Using a mixed-methods intervention design, adults with SCD (ages 21-57; mean age 32.33) were randomized (1:1) to either 1) a 6-session music therapy (MT) intervention (n = 12) or 2) waitlist control (WLC) (n = 12) using stratified randomization where factors were age in years (≤30 vs >30), and sex (male, female). All participants completed two weeks of daily electronic pain diary entries and self-efficacy, quality of life, and coping skills measures before and after their assigned study condition to explore preliminary efficacy. MT participants were taught music exercises accessed via smartphone and subsequently interviewed to determine feasibility and acceptability. RESULTS: The enrollment rate was 89%. All study measures were completed, with high rates of electronic pain diary completion at baseline (70%) and 2-week follow-up (66%). Interviews revealed two overall themes related to MT participants experience: 1) participants learned new self-management skills and 2) MT improved participants ability to cope with pain. MT participants demonstrated 100% attendance. In preliminary analyses, MT participants demonstrated significant improvements (means ± SD) in self-efficacy (5.42 ± 5.43, p = 0.008, d = 1.20), PROMIS sleep disturbance (-1.49 ± 6.68, p = 0.023, d = -0.99), PROMIS pain interference (-2.10 ± 4.68, p = 0.016, d = -1.06), and ASCQ-Me social functioning impact scores (2.97 ± 6.91, p = 0.018, d = 1.05) compared to WLC participants. CONCLUSION: Preliminary findings support the feasibility and acceptability of music therapy for home use in adults with SCD. While music therapy may assist adults with SCD in improving self-efficacy and quality of life, subsequent, fully-powered clinical research is needed to determine its efficacy.

Abstract As the prevalence of childhood and adolescent anxiety, depression, and other mental health concerns continues to rise, there has been an unprecedented increase in support of mind–body practices like yoga, dance, meditation, mindfulness, aerobic exercise, and more—in part driven by the mental health burden imposed by the COVID‐19 pandemic. While a growing body of evidence supports the safety and effectiveness of mind–body approaches, gaps in funding for and empirical research on mechanistic underpinnings, methodology development to assess multicomponent therapeutic practices, dissemination and implementation, and diversity in researchers, practitioners, and recipients remain. As a consequence, the neurobiological impacts of mind–body techniques are not well understood nor broadly accepted as standard forms of care by clinicians and insurers—often being considered as “alternative” rather than “complementary” or “integrative.” In this commentary, we summarize work from our labs and others highlighting the promise of mind–body approaches for improving mental health in youth, in line with the National Institute of Mental Health's strategic plan to address health disparities. We offer a potential framework for implementation and research—the Expressive Therapies Continuum. We also propose solutions to key research and policy gaps, that by could have positive public health impacts for those who are struggling and to prevent emergence of psychiatric illness, especially in developing youth.

Aims: Distance between dentistry and medicine is a traditional and historical obstacle that affects multiple levels of the health system, especially the health policies to improve health service quality. Changes in dental education, especially involving the adoption of integrative health models in professional development, are considered essential for reducing this gap. We aimed to show a dental curriculum focused on special care as a tool for medicine‐dentistry integration. Methods: In this study, we present a new proposal for an undergraduate dental curriculum in which topics related to special care are addressed transversally and are the core for interdisciplinary integration of oral health with systemic health. We also describe how themes related to dental home care and hospital dentistry were included in this course as basic professional competencies. Results and Conclusion: This initiative is aligned with the global trend to adopt educational systems that contribute to the reduction of health care inequalities and improve health service quality. [ABSTRACT FROM AUTHOR]

Complementary and integrative health approaches can improve health and well‐being, as well as play an important role in disease prevention. The concept of whole person health builds on these concepts by empowering individuals, families, communities, and populations to improve their health in multiple interconnected domains: biological, behavioural, social, and environmental. Research on whole person health involves studies of interconnected biological systems and complex approaches to prevention and treatment. Some of these approaches may involve methods of diagnosis and therapy that differ from those used in conventional Western medicine. Of growing interest is how complementary, integrative, and whole person health approaches contribute to resilience. This brief commentary describes an integrated framework for mapping the connections between various complementary and integrative health therapeutic inputs onto aspects of resilience, including the ability to resist, recover (partially or fully), adapt, and/or grow in response to a following a stressor. The authors present selected examples of research studies supported by the National Institutes of Health that test whether complementary and integrative health approaches can promote some aspect of resilience. We conclude with a discussion of the challenges and opportunities in incorporating the study of resilience in complementary, integrative, and whole person health research. [ABSTRACT FROM AUTHOR]

Background: Menopause symptoms can be debilitating, and the use of menopausal hormone therapy (MHT) has declined significantly since the Women's Health Initiative. Materials and Methods: We surveyed 508 peri- and postmenopausal females to determine (1) the use of complementary and integrative therapies (CIT), MHT; and pharmacotherapies; (2) the perceptions, perceived benefits/risks of CIT, MHT; and pharmacotherapy use; and (3) factors associated with CIT and MHT use for menopause symptom treatment. Results: The majority of respondents used CIT to treat menopause symptoms based on physician recommendation and research studies. Treatments that were perceived as most beneficial included exercise, mind?body therapies, diet, and spiritual practices, with exercise and mind?body therapies chosen to treat the most common symptoms of sleep disturbances, depressive mood, and anxiety. Higher education level was the main predictive variable for choosing exercise (odds ratio [OR]?=?1.27, p?=?0.02) and mind?body therapies (OR?=?1.57, p?=?0.02) to treat menopausal symptoms. Perceptions, beliefs, and use of different CIT by primarily white, affluent, and educated peri- and postmenopausal females to treat menopause symptoms, including sleep disturbances, depression, and anxiety, are driven by conversations with physicians and evidence-based research. Conclusion: These findings reinforce the necessity for both additional research in more diverse populations, as well as comprehensive, individualized personalized care from an interdisciplinary team that considers the best options available for all female patients.

We aimed to collect parallel perspectives from pharmacists and pharmacy students on their use, knowledge, attitudes, and perceptions about herbal supplements/natural products. Two cross-sectional descriptive survey questionnaires—one focusing on pharmacists and the other focusing on pharmacy students—were administered from March to June 2021 via Qualtrics. The surveys were sent out to preceptor pharmacists and pharmacy students currently enrolled at a single U.S. school of pharmacy. The questionnaires were composed of five main sections, including (1) demographics; (2) attitudes/perceptions; (3) educational experience; (4) resource availability; and (5) objective knowledge of herbal supplements/natural products. Data analysis primarily utilized descriptive statistics with relevant comparisons across domains. A total of 73 pharmacists and 92 pharmacy students participated, with response rates of 8.8% and 19.3%, respectively. A total of 59.2% of pharmacists and 50% of pharmacy students stated they personally used herbal supplements/natural products. Most respondents (>95% for both groups) considered vitamins/minerals safe, although a lower percentage agreed on this for herbal supplements/natural products (60% and 79.3% for pharmacists and pharmacy students, respectively). Patient inquiries in the pharmacy setting were most seen for vitamin D, zinc, cannabidiol, and omega-3. A total of 34.2% of pharmacists reported having training in herbal supplements/natural products as a required part of their Pharm.D. training, and 89.1% of pharmacy students desired to learn more. The median score on the objective knowledge quiz was 50% for pharmacists and 45% for pharmacy students. Ultimately, herbal supplements/natural products are recognized by pharmacists/pharmacy students as a consistent and embedded part of pharmacy practice, although there is a need to enhance knowledge and skills in this area. [ABSTRACT FROM AUTHOR]

BackgroundVeterans Affairs (VA) has rolled out a holistic, multicomponent Whole Health care model nationwide, yet no pragmatic trials have been conducted in real-world clinical settings to compare its effectiveness against other evidence-based approaches for chronic pain management in veterans.ObjectivesWe describe the adaptation of the first large pragmatic randomized controlled trial of the Whole Health model for chronic pain care for diverse VA clinical settings.Research designInformed by the Promoting Action on Research Implementation in Health Systems implementation framework, we conducted qualitative semistructured interviews to obtain feedback on trial design from VA leadership, frontline clinicians, and veterans with chronic pain at 5 VA enrollment sites. Next, we convened in-person evidence-based quality improvement (EBQI) meetings with study stakeholders (including frontline clinicians and administrators) at each site to discuss study design; review interview themes; and identify site-specific barriers, facilitators, and approaches to implementation. Ethnographic observations from EBQI meetings provided additional insight into implementation strategies.SubjectsSeventy-four veteran and VA staff stakeholders were interviewed; 71 stakeholders participated in EBQI meetings.ResultsAt each site, unique clinical contexts and varying resources for Whole Health and pain care delivery affected plans for trial implementation. We present examples of local adaptations that emerged through the formative evaluation process to facilitate implementation and yield a more pragmatic trial design.ConclusionsA systematic formative evaluation can facilitate engagement and buy-in of study stakeholders. Locally tailored pragmatic implementation strategies may improve the likelihood of successful trial execution as well as future implementation of evidence-based pain care approaches in real-world clinical settings.

Pain after traumatic brain injury (TBI) is common and can become chronic. Acupuncture is an increasingly popular non-pharmacologic option in the United States and is commonly used for pain. We explored demographics, injury characteristics, and pain characteristics of individuals who reported using acupuncture for chronic pain after TBI. We analyzed a subset of data collected as part of the Pain After Traumatic Brain Injury collaborative study and identified individuals reporting a history of acupuncture as part of management for chronic pain after TBI. We characterized and compared basic demographic data, pain treatment engagements, pain severity, pain interference, functional independence, and pain locations using descriptive and inferential statistics. Our sample included 1,064 individuals. Acupuncture use (n = 208) was lower proportionally among females, Blacks/African Americans, Asians, less educated, and nonmilitary service members. Insurance type varied between acupuncture and non-acupuncture users. Functional and pain outcomes were similar, but acupuncture users reported a higher number of pain sites. Acupuncture is one treatment utilized by individuals with TBI and chronic pain. Further investigation would be helpful to understand the barriers and facilitators of acupuncture use to inform clinical trials to examine the potential benefit of acupuncture on pain outcomes after TBI. [ABSTRACT FROM AUTHOR]

Purpose of Review: Patients diagnosed with neuropathic pain experience continuous or intermittent spontaneous pain throughout their lives. Pharmacological treatments often provide limited relief; therefore, a multidisciplinary approach should be utilized to manage neuropathic pain. This review examines the current literature on integrative health modalities (anti-inflammatory diets, functional movement, acupuncture, meditation, and transcutaneous therapy) for treating patients with neuropathic pain. Recent Findings: The use of an anti-inflammatory diet, functional movement, acupuncture, meditation, and transcutaneous therapy in treating neuropathic pain has been investigated in prior literature with positive outcomes. However, there remains a large void in evidence-based knowledge and clinical applicability for these interventions. Overall, integrative health offers a cost-efficient and harmless way of creating a multidisciplinary approach to managing neuropathic pain. Summary: There are many complementary approaches to treating neuropathic pain as part of an integrative medicine approach. Research is needed to explore other herbs and spices not yet reported in the peer-review literature. Additionally, follow-on research is needed to understand the clinical applicability of the proposed interventions as well as the dose and timing of the interventions to predict response and duration. [ABSTRACT FROM AUTHOR]

Abstract Background Low- and middle-income countries (LMICs) bear a disproportionately high burden of noncommunicable diseases (NCDs) with severe socioeconomic consequences. Targeted interventions that are faith-based or take place in faith-based settings are historically viable for health promotion and disease prevention programmes. However, evidence of their effectiveness often comes from high-income countries. This paper outlines the protocol for the systematic review of faith-based and faith-placed interventions for NCDs in low- and middle-income countries. Objective To determine the effectiveness of faith-based and faith-placed interventions or interventions within faith-based settings targeted at NCDs and/or their risk factors in LMICs. Methods We will conduct a systematic search of PubMed, Embase, Scopus, WHO Library, and grey literature to locate published and unpublished studies. We will consider quantitative studies that report on interventions (a) with faith-based components or that take place in faith-based settings (b) for the prevention and control of one or more of the top ten NCDs listed in the Global Burden of Disease or their known risk factors (c) occurring among adults aged 18 and above (d) that take place in one or more LMICs. We will screen the titles, abstracts, and full text of articles for eligibility. Included articles will be critically appraised for quality and the inclusion of faith-based components by at least two independent reviewers. Data extraction will be performed for study characteristics and findings. A meta-analysis will be used to synthesize the results; if impossible, a narrative synthesis will be performed. Discussion This review will attempt to synthesize up-to-date evidence to guide effective decision-making, allocation of health resources, and the design of future trials to test the efficacy of NCD interventions in faith-based settings. The study will increase the understanding of the existing evidence, highlight the need for additional evidence, and guide possible directions for future collaborations between public health professionals and faith-based health service providers. Systematic review registration PROSPERO CRD42020186299

• Yoga was associated with significant improvements in PTSD and depression symptoms. • TCTSY, Kundalini, Satyananda, and Holistic yoga were most effective for PTSD. • No serious adverse events were indicated in the six studies that reported them. Yoga is an increasingly popular complementary intervention to reduce posttraumatic stress disorder (PTSD) symptoms and related comorbidities, but its safety and treatment efficacy are not firmly established. We conducted a systematic review and meta-analysis of existing randomized control trials (RCTs) of yoga interventions for PTSD and related secondary outcomes (e.g., depression). Initial search results found over 668 potential papers. Twenty met inclusion criteria (e.g., RCTs on adult participants with PTSD that evaluated safety or efficacy outcomes). Meta-analysis indicated that, compared to control interventions, participation in yoga interventions significantly improved self-report PTSD (standardized mean difference [SMD]: -0.51; 95 % confidence interval [CI]: -0.68, -0.35) and immediate (SMD: -0.39; 95 % CI: -0.56, -0.22) and long-term (SMD: -0.44; 95 % CI: -0.74, -0.13) depression symptoms. However, using clinician-reported assessments, yoga interventions were not associated with improved PTSD symptoms. Type of yoga differentially predicted outcomes. Sensitivity analysis showed consistent effect sizes when omitting each study from main analyses. Six studies reported whether any serious adverse events occurred. None were indicated. No publication bias was found, although individual intervention studies tended to be high in bias. Results suggest yoga is likely a safe and effective complementary intervention for reducing PTSD and depressive symptoms in individuals with PTSD. More rigorous RCTs are warranted. [ABSTRACT FROM AUTHOR]

Samuel N Rodgers-Melnick,1,2 Lucas Lin,3 Kristina Gam,4 Evanilda Souza de Santana Carvalho,5 Coretta Jenerette,6 Douglas Y Rowland,2 Jane A Little,7 Jeffery A Dusek,1,8 Nitya Bakshi,9,10 Lakshmanan Krishnamurti9,10 1Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA; 2Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; 3School of Medicine, Case Western Reserve University, Cleveland, OH, USA; 4Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA; 5Department of Health, Universidade Estadual de Feira de Santana, Feira de Santana, Brazil; 6College of Nursing, University of South Carolina, Columbia, SC, USA; 7Department of Medicine, University of North Carolina, Chapel Hill, NC, USA; 8Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; 9Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; 10Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Atlanta, GA, USACorrespondence: Samuel N Rodgers-MelnickUniversity Hospitals Connor Whole Health, 11100 Euclid Avenue, Cleveland, OH, 44106, USATel +1 216 844 7727Fax +216 201 6220Email Samuel.RodgersMelnick@UHhospitals.orgPurpose: To investigate the feasibility, acceptability, and preliminary efficacy of a 6-session music therapy protocol on self-efficacy, quality of life, and coping skills in adults with sickle cell disease (SCD).Patients and Methods: Using a mixed-methods intervention design, adults with SCD (ages 21– 57; mean age 32.33) were randomized (1:1) to either 1) a 6-session music therapy (MT) intervention (n = 12) or 2) waitlist control (WLC) (n = 12) using stratified randomization where factors were age in years (≤ 30 vs > 30), and sex (male, female). All participants completed two weeks of daily electronic pain diary entries and self-efficacy, quality of life, and coping skills measures before and after their assigned study condition to explore preliminary efficacy. MT participants were taught music exercises accessed via smartphone and subsequently interviewed to determine feasibility and acceptability.Results: The enrollment rate was 89%. All study measures were completed, with high rates of electronic pain diary completion at baseline (70%) and 2-week follow-up (66%). Interviews revealed two overall themes related to MT participants’ experience: 1) participants learned new self-management skills and 2) MT improved participants’ ability to cope with pain. MT participants demonstrated 100% attendance. In preliminary analyses, MT participants demonstrated significant improvements (means ± SD) in self-efficacy (5.42 ± 5.43, p = 0.008, d = 1.20), PROMIS sleep disturbance (− 1.49 ± 6.68, p = 0.023, d = − 0.99), PROMIS pain interference (− 2.10 ± 4.68, p = 0.016, d = − 1.06), and ASCQ-Me social functioning impact scores (2.97 ± 6.91, p = 0.018, d = 1.05) compared to WLC participants.Conclusion: Preliminary findings support the feasibility and acceptability of music therapy for home use in adults with SCD. While music therapy may assist adults with SCD in improving self-efficacy and quality of life, subsequent, fully-powered clinical research is needed to determine its efficacy.Keywords: quality of life, chronic pain, integrative health, self-efficacy

The Yellow Emperor's Classic of Internal Medicine is an important book in the study of Traditional Chinese Medicine (TCM) with the text presenting an integration of the essential TCM practices and philosophy in the use and application of Chinese medicine for healthcare. Within the Chinese Health System, TCM provides a balancing and integrating approach to health and the prevention of disease. The book provides the story of human existence, of our relationship to the environment and how ‘balance’ provides us with health and wellbeing in our daily lives. The role of the TCM practitioner is to look for wellness as a way of preventing disease. This paper discusses the key terms of the ‘Dao’, ‘Qi’, ‘Yin’ and ‘Yang’, ‘Ben’ and ‘Biao’ and the essence and role of the elements of fire, water, wood, metal and earth in health and disease prevention. TCM is an integrative approach to health and has many lessons for global health systems.

IntroductionIntegrative health care and complementary medicine are widely used by the U.S. population, yet health professions learners are typically inadequately educated to counsel patients on the use of these approaches. This interprofessional standardized patient exercise (ISPE) provides learners the opportunity to discuss various health care professionals' roles in caring for a patient interested in integrative health strategies, and to collaborate on a care plan. Utilizing this ISPE format aligns with the principles of integrative health as it requires interprofessional collaboration to address the multifaceted needs of patients.MethodsThe ISPE is approximately three hours in duration, and required of all UCSF, third-year dentistry, physical therapy, and medical students; second-year nurse practitioner students, and fourth-year pharmacy students. Social work, nutrition, and chaplain trainees also participated. Working in interprofessional teams of 4-5 learners, team members discuss case information, interview the standardized patient (SP) individually, jointly formulate a care plan, and, discuss the plan with the SP. The experience is debriefed with a facilitator.ResultsIn 2016-17, 520 learners participated in the ISPE. They agreed that they learned about the roles of other health care professionals (M = 5.24 on a six-point scale, SD = 1.27), and that they would recommend the ISPE to fellow students in their profession (M = 5.25, SD = 1.30).DiscussionStudents appreciated the ability to observe learners from other health professions interacting with the SP, and how different perspectives and expertise were integrated to create a comprehensive care plan. The exercise can be adapted to accommodate local health professions learners.

Objective: Chinese-American patients use CIH at high rates but disclosure of CIH use to clinicians is low. Further, the content of CIH talk between patients and their clinicians is not well described. We aimed to characterize CIH talk between Chinese-American patients and their primary care clinicians. Methods: Discourse analysis of 70 audio-recordings of language concordant and discordant-interpreted visits. Results: Nearly half of all visits (48.6%) had some form of CIH communication. ‘Simple CIH talk’ focused on a single CIH topic resulting in a positive, neutral, or negative response by clinicians. ‘CIH-furthering talk’ was characterized by clinicians and patients addressing more than one CIH topic or including a combination of orientations to CIH by both clinicians and patients. CIH-furthering talk characterized by clinician humility could enhance rapport, cultural understanding, and open communication. CIH-furthering talk also led to miscommunication and retreat toward biomedicine. Conclusion: CIH communication occurred frequently during language concordant and discordant-interpreted visits with Chinese-American patients. Both patients and clinicians used CIH-furthering talk as a conversational resource for managing care. Innovation: This discourse analysis of visits between Chinese-American patients and their clinicians advances understanding of CIH communication beyond disclosure, illustrating the complexity of linguistic and cultural nuances that affect patient care.

The American Nurses Association's (ANA) recently published 4th edition of the Scope and Standards of Practice provides authoritative guidance on actions and behaviors that all registered nurses are expected to perform competently, regardless of role, population, specialty, or setting. The newly defined scope emphasizes the art and science of caring, compassionate presence, and the expectation that nurses be advocates for all, recognizing the connections of all humanity. It also makes frequent reference to whole-person care and highlights the importance of mindfulness by inviting nurses to reflect on how they can incorporate mindfulness and other integrative therapies into their self-care and professional practice. A new standard explicitly states that advanced practice registered nurses should have the competency to prescribe evidence-based traditional and integrative treatments, therapies, and procedures that are compatible with the consumer's cultural preferences, norms, and abilities. Integrative Nursing is aligned with the ANA Scope and Standards of Practice and provides a useful framework for practice that expands the reach of nursing across clinical and community settings and patient populations. In this article, exemplars highlight how Integrative Nursing is being implemented in clinical settings and nursing education programs. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to examine the extant research on modalities that fall within the recreational therapy scope of practice. A systematic search of the literature was conducted following the PRISMAScR guidelines for scoping reviews. The original database search yielded 706 studies (with duplicates removed) and 22 studies were included in the final review. The scoping review included peer-reviewed intervention studies for survivors of intimate partner violence (IPV), with the purpose of addressing the following research questions: RQ1: What recreational therapy modalities have been used and researched for treating survivors of IPV? RQ2: What are the primary health outcomes measured of recreational therapy modalities for survivors of IPV? RQ3: What are the biggest gaps within the research? Types of modalities used included mind-body interventions, creative expression, and physically active leisure. Outcomes measured were primarily depression, anxiety, and post-traumatic stress disorder symptoms. Future research directions include the need for interventions to be evaluated specifically in the recreational therapy context, the need for evaluation of current practices with intimate partner violence and trauma-informed care, and the need for more diverse sampling to establish culturally affirming interventions for people who identify as LGBTQIA+ or racial/ethnic minorities. [ABSTRACT FROM AUTHOR]

Introduction: Complementary health (CH) modalities can be used as part of a Lifestyle Medicine (LM) approach to preventing and managing chronic conditions., Methods: This cross-sectional study used data for respondents to the 2020 (N = 6,715) and 2014/2015 (N = 11,112) cycles of a Northern California health plan member survey to estimate use in 2020 of five CH modalities relevant to LM: vegetarian/vegan diet, mind/body stress management techniques (MBSM), yoga/Pilates, massage therapy, and prayer/spiritual practice. Use was estimated by sex and racial/ethnic group (White, Black, Latino, Asian/PI)) for ages 35-64 and 65-79 years and for adults 35-79 years with diabetes, hypertension, heart disease, fair/poor sleep quality, and chronic stress. CH use in 2020 was compared to 2014/2015., Results: In 2020, 53% of adults used ≥1 of these CH modalities, including 8.4% vegetarian/vegan diet, 25.8% MBSM, 23.7% prayer/spiritual practice, 16.5% yoga/Pilates, and 17.7% massage. Sex, age group, and racial/ethnic differences were seen in use of most CH modalities, and CH modality use varied by health condition. Significant increases from 2014/2015 to 2020 were seen in use of MBSM and yoga/Pilates, vegetarian/vegan diet, and prayer/spiritual practice., Conclusion: There is substantial opportunity to increase use of CH modalities within a LM approach to preventing and managing chronic health conditions., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Author(s).)

We aimed to collect parallel perspectives from pharmacists and pharmacy students on their use, knowledge, attitudes, and perceptions about herbal supplements/natural products. Two cross-sectional descriptive survey questionnaires—one focusing on pharmacists and the other focusing on pharmacy students—were administered from March to June 2021 via Qualtrics. The surveys were sent out to preceptor pharmacists and pharmacy students currently enrolled at a single U.S. school of pharmacy. The questionnaires were composed of five main sections, including (1) demographics; (2) attitudes/perceptions; (3) educational experience; (4) resource availability; and (5) objective knowledge of herbal supplements/natural products. Data analysis primarily utilized descriptive statistics with relevant comparisons across domains. A total of 73 pharmacists and 92 pharmacy students participated, with response rates of 8.8% and 19.3%, respectively. A total of 59.2% of pharmacists and 50% of pharmacy students stated they personally used herbal supplements/natural products. Most respondents (>95% for both groups) considered vitamins/minerals safe, although a lower percentage agreed on this for herbal supplements/natural products (60% and 79.3% for pharmacists and pharmacy students, respectively). Patient inquiries in the pharmacy setting were most seen for vitamin D, zinc, cannabidiol, and omega-3. A total of 34.2% of pharmacists reported having training in herbal supplements/natural products as a required part of their Pharm.D. training, and 89.1% of pharmacy students desired to learn more. The median score on the objective knowledge quiz was 50% for pharmacists and 45% for pharmacy students. Ultimately, herbal supplements/natural products are recognized by pharmacists/pharmacy students as a consistent and embedded part of pharmacy practice, although there is a need to enhance knowledge and skills in this area.

Introduction: The Institute of Medicine has described the need for comparing models of care delivery involving complementary health approaches and conventional medical practitioners. As a step toward addressing this need, we used a nationally representative 11-year sample of office-based visits to physicians from the National Ambulatory Medical Care Survey (NAMCS), to examine a comprehensive list of factors believed to be associated with visits where complementary health approaches were recommended or provided. Methods: NAMCS is a national health care survey designed to collect data on the provision and use of ambulatory medical care services provided by office-based physicians in the United States. Patient medical records were abstracted from a random sample of office-based physician visits. We examined several visit characteristics, including patient demographics, physician specialty, documented health conditions, and reasons for health visit. We ran chi-square analyses to test bivariate associations between visit factors and whether complementary health approaches were recommended or provided to guide development of logistic regression models. Results: Of the 550,114 office visits abstracted, 4.43% contained a report that complementary health approaches were ordered, supplied, administered, or continued. Among complementary health visits, 87% of patient charts mentioned nonvitamin nonmineral dietary supplements. The prevalence of complementary health visits significantly increased from 2% in 2005 to almost 8% in 2015. Returning patient status, survey year, physician specialty and degree, menopause, cardiovascular, and musculoskeletal diagnoses were significantly associated with complementary health visits, as was seeking preventative care or care for a chronic problem. Conclusion: We present an overview of the first study of office-based physician visits where complementary health approaches were recommended or ordered to their patients. These data confirm the growing popularity of complementary health approaches in the United States, provide a baseline for further studies, and inform subsequent investigations of integrative health care. [ABSTRACT FROM AUTHOR]

Yoga is an ancient South Asian philosophical system associated with an extensive set of physical, mental, and religious practices. The purpose of this paper is to discuss the forms of yoga's production-consumption-identity and cultural regulation within the framework of Cultural Studies. This paper is based on the findings of an Evidence Map on Yoga and corroborates the fact that yoga is being consumed as a cultural symbol and has mushroomed into a heterogeneous and deregulated market, in which many competing organizations promote different yoga styles and levels of certifications. Yoga has become entangled with economic and political logics and the commodification/branding process has transformed it from an Asian soul-searching practice into an industry. [ABSTRACT FROM AUTHOR]

Background and Purpose : The objective of this study was to examine the content validity of the Omaha System to represent integrative healthcare (IH) interventions. Methods : A two-step classification procedure was used to validate Omaha System target terms that can represent IH interventions. Target terms were initially sorted based on evidence of use in IH interventions, including systematic reviews published in scientific journals and the Omaha System Guidelines website. Three Omaha System and integrative nursing content experts reviewed and validated target terms based on their definitions. Expert comments were reviewed and addressed, and final decisions were reached by consensus. Results : The content validity of Omaha System target terms was established for 49 of 75 (65.3%) target terms for IH interventions. These 49 targets were employed in 1145 of 1639 (69.9%) interventions in all Omaha System guidelines available online. Implications for Practice : A majority of Omaha System target terms may be used to represent IH interventions. Use of the Omaha System may facilitate efficient, structured, and thorough IH data collection to leverage informatics technology for supporting IH intervention clinical decisions, delivery, evaluation, and knowledge discovery. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries (LMICs) bear a disproportionately high burden of noncommunicable diseases (NCDs) with severe socioeconomic consequences. Targeted interventions that are faith-based or take place in faith-based settings are historically viable for health promotion and disease prevention programmes. However, evidence of their effectiveness often comes from high-income countries. This paper outlines the protocol for the systematic review of faith-based and faith-placed interventions for NCDs in low- and middle-income countries. Objective: To determine the effectiveness of faith-based and faith-placed interventions or interventions within faith-based settings targeted at NCDs and/or their risk factors in LMICs. Methods: We will conduct a systematic search of PubMed, Embase, Scopus, WHO Library, and grey literature to locate published and unpublished studies. We will consider quantitative studies that report on interventions (a) with faith-based components or that take place in faith-based settings (b) for the prevention and control of one or more of the top ten NCDs listed in the Global Burden of Disease or their known risk factors (c) occurring among adults aged 18 and above (d) that take place in one or more LMICs. We will screen the titles, abstracts, and full text of articles for eligibility. Included articles will be critically appraised for quality and the inclusion of faith-based components by at least two independent reviewers. Data extraction will be performed for study characteristics and findings. A meta-analysis will be used to synthesize the results; if impossible, a narrative synthesis will be performed. Discussion: This review will attempt to synthesize up-to-date evidence to guide effective decision-making, allocation of health resources, and the design of future trials to test the efficacy of NCD interventions in faith-based settings. The study will increase the understanding of the existing evidence, highlight the need for additional evidence, and guide possible directions for future collaborations between public health professionals and faith-based health service providers. Systematic review registration: PROSPERO CRD42020186299 [ABSTRACT FROM AUTHOR]

Abstract Background Traditional, complementary, alternative and integrative medicine (TCAIM) can be described as diverse medical and healthcare interventions, practices, products, or disciplines that are not considered as part of conventional medicine. Inherent in its definition, TCAIMs are comprised of a wide variety of therapies with highly variable safety and effectiveness evidence profiles. Despite this, the use of many TCAIMs is highly prevalent among patients globally. The present study consists of a bibliometric analysis of TCAIM journals. Methods A single search of all International Standard Serial Number (ISSNs) of all journals categorized as “complementary and alternative medicine” (code 2707) based on the All Science Journal Classification (ASJC) was run on Scopus on April 17, 2021. All publication types were included; no further search limits were applied. The following bibliometric data were collected: number of publications (in total and per year), authors and journals; open access status; journals publishing the highest volume of literature and their impact factors; language, countries, institutional affiliations, and funding sponsors of publications; most productive authors; and highest-cited publications. Trends associated with this subset of publications were identified and presented. Bibliometric indicators of production were calculated, and bibliometric networks were constructed and visualized using the software tool VOSviewer. Results A total of 172,466 publications (42,331 open access), were published by 219,680 authors in 143 journals from 1938 to 2021. Since the 1940s, an upward trend with respect to the volume of publications can be observed, with a steep increase observed between the mid-2000s and mid-2010s. The journal that published the largest number of publications was the Journal of Natural Products (n = 15,144). The most productive countries included China (n = 45,860), the United States (n = 29,523), and Germany (n = 10,120); a number of the most common institutional affiliations and funding sponsors also originated from these three countries. Conclusions The number of publications collectively published in TCAIM journals follows an upward trend. Given a high prevalence of TCAIM use among patients, increased acceptance of TCAIM among conventional healthcare providers, and growing interest in the research of TCAIM, future work should continue to investigate and track changes in the publication characteristics of the emerging research on this topic.