NCCAM published PAR 03-102 on April 11, 2003, with the purpose of promoting the analysis of previously collected data to increase knowledge regarding complementary and alternative medicine (CAM) use in racial and ethnic minority populations. The objectives of this solicitation are to enhance the understanding of CAM use by racial and ethnic minority populations as well as to inform and further the associated research agenda. The specific objectives of the solicitation are to provide support for (a) analyzing previously collected data that would advance scientific knowledge on the use, effectiveness, and outcomes of CAM in minority populations; (b) studying patterns of CAM use and the types of problems for which CAM is used in minority populations and specific sub-populations; (c) characterizing differences in CAM use among racial/ethnic groups; (d) evaluating, where possible, the cost and cost-effectiveness of CAM use; (e) preliminary projects using secondary analyses that could lead to subsequent applications for individual research awards; and (f) the archiving of datasets to be made available for public use to conduct research related to CAM.

In response to the applications received on the first two receipt dates, NCCAM funded eleven projects on a range of topics consistent with the objective of the PA. As a result of those funding decisions, subsequent applications for projects in subject areas that overlap with previously funded grants may be considered to have low program priority. Listed below are the projects and brief descriptions.

CAM Use in Asians and Pacific Islanders
Principal Investigator: Gotay, Carolyn C.
Institution: University of Hawaii

This study of CAM in cancer patients from a primarily Asian and Pacific Islander (API) population seeks to understand predictors of CAM use and effects of CAM use in API minority populations. Using data previously collected in a series of 10 NIH grants and contracts examining well-being in Hawaii cancer survivors (including large proportions of patients with Japanese, Filipino, and Native Hawaiian ancestry), it will examine CAM use among API minority populations and compare it to CAM use among Caucasian patients in Hawaii who participated in the same studies. The study also will investigate whether APIs report different reasons for CAM use than Caucasian patients and determine the relationship between CAM use and outcomes including quality of life (QoL) and survival.

Minorities and CAM Use: A Health Services Perspective
Investigator: Kronenberg, Fredi
Institution: Columbia University

This study will explore how CAM use is associated with potential strategies for improving quality of care and the elimination of health disparities. Using two national surveys (NHIS and the Commonwealth Fund's 2001 Health Care Quality Survey), this project will analyze data on four racial/ethnic groups (non-Hispanic White Americans, non-Hispanic African Americans, non-Hispanic Asian Americans, and Hispanic Americans) to study the nuances of medical pluralism from a health services perspective.

Race and Herbal Medications Among Medicare Recipients
Principal Investigator: Lafferty, William E.
Institution: University of Washington

This project is analyzing survey data from the Cardiovascular Health Study (CHS) that have been collected for approximately 6,000 Medicare recipients. CHS oversampled African-Americans and will compare two time spans, from 1993 to 1999. The study will examine the use of prescription drugs, supplements, herbals and other non-prescription medications and changes in use over time. Simultaneous use of herbal and prescription drugs will be identified in the population and the risk of adverse reaction assessed.

CAM Use in Hispanics 75+ Years Old in US and Mexico
Principal Investigator: Loera, Jose A.
Institution: University of Texas Medical Branch

Analyzing two data sets, this study will undertake a comparative analysis of the use of CAM and related health services by older adults in Mexico and the US. Using the Hispanic-Established Populations for the Epidemiologic Study for the Elderly (H-EPESE), and the INEGI (Institute Nacional de Estadistica, Geografia, e Informatica) National Mexican Health and Aging Study (NMHAS), the project will focus on the 75+ year old Hispanic population to examine the relationship between self-reported functional status, social networks, health beliefs and similarities in usage patterns of CAM, pharmacists and health care services. This project will help in understanding longitudinal CAM use in an elderly population and also compare, for the first time, similar variables across two data sets, operationalizing them in the same way.

Racial Differences in CAM for Common Medical Conditions
Principal Investigator: McCarthy, Ellen P.
Institution: Beth Israel Deaconess Medical Center

This study will use data from the 2002 National Health Interview Survey to study the prevalence of CAM use, variations in CAM use, parameters of CAM use, and disclosure to health providers in racial/ethnic and economically disadvantaged populations. This study will provide insight into national rates of CAM use by racial and ethnic minorities and economically disadvantaged individuals; the reasons for CAM use, such as treatment of common medical conditions and promotion of overall health and well-being, and the relationship between CAM and conventional medical care.

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Differences in CAM Use Among Minority Older Adults
Principal Investigator: Arcury, Thomas A.
Institution: Wake Forest University

This project will analyze four data sets to examine patterns of CAM use in the ethnic minority older adults: The 2002 National Health Interview Survey (NHIS), the 1993-94 wave of the National Survey of Self-Care and Aging (NSSCA), the 1993-94 Hispanic Established Populations for the Epidemiologic Study for the Elderly (HEPESE), and the Evaluation of Long-term Diabetes Self-management among Elder Rural Adults (ELDER) Study. The project aims to describe ethnic differences in CAM use; delineate how those differences are influenced by gender, age, and rural/urban residence; identify predisposing, enabling, and need factors related to CAM use (social, economic, cultural, health status, health care access); and determine factors related to CAM use for chronic conditions highly prevalent among older minorities, such as arthritis and depression.

Use of Herbs and Dietary Supplements in Four Ethnicities
Principal Investigator: Fitzpatrick, Annette L.
Institution: University of Washington

This project will analyze data from MESA (Multi-Ethnic Study of Atherosclerosis), an NHLBI-sponsored six-city study of 6,814 adults aged 45-84, to examine the prevalence of herbal medicine, botanical, and dietary supplement use among Whites, African-Americans, Hispanics, and Chinese living in six communities within the United States, as well as the sociodemographic and health correlates of CAM use.

CAM Use in Midlife Women in Five Ethnic Groups
Principal Investigator: Gold, Ellen B.
Institution: University of California, Davis

This project will analyze data collected in the multi-ethnic cohort of 3,300 midlife women included in the longitudinal Study of Women's Health Across the Nation (SWAN) and the CAM Supplement to the 2002 National Health Interview Survey (NHIS). The project will examine longitudinally racial/ethnic differences in CAM use, the demographic, lifestyle, and medical factors that affect initiation and continuation of CAM use, and determine the types of problems for which women use specific types of CAM in midlife as well as whether these differ by race/ethnicity and change longitudinally with changes in menopausal status. It also will compare the types of and reasons for CAM use in the SWAN cohort of midlife women to those in women of similar age and racial/ethnic groups in the 2002 NHIS cohort.

CAM Use and Access to Care by Asian Pacific Islanders
Principal Investigator: Hsiao, An-Fu
Institution: University of California, Los Angeles

This project will use data from the California Health Interview Survey (CHIS) and a Health Behavioral Model to identify key factors relating to health issues in CAM use for Asian Americans and Pacific Islanders (AAPIs). The project will examine CAM use as it relates to demographics, health status, acculturation, and perceived discrimination in AAPIs and AAPI subgroups including Filipinos, Chinese, Koreans, Japanese, Southeast Asians, South Asians, and Pacific Islanders.

Herbal Medicine Use in Minority Populations in the US
Principal Investigator: Kaufman, David W.
Institution: Boston University

This project will use data from the Sloan Survey, an ongoing large national survey of medication use, to analyze and present information on herbal medication use by African-American, Hispanic, and Asian/Pacific Islander adults and children over time identifying the reason for use and how herbal use is combined with prescription drug use.

Use and Correlates of CAM Among Racial/Ethnic Minorities
Principal Investigator: Mitchell, Shannon M.
Institution: Yale University

This project will analyze data from The National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS) to evaluate the use and correlates of CAM among racial and ethnic minorities, including both self-administered and provider-based therapies. The project will study health status, health behaviors, insurance coverage, out-of-pocket costs, and demographic characteristics of respondents, which will allow the investigators to examine whether factors associated with disparities in conventional medicine predict differential use of CAM therapies.

Archiving Minority CAM Use Datasets
Principal Investigator: Wallander, Jan L.
Institution: Sociometrics Corporation

This project will archive CAM data sets in order to facilitate increased research on minority populations and the use of CAM. The project will identify, analyze, and archive the best of CAM data sets in ways that facilitate their visibility and usability, resulting in a "Minority CAM Data Archive" (M-CAMDA).

Prospective applicants are also notified that NCCAM and CDC staff are engaged in ongoing research on (1) the relationship of CAM use with various health behaviors, race and gender, and (2) differences between persons who use CAM in conjunction with conventional medicine and those who use only CAM or only conventional medicine.

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For further questions regarding this solicitation, please contact:

Morgan N. Jackson, M.D., M.P.H.
Director, Office of Special Populations
Division of Extramural Research and Training
National Center for Complementary and Alternative Medicine
National Institutes of Health
6707 Democracy Blvd., Suite 401
Bethesda, MD 20892-5475
Phone: 301-402-1278
E-mail: mj145m@nih.gov

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