Telerehabilitation for Integrative Health

2022 ◽  
pp. 213-224
Author(s):  
Chelsea G. Ratcliff ◽  
Savitha Bonthala ◽  
Debbie Torres ◽  
Radha Korupolu
Keyword(s):  
2019 ◽  
Author(s):  
Amanda Vitale ◽  
Lauren Byma ◽  
Evan Podolak ◽  
Zhaoyu Wang ◽  
Shengnan Sun ◽  
...  

Suicide is a major public health problem in the US, specifically among Veterans. The Resilience and Wellness Center (RWC) is an innovative program focused on suicide prevention. The RWC targets vulnerable veterans by augmenting traditional treatments with complementary and integrative health interventions. One critical problem in suicide prevention is lack of engagement in traditional mental health programs, with stigma an oft-cited barrier. The RWC, an alternative paradigm, attempts to break through this barrier by addressing isolation through promoting group camaraderie and accountability, integral to the success of the program. This innovative program provides a unique opportunity to enhance life skills through Whole Health intervention, including: meditation, yoga, music therapy, exercise/dance etc. Specifically, the RWC is a four-week outpatient program, where admission is determined via hospital-wide consults. With a focus on Measurement Based Care, Veterans complete baseline and post-program assessments such as the Personal Health Questionnaire (PHQ9) and scales measuring: depression, hopelessness, sleep quality, and diet & nutrition. Data for 9 cohorts to date demonstrate significant improvements, with large treatment effects as evidenced by reduction in PHQ-9 totals and feelings of depression and hopelessness, especially for Veterans with histories of suicide attempts or ideation. Overall, Veterans found the RWC program experience favorable, with > 98% completing. The RWC can be rapidly deployed in the VHA by drawing on existing hospital services and clinics. According to participants, the RWC engages Veterans in building a partnership to pave the way towards a healthier, more sustainable lifestyle.


Author(s):  
Deborah Carr ◽  
Vera K. Tsenkova

The body weight of U.S. adults and children has risen markedly over the past three decades. The physical health consequences of obesity are widely documented, and emerging research from the Midlife in the United States study and other large-scale surveys reveals the harmful impact of obesity on adults’ psychosocial and interpersonal well-being. This chapter synthesizes recent research on the psychosocial implications of body weight, with attention to explanatory mechanisms and subgroup differences in these patterns. A brief statistical portrait of body weight is provided, documenting rates and correlates of obesity, with a focus on race, gender, and socioeconomic status disparities. The consequences of body weight for three main outcomes are described: institutional and everyday discrimination, interpersonal relationships, and psychological well-being. The chapter concludes with a discussion of the ways that recent integrative health research on the psychosocial consequences of overweight and obesity inform our understanding of population health.


This handbook signals a paradigm shift in health research. Population-based disciplines have employed large national samples to examine how sociodemographic factors contour rates of morbidity and mortality. Behavioral and psychosocial disciplines have studied the factors that influence these domains using small, nonrepresentative samples in experimental or longitudinal contexts. Biomedical disciplines, drawing on diverse fields, have examined mechanistic processes implicated in disease outcomes. The collection of chapters in this handbook embraces all such prior approaches and, via targeted questions, illustrates how they can be woven together. Diverse contributions showcase how social structural influences work together with psychosocial influences or experiential factors to impact differing health outcomes, including profiles of biological risk across distinct physiological systems. These varied biopsychosocial advances have grown up around the Midlife in the United States (MIDUS) national study of health, begun over 20 years ago and now encompassing over 12,000 Americans followed through time. The overarching principle behind the MIDUS enterprise is that deeper understanding of why some individuals remain healthy and well as they move across the decades of adult life, while others succumb to differing varieties of disease, dysfunction, or disability, requires a commitment to comprehensiveness that attends to the interplay of multiple interacting influences. Put another way, all of the disciplines mentioned have reliably documented influences on health, but in and of themselves, each is inherently limited because it neglects factors known to matter for health outside the discipline’s purview. Integrative health science is the alternative seeking to overcome these limitations.


Author(s):  
Robert F. Krueger ◽  
Susan C. South

This chapter focuses on genetically informative research design and strategy in integrative health science (IHS). A feature of IHS is studying individual differences in health outcomes together and in a multidisciplinary manner. The chapter focuses on the advantages of using genetically informative research strategies for IHS. Genetically informative strategies are tools to enrich inferences within the IHS paradigm. They help parse the meaning of observed associations between exposures and outcomes. Two strategies are considered for the Midlife in the United States study : (1) Gene × Environment interactions and (2) correlations between education and allostatic load. A strategy likely to be employed in IHS research involves using segments of RNA to understand mechanisms underlying health and illness, focusing on the conserved transcriptional response to adversity (CTRA). The conclusion is that IHS and genetically informative research strategies are natural allies in understanding origins of health and illness in the population at large.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 203-203
Author(s):  
Ling Han ◽  
Robert Kerns ◽  
Melissa Skanderson ◽  
Stephen Luther ◽  
Samah Fodeh ◽  
...  

Abstract Complementary and integrative health (CIH) approaches are recommended in national policy guidelines as viable options for managing chronic pain, yet their use among Veterans has been suboptimal, especially for older Veterans. We identified 64,444 Veterans with a diagnosis of musculoskeletal disorders (MSD) who reported a moderate to severe pain intensity during primary care visits in 2013 from the Veterans Health Administration (VHA) electronic records. Using natural language processing (NLP), CIH use (acupuncture, chiropractic care and massage) was documented for 8169 (6.5%) of 125408 primary care visits in providers’ progress notes. Compared to their younger counterparts, older Veterans aged ≥ 65 years had 21% lower likelihood of using CIH during the year [Odds Ratio (OR): 0.79; 95% Confidence Intervals (CI): 0.73, 0.86] after accounting for demographic, clinical, temporal and spatial confounding using a generalized estimating equation logistic model. Non-white race/ethnicity, tobacco use, medical comorbidities and diagnosis of alcohol or substance use disorders were independently associated with less CIH use (ORs ranging 0.97-0.80, p<0.03-0.0001); whereas female gender, being married and number of MSD diagnoses were associated with greater CIH use (ORs ranging 1.13-1.30, p<0.0001). Redefining CIH use as chiropractic care alone [4.8% person-visits; OR: 0.78 (95% CI: 0.70, 0.86)] or incorporating structured data [9.0% person-visits; OR: 0.76 (95% CI: 0.70-0.82)] in the adjusted GEE model derived consistent results. Research to identify and address barriers to CIH use among older Veterans is encouraged.


2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.


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