Use of Traditional Health Practices Among Native Americans in a Primary Care Setting

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Abstract
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. 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. 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 ≤0.001). Being of male gender (P ≤0.001), having more than a high school education (P ≤0.05), visiting friends/relatives on a reservation (P ≤0.01), living the Native way of life (P ≤0.001) and not the white way (P ≤0.05), experiencing back pain (P ≤0.01), and having a physical injury inflicted by a family member (P ≤0.001) were predictive of use. 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.