Adolescents’ knowledge of and beliefs about complementary and alternative medicine: a qualitative study

• Published in: Journal of adolescent health Vol. 32; no. 2; p. 126
• Main Authors: Sesselberg, Tracy S., Wilson, Karen M., Gray, Nicola J., Klein, Jonathan D.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-02-2003
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/S1054-139X(02)00621-3

Purpose: As many as 54% of adolescents report using Complementary and Alternative Medicine (CAM). Most research on adolescent CAM use has been quantitative, focusing on prevalence of use; little is known about adolescents' knowledge of and beliefs about CAM and over-the-counter medications (OTCs). We studied CAM and OTC use among adolescents as they relate to two of the Institute of Medicine's described consumer perspectives on health care quality: staying healthy and getting better. Methods: Fourteen focus groups were held to explore teens' understanding of CAM and their reasons for using or not using CAM and OTCs. A total of 49 adolescents participated. Separate groups were conducted with adolescent CAM users, urban minority adolescents, and adolescents with chronic illness--asthma, eating disorders, and diabetes--in Monroe County, New York. Qualitative analysis of transcripts identified themes related to adolescents' understanding of CAM and OTCs. Results: Many adolescents in all groups were unsure about what "alternative medicine" meant; adolescents often confused CAM and OTCs. Most adolescents were familiar with "herbal medicine", "herbal remedies", or "nutritional supplements". Many could name specific CAM modalities, especially nutritional supplements and herbs, but teens often did not know what specific products were actually used for. Adolescents were most familiar with herbal remedies or CAM modalities that were specific to their family background or cultural tradition; these therapies were generally identified as used for getting better, rather than for staying healthy. Older females, especially those with eating disorders or diabetes, were most familiar with CAM. Females with eating disorders also were familiar with CAM therapies for staying healthy, mentioning mind/body treatments like yoga or meditation. Both CAM users and non-users thought that CAM might be used if someone "had tried everything else and it didn't work" to get better, or as an alternative to pharmaceuticals. CAM users had positive opinions about CAM, whereas non-users felt that they did not need CAM, and many held negative stereotypes about CAM users. Most adolescents agreed that herbal products are "natural" but thought that the ingredients may have been manipulated, and recognized the potential for herb/drug interactions or undesirable side effects. All of the adolescents were familiar with a wide variety of OTCs, referred to them by brand name, and knew they were used for getting better. Most adolescents used OTCs, although they were skeptical of advertisements for them, and did not believe OTC medications were "natural". Conclusions: Many adolescents are unfamiliar with the concept of "alternative medicine", although they are familiar with many different types of products, including nutritional supplements, herbal medicines, and OTC drugs, especially those that are used for getting better when sick. Adolescents' knowledge of herbs is culturally specific. Providers and researchers should consider chronic illness status, culture, and family tradition, and should clarify terms, when asking adolescents about self-care, OTCs, or CAM use.