Cheryl Ritenbaugh

The University of Arizona | UA · Department of Family and Community Medicine

Background: Research in complementary and alternative medicine (CAM) encounters a variety of challenges, such as potentially synergistic, multimodal, and complex interventions which are often dependent on the relationship between practitioner and patient, on specific settings, and on patients' individual preferences, expectations, beliefs, and mot...

Objectives: The authors employ a Whole Systems framework to explore implementation of new guidelines for back and neck pain in Oregon's Medicaid system. Whole Systems research is useful for understanding the relationship between complementary and integrative health care (CIH) and conventional health care systems in real-world clinical and practice...

Context: Value-based health care has emerged as a manifestation of the conventional medicine community's awareness of the overlapping needs to both better incorporate patient centeredness into practice and research paradigms and further develop a systemic approach to cost reduction. Background: The origins of the whole systems research (WSR) mov...

The anthropological study of placebo intersects with long‐standing interests in the symbolic efficacy of ritual or ritual behavior. Placebo studies in anthropology emphasize both cognitive meaning and embodied awareness as facilitators of the placebo effect. The placebo effect is commonly understood within anthropology as the body's ability to heal...

Background: Chiropractic care is a popular alternative for back and neck pain, with efficacy comparable to usual care in randomized trials. However, the effectiveness of chiropractic care as delivered through conventional care settings remains largely unexplored. Objective: To evaluate the comparative effectiveness of usual care with or without...

Birth outcomes tend to be better among Hispanics than among other ethnic groups, even when matched for poverty and education, and foreign-born Latinas compared to their US-born counterparts. These patterns suggest that sociocultural factors exhibited by recent immigrants have the potential to protect birth outcomes against the instability of minori...

Background In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)—despite concerns within the medical community and the availability of new FDA approved “bioidentical” products. This study aims to characterize the motivations for using CBHT in a U.S. sa...

Background This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners’ in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: t...

Background Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Methods Qua...

Background Propensity scores are typically applied in retrospective cohort studies. We describe the feasibility of matching on a propensity score derived from a retrospective cohort and subsequently applied in a prospective cohort study of patients with chronic musculoskeletal pain before the start of acupuncture or usual care treatment and enrollm...

Background: Patient expectations may be associated with outcomes of complementary and alternative medicine (CAM) treatments for chronic pain. However, a psychometrically sound measure of such expectations is needed. Objectives: The purpose of this study was to develop and evaluate a questionnaire to assess individuals' expectations regarding out...

Printed educational materials (PEMs) have long demonstrated their usefulness as economical and effective media for health communication. In this article, we evaluate the impact of targeted tobacco cessation PEMS for use along with a brief intervention training designed for three types of complementary and alternative medicine (CAM) practitioners: c...

Introduction: Brief behavioral intervention (BI) is a tobacco-cessation best practice well established among conventional healthcare practitioners. Complementary and alternative medicine (CAM) practitioners treat significant numbers of tobacco users, but do not systematically receive BI training. The CAM Reach study developed and evaluated a tobac...

Introduction: Food intolerance is non-allergic food hyper-sensitivity. This a term used for varied physiological responses associated with food, or compound of foods. Aim of this study is to detect food intolerance and associated risk factors in patients diagnosed by using indirect Bi-Digital O-Ring Test (BDORT), lab and clinical testing for depres...

To describe acupuncture and chiropractic use among patients with chronic musculoskeletal pain (CMP) at a health maintenance organization, and explore issues of benefit design and electronic medical record (EMR) capture. Cross-sectional survey. Kaiser Permanente members meeting EMR diagnostic criteria for CMP were invited to participate. The survey...

In this paper, we explore hope in the context of living with chronic pain. Individuals with chronic pain from temporomandibular disorder(s) were interviewed four to five times over the course of their 18-month participation in a clinical trial investigating the effectiveness of Traditional Chinese Medicine. We sought to understand shifts in partici...

The purpose of this study was to evaluate the short-term effects of massage therapy using gas discharge visualization (GDV), a computerized biophysical electrophoton capture (EPC), in tandem with traditional self-report measures to evaluate the use of GDV measurement to assess the bioenergetic whole-person effects of massage therapy. This study use...

Complementary and alternative medicine (CAM) represents an array of non-mainstream health care approaches that include the use of natural product dietary supplements and mind-body and manipulation practices, such as acupuncture, massage therapy, chiropractic, meditation, tai chi, qigong, yoga, and hypnotherapy. The field of dentistry has a long his...

Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantif...

Background Practitioners of complementary and alternative medicine (CAM) therapies are an important and growing presence in health care systems worldwide. A central question is whether evidence-based behavior change interventions routinely employed in conventional health care could also be integrated into CAM practice to address public health prior...

Background The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examin...

Tobacco use remains the leading cause of morbidity and mortality in the US. Effective tobacco cessation aids are widely available, yet underutilized. Tobacco cessation brief interventions (BIs) increase quit rates. However, BI training has focused on conventional medical providers, overlooking other health practitioners with regular contact with to...

Many of the leading causes of mortality and morbidity in American Indians and Alaska Natives (AI/ANs) are preventable, which indicates that lifestyle is a key risk factor. Behavioral change interventions attempted with AI/ANs that focus on lifestyle have begun to incorporate Native cultural traditions, or cultural capital. This article discusses on...

Temporomandibular Disorders (TMD) represent a particular form of chronic pain that, while not outwardly debilitating, profoundly impacts interactions as fundamental to human existence as smiling, laughing, speaking, eating, and intimacy. Our analysis, informed by an expanded “works of illness” assessment, draws attention to work surrounding social...

Background Positive patient expectations are often believed to be associated with greater benefits from complementary and alternative medicine (CAM) treatments. However, clinical studies of CAM treatments for chronic pain have not consistently supported this assumption, possibly because of differences in definitions and measures of expectations. Th...

This article explores the role of hope in participants’ assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for Temporomandibular Disorders (TMD,...

The promotion of healthy infant feeding is increasingly recognized as an important obesity-prevention strategy. This is relevant for American Indian populations that exhibit high levels of obesity and low compliance with infant feeding guidelines. The literature examining the knowledge, attitudes, and beliefs surrounding infant feeding within the A...

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for...

Background: The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we exami...

No consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive int...

PurposeThe purpose of the Families United/Familias Unidas study was to evaluate the feasibility and efficacy of group office visits on reducing diabetes risk in a multiethnic, primary care population.Methods Adults, ages 18 to 70 years, with any diabetes risk factor were recruited to attend 12 group office visits over 6 months. Each participant ide...

Introduction: Lifestyle-related diseases are leading causes of US morbidity and mortality, spurring increased efforts to promote healthy behaviors. With growing complementary and alternative medicine (CAM) use in the US, CAM practitioners are an increasingly important part of the health care system. CAM practitioners' training, healing paradigms, a...

Back pain consists of a spectrum of conditions, with no common etiology and therefore no dominant method of treatment. The purpose of this study is to describe the complexity of a collection of 8000 back pain patients who appeared in an integrative medicine clinic, as a prelude to conducing comparative effectiveness research on CAM alternatives to...

Context: Medical authorities have identified obesity as a causal factor in the development of diabetes, hypertension, and cardiovascular disease (CVD), and more broadly, of metabolic syndrome/insulin resistance syndrome. To provide solutions that can modify this risk factor, researchers need to identify methods of effective risk reduction and prim...

Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model. The intervention lasted for 3 months, with...

The LIFE study was a randomized controlled trial assessing the impact of a self-acupressure intervention, Tapas Acupressure Technique® (TAT®), on weight-loss maintenance. The primary analysis showed no significant difference between TAT and social support (SS) for weight-loss maintenance, while exploratory post hoc tests suggested that, among parti...

Background Some researchers think that patients with higher expectations for CAM therapies experience better outcomes and that enthusiastic providers can enhance treatment outcomes. This is in contrast to evidence suggesting conventional medical providers often reorient patient expectations to better match what providers believe to be realistic. Ho...

Conceptual model of factors influencing patient expectations.

Unlabelled: This dual-site study sought to identify the appropriate role for traditional Chinese medicine (TCM; acupuncture and herbs) in conjunction with a validated psychosocial self-care (SC) intervention for treating chronic temporomandibular disorders (TMD)-associated pain. Participants with Research Diagnostic Criteria for Temporomandibular...

PurposeThe purpose of this study is to describe the development and implementation of a new diabetes prevention intervention that combines the benefits of family support with the group office model. Intensive lifestyle modification can effectively delay the onset of type 2 diabetes, yet health providers are challenged in translating these results t...

Background There is a need for more Comparative Effectiveness Research (CER) to strengthen the evidence base for clinical and policy decision-making. Effectiveness Guidance Documents (EGD) are targeted to clinical researchers. The aim of this EGD is to provide specific recommendations for the design of prospective acupuncture studies to support opt...

Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that Americ...

Context: Participants in a randomized trial of traditional Chinese medicine (TCM) for temporomandibular joint dysfunction (TMD) had a linear decline in pain over 16 TCM visits. Objective: To investigate whether reductions in pain among participants receiving TCM can be explained by increased use of pain medications, or whether use of pain medica...

Purpose To provide an in depth analysis of adherence and satisfaction with the mind and body intervention for participants in the LIFE weight loss maintenance trial. Methods We performed a secondary analysis of 142 obese participants who had lost at least 10 pounds in a conventional weight loss program and who were randomized to the experimental we...

There is a 20-fold difference in incidence rates of colorectal cancer between the areas of highest incidence (North America and Australia) and lowest incidence (India). Animal studies, epidemiologic research, and clinical trials continue to focus on diet in the search for responsible environmental factors. Between 1997 and 1999, a number of researc...

Obesity is an urgent public health problem, yet only a few clinical trials have systematically tested the efficacy of long-term weight-loss maintenance interventions. This randomized clinical trial tested the efficacy of a novel mind and body technique for weight-loss maintenance. Participants were obese adults who had completed a six-month behavio...

Checklist of Items for Reporting Trials of Nonpharmacologic Treatments.

Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods...

Stable word pairs. This file provides summary descriptions for each of the nine 'stable' word pairs. This material is provided for readers interested in the specific meanings ascribed to each term by participants. We also provide quotations illustrating how cognitive interview participants used them in context.

Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were sub...

Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic...

Reports an error in "Rebuttal re: "Confirmatory bias and the persistent influence of discredited data in interpreting the stress-cancer link: Commentary on Michael et al. (2009)"" by Yvonne L. Michael, Nichole E. Carlson, Deborah J. Bowen and Cheryl Ritenbaugh (Health Psychology, 2011[May], Vol 30[3], 375-376). The letter was missing the doi. The c...

Responds to the comments by J. C. Coyne and C. Johansen (see record 2011-09497-016) on the current author's original article, "Influence of stressors on breast cancer incidence in the Women's Health Initiative" (see record 2009-03297-001). Coyne and Johansen (2011) took issue with the study conducted by the current authors' group (Michael et al., 2...

Excess weight gain in American Indian/Alaskan native (AI/AN) children is a public health concern. This study tested (1) the feasibility of delivering community-wide interventions, alone or in combination with family-based interventions, to promote breastfeeding and reduce the consumption of sugar-sweetened beverages; and (2) whether these intervent...

To investigate the relationships between lifestyle behaviors of diet, smoking, and physical activity and the subsequent prevalence of age-related macular degeneration (AMD). The population included 1313 participants (aged 55-74 years) in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative Observatio...