The latent structure of traditional, complementary, and alternative medicine practices based on patterns of use

Abstract

Despite unknown efficiency, known risks, and associated adverse effects of certain traditional, complementary, and alternative medicine (TCAM) practices, the number of people using them appears to be on the rise. Existing taxonomies of TCAM practices mostly relied on either conceptual reasons, or they relied on attitudes toward TCAM, rather than its actual use. In this study, we sought to group TCAM practices based on their patterns of use. A sample of N = 583 (Mage = 39.01 years, SDage = 12.10; 74.4% females) participants residing in Serbia completed an online survey including a list of 71 TCAM practices. For each practice, they indicated if and when they used it to promote their own or their children's health (options: never heard about it/never used it/more than a year ago/in the past year/during the past two weeks). To evaluate the lifetime use of TCAM, we binarized all TCAM items to reflect whether participants have ever used a given practice (never using a practice was coded as 0, using it at least once as 1). After excluding items with frequencies below 5%, we performed an exploratory factor analysis on the tetrachoric correlation matrix for the remaining 49 items. Using a minimum residual method of extraction and oblimin rotation, we identified four meaningful factors explaining 42% of total variance: 1) Natural product-based practices (NP) comprising the use of products such as extracts and supplements of herbal and non-herbal origin; 2) Rituals/Customs (RC) which reflected the use of traditional medicine and religious practices, such as visiting monasteries; 3) New age medicine (NA) incorporating mind-body therapies and energy medicine practices; and 4) Alternative medical systems (AMS) such as acupuncture, homeopathy, quantum medicine, and osteopathy/chiropractic. Factor correlations ranged from r = .18, p <.001 for RC and AMS to r = .30, p < .001 for NA and AMS. The latent structure we obtained based on the pattern of TCAM use corresponds closely to existing conceptual typologies, as well as to those based on attitudes toward TCAM. This suggests that consumers are sensitive to common characteristics of certain TCAM treatments and are more likely to resort to similar types of TCAM practices to promote their health. The existence of relatively independent factors of TCAM use opens the possibility of differential patterns of their psychological predictors and health-related outcomes.