We Built it, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

Stephanie L. Taylor; Hannah M. Gelman; Rian DeFaccio; Jamie Douglas; Matthew J. Hawrilenko; Nathan K. McGinty; Adam Resnick; Nathan C. Tomlanovich; Joy Toyama; Alison M. Whitehead; Benjamin Kligler; Steven B. Zeliadt

doi:10.1007/s11606-022-07889-4

Table 6
Predictors of veterans’ use of CIH approaches or chiropractic care, Oct. 2018–Sept. 2019: part 2 (n=5,260,921)
Yoga Tai Chi/Qigong Biofeedback Guided Imagery Clinical Hypnosis
RR (CI) RR (CI) RR (CI) RR (CI) RR (CI)
Gender *** *** *** *** ***
  Male -- -- -- -- --
  Female 2.10(2.02, 2.19) 1.79(1.7, 1.89) 1.37(1.26, 1.49) 1.79(1.56, 2.06) 1.56(1.34, 1.83)
Age
  18–39 -- -- -- -- --
  40–49 1.20(1.13, 1.27) 1.49(1.37, 1.62) 1.02(0.92, 1.14) 1.24(1.01, 1.53) 1.33(1.06, 1.67)
  50–59 1.38(1.31, 1.46) 1.98(1.83, 2.14) 1.03(0.93, 1.14) 1.41(1.16, 1.72) 1.67(1.36, 2.06)
  60–69 1.36(1.29, 1.44) 2.42(2.23, 2.62) 0.81(0.73, 0.91) 1.52(1.24, 1.86) 1.63(1.31, 2.02)
  70 + 0.95(0.89, 1.01) 1.89(1.73, 2.06) 0.46(0.40, 0.52) 1.15(0.92, 1.44) 0.96(0.76, 1.22)
Race
  White -- -- -- -- --
  Black 1.11(1.07, 1.16) 1.28(1.22, 1.34) 1.08(0.99, 1.17) 1.23(1.08, 1.41) 1.01(0.87, 1.16)
  Other 1.02(0.93, 1.12) 1.05(0.93, 1.18) 0.78(0.63, 0.96) 0.88(0.61, 1.25) 0.67(0.44, 1.01)
  Unknown 0.91(0.84, 0.98) 0.98(0.88, 1.08) 0.84(0.71, 0.99) 1.03(0.79, 1.33) 0.72(0.52, 0.99)
Ethnicity
  Not Hispanic Latino -- -- -- -- --
  Hispanic Latino 0.95(0.89, 1.02) 1.00(0.92, 1.09) 0.94(0.83, 1.08) 0.88(0.70, 1.10) 0.72(0.54, 0.96)
  Unknown 0.84(0.72, 0.97) 0.72(0.6, 0.87) 0.80(0.59, 1.09) 0.68(0.41, 1.11) 0.64(0.34, 1.20)
Urban
  Yes -- -- -- -- --
  No 0.54(0.51, 0.57) 0.72(0.68, 0.76) 0.53(0.48, 0.59) 0.94(0.81, 1.09) 0.85(0.73, 0.99)
  Unknown 0.54(0.44, 0.66) 0.07(0.04, 0.14) 0.21(0.11, 0.4) 0.88(0.51, 1.53) 0.61(0.27, 1.36)
Chronic Musculoskeletal pain
  No -- -- -- -- --
  Yes 2.54(2.45, 2.63) 2.63(2.52, 2.75) 3.02(2.81, 3.25) 3.20(2.84, 3.61) 3.45(3.03, 3.93)
Anxiety
  No -- -- -- -- --
  Yes 1.51(1.46, 1.58) 1.51(1.44, 1.59) 2.51(2.32, 2.71) 1.73(1.52, 1.97) 1.69(1.46, 1.95)
Depression
  No -- -- -- -- --
  Yes 1.96(1.88, 2.04) 1.85(1.76, 1.94) 1.87(1.73, 2.03) 2.12(1.86, 2.42) 1.93(1.67, 2.22)
PTSD
  No -- -- -- -- --
  Yes 2.32(2.24, 2.41) 2.02(1.93, 2.12) 2.38(2.21, 2.56) 1.87(1.65, 2.12) 1.88(1.64, 2.15)
Diabetes
  No -- -- -- -- --
  Yes 0.96(0.92, 1.00) 1.08(1.03, 1.13) 0.98(0.90, 1.07) 1.03(0.91, 1.18) 1.13(0.98, 1.30)
Obesity
  No -- -- -- -- --
  Yes 1.70(1.64, 1.76) 2.03(1.95, 2.12) 1.21(1.12, 1.31) 1.75(1.56, 1.97) 1.34(1.17, 1.53)
Cardiovascular Disease
  No -- -- -- -- --
  Yes 0.94(0.90, 0.98) 0.91(0.87, 0.96) 0.94(0.87, 1.02) 1.04(0.91, 1.19) 0.89(0.77, 1.02)

RR relative risk, CI 95% confidence interval

	Yoga	Tai Chi/Qigong	Biofeedback	Guided Imagery	Clinical Hypnosis
	RR (CI)	RR (CI)	RR (CI)	RR (CI)	RR (CI)
Gender	***	***	*******	***	***
Male	--	--	--	--	--
Female	2.10(2.02, 2.19)	1.79(1.7, 1.89)	1.37(1.26, 1.49)	1.79(1.56, 2.06)	1.56(1.34, 1.83)
Age
18–39	--	--	--	--	--
40–49	1.20(1.13, 1.27)	1.49(1.37, 1.62)	1.02(0.92, 1.14)	1.24(1.01, 1.53)	1.33(1.06, 1.67)
50–59	1.38(1.31, 1.46)	1.98(1.83, 2.14)	1.03(0.93, 1.14)	1.41(1.16, 1.72)	1.67(1.36, 2.06)
60–69	1.36(1.29, 1.44)	2.42(2.23, 2.62)	0.81(0.73, 0.91)	1.52(1.24, 1.86)	1.63(1.31, 2.02)
70 +	0.95(0.89, 1.01)	1.89(1.73, 2.06)	0.46(0.40, 0.52)	1.15(0.92, 1.44)	0.96(0.76, 1.22)
Race
White	--	--	--	--	--
Black	1.11(1.07, 1.16)	1.28(1.22, 1.34)	1.08(0.99, 1.17)	1.23(1.08, 1.41)	1.01(0.87, 1.16)
Other	1.02(0.93, 1.12)	1.05(0.93, 1.18)	0.78(0.63, 0.96)	0.88(0.61, 1.25)	0.67(0.44, 1.01)
Unknown	0.91(0.84, 0.98)	0.98(0.88, 1.08)	0.84(0.71, 0.99)	1.03(0.79, 1.33)	0.72(0.52, 0.99)
Ethnicity
Not Hispanic Latino	--	--	--	--	--
Hispanic Latino	0.95(0.89, 1.02)	1.00(0.92, 1.09)	0.94(0.83, 1.08)	0.88(0.70, 1.10)	0.72(0.54, 0.96)
Unknown	0.84(0.72, 0.97)	0.72(0.6, 0.87)	0.80(0.59, 1.09)	0.68(0.41, 1.11)	0.64(0.34, 1.20)
Urban
Yes	--	--	--	--	--
No	0.54(0.51, 0.57)	0.72(0.68, 0.76)	0.53(0.48, 0.59)	0.94(0.81, 1.09)	0.85(0.73, 0.99)
Unknown	0.54(0.44, 0.66)	0.07(0.04, 0.14)	0.21(0.11, 0.4)	0.88(0.51, 1.53)	0.61(0.27, 1.36)
Chronic Musculoskeletal pain
No	--	--	--	--	--
Yes	2.54(2.45, 2.63)	2.63(2.52, 2.75)	3.02(2.81, 3.25)	3.20(2.84, 3.61)	3.45(3.03, 3.93)
Anxiety
No	--	--	--	--	--
Yes	1.51(1.46, 1.58)	1.51(1.44, 1.59)	2.51(2.32, 2.71)	1.73(1.52, 1.97)	1.69(1.46, 1.95)
Depression
No	--	--	--	--	--
Yes	1.96(1.88, 2.04)	1.85(1.76, 1.94)	1.87(1.73, 2.03)	2.12(1.86, 2.42)	1.93(1.67, 2.22)
PTSD
No	--	--	--	--	--
Yes	2.32(2.24, 2.41)	2.02(1.93, 2.12)	2.38(2.21, 2.56)	1.87(1.65, 2.12)	1.88(1.64, 2.15)
Diabetes
No	--	--	--	--	--
Yes	0.96(0.92, 1.00)	1.08(1.03, 1.13)	0.98(0.90, 1.07)	1.03(0.91, 1.18)	1.13(0.98, 1.30)
Obesity
No	--	--	--	--	--
Yes	1.70(1.64, 1.76)	2.03(1.95, 2.12)	1.21(1.12, 1.31)	1.75(1.56, 1.97)	1.34(1.17, 1.53)
Cardiovascular Disease
No	--	--	--	--	--
Yes	0.94(0.90, 0.98)	0.91(0.87, 0.96)	0.94(0.87, 1.02)	1.04(0.91, 1.19)	0.89(0.77, 1.02)