Features Continuing Education Education
Research Opportunities

There are a broad number of opportunities for massage therapists and other complementary and alternative medicine (CAM) professionals to initiate and engage in research. This article addresses four of such opportunities. Moreover, this article endorses use of a community based participatory research (CBPR) approach as a practical way for massage therapists and others to conduct research, wherein its use may serve as a practical means to effectively ascertain a given communities real health service needs.

Opportunity 1
As the prevalence of chronicity increases with age,1 and as CAM users typically report having one or more chronic conditions,2 due to population aging the future demand for CAM has the potential to increase significantly.3-4 Despite such projections, however, little is known to date regarding the characteristics of older users of specific types of CAM therapies like massage. Only recently have reasons for CAM related use been studied in earnest. 5 More in-depth analysis of user characteristics of complementary and alternative health care services “would be a valuable area for further study.” 6 As it stands, though, there remains a lack of empirically-based information about the self-care use of CAM by such populations as the chronically ill. 7

Opportunity 2
Nursing has long embraced a holistic approach to care and, providing such an approach is often a goal embodied within many complementary therapy practices, such as Swedish massage therapy (SMT). The potential for improved collaborations between allopathic (conventional) health care professionals (e.g. nurses) and massage therapists, so as to improve and support holistic health care, needs to be further explored within the social/scientific literature. 8

Opportunity 3
Unlike conventional medical education and care, which relies heavily on high technology and pharmaceuticals, CAM exists in a low-tech arena and, therefore, is generally less costly.9-10 Moreover, CAM treatments users have reported that use of conventional services and prescription drugs decreased after their use of CAM.11

CAM use, in conjunction with biomedicine, has also been attributed to a reported decrease in the number of hospital days (reductions up to 58 per cent), hospital admissions (reductions up to 43 per cent), outpatient surgeries and procedures (reductions up to 43 per cent), as well as pharmaceutical utilization (cost reductions up to 52 per cent).10 While there is reason to believe that the use of CAM may actually yield health care savings in the long term, more research is needed as data on the cost-effectiveness of CAM remains very limited.3 This area of research may best be done through a collaborative effort, formed between academic/business (e.g. health care economists) and CAM professionals and, with the volunteer participation of the general public. To form such a research alliance and/or network, a community based participatory research (CBPR) approach is encouraged.

The Potential & Importance Of Using A CBPR Approach
Community Based Research (CBR) is a collaborative, partnership approach to research that equitably and actively involves community members, organizational representatives, and researchers in all aspects of the research process. Here, the general public is given opportunity to contribute their expertise and/or life experiences to enhance understanding of a given phenomenon (e.g. ways/needs of coping with musculoskeletal disorders) and integrate the knowledge gained with action to benefit the community involved.12

By providing independent community members opportunities to indicate their needs and preferences, this may help to identify gaps in existing services. Moreover, community input can help identify barriers to obtaining services and support, and systematic inequalities. Rather than being ignored, patients and communities at large may instead be empowered and seen as partners in research. Herein, the general public is given opportunity to provide input on means they perceive can improve their own care.

As regulated CAM professionals and their businesses are predominately nested in communities, usually based outside of hospitals and other publicly funded health care institutions 3, people in communities may be more open to CAM professionals toward using a CBPR approach. This in itself serves as a potentially fruitful exploratory research project for CAM professionals to consider.

In general, by engaging in research massage therapists are provided opportunities to share their expertise with other professionals and members of the general public. Moreover, by conducting research massage therapists have the potential to convey to others what their profession is all about and, further positively contribute towards improving overall population health and well-being.

Acknowledgements
Kevin Willison has been a regular contributor to MT Canada. His key interests include teaching and health care research  (see: http://myprofile.cos.com/kdwillison). Kevin is a 2006 graduate of a 30-hour program in community based research through the Wellesley Institute (Toronto) – http://wellesleyinstitute.com. This valuable and very affordable program offers an excellent opportunity for regulated CAM practitioners and other (e.g. public health)
professionals within the Toronto Canada area to build upon their existing research skills and pursue ongoing
professional development and interdisciplinary partnerships.

References
[1] Schultz, S.E., Kopec J.A. (2003). Impact of chronic conditions. Statistics Canada. Health Reports; 14 (4): 41-53. Statistics Canada Catalogue 82-003-XPE.
[2] Ramsey, S.D., Spencer A.C., Topolski T.D., Belza B., Patrick D.L. (2001). Use of alternative therapies by older people with osteoarthritis. Arthritis and Rheumatism; 45(3): 222-227.
[3] Willison, K.D., Andrews G.J. (2004). Complementary medicine and older people: past research and future directions. Complementary Therapies in Nursing & Midwifery; 10(2): 80-91.
[4] Millar, W.J. (2001). Patterns of use – alternative health care practitioners. Health Reports. Statistics Canada, December; 13 (1). Catalogue 82-003.
[5] Schuster, T.L., Dobson M., Jauregui M., Blanks R.H.I. (2004). Wellness Lifestyles I: A Theoretical Framework Linking Wellness, Health Lifestyles, and Complementary and Alternative Medicine. The Journal of Alternative and Complementary Medicine; 10 (2):349-356.
[6] Health Canada. (2003). Complementary and Alternative Health Care: The Other Mainstream. Health Policy Bulletin; 7 (November).http://www.hc-sc.gc.ca/english/  Quote from page 13.
[7] Gallagher, E.B., Stratton T.D. (1997). Health Behavior in Persons Living with Chronic Conditions. Chapter 11 of: Handbook of Health Behavior Research III: Demography, Development and Diversity. David S. Gochman (Ed.). New York/London: Plenum Press.
[8] Willison, K.D. (2006). Integrating Swedish Massage Therapy With Primary Health Care Initiatives As Part Of A Holistic Nursing Approach. Complementary Therapies in Medicine. In Press. http://dx.doi.org/10.1016/j.ctim.2005.11.001
[9] Willison, K.D., Mitmaker L., Andrews G.J. (2005). Integrating Complementary and Alternative Medicine with Primary Health Care through Public Health to Improve Chronic Disease Management. Journal of Complementary and Integrative Medicine; 2(1) – Article 2. The Berkeley Electronic Press.  http://www.bepress.com/jcim/vol2/iss1/2
[10] Sarnat, R.L., Winterstein J. (2004). Clinical and Cost Outcomes of an Integrative Medicine IPA.  Journal of Manipulative and Physiological Therapeutics; 27(5):336-347.
[11] Stewart, D., Weeks J., Bent S. (2001). Utilization, patient satisfaction, and cost implications of acupuncture, massage, and naturopathic medicine offered as covered health benefits: a comparison of two delivery models. Alternative Therapies: 7(4): 66-70.
[12] Israel, B.A., Schulz A.J., Parker E.A., Becker A.B. (2001). Community-based participatory research: policy
recommendations for promoting a partnership approach in health research. Education for Health; 14 (2):182-197.