{"doi":"10.1007/s11606-025-09620-5","title":"The Use of Complementary Health Approaches Among U.S. Veterans from 2002 to 2022: a Prevalence and Sex-Stratified Analysis","abstract":null,"journal":"Journal of General Internal Medicine","year":2025,"id":614858,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1338023,"name":"Zhi Chen","orcid":"0000-0002-4385-1484","position":1,"is_corresponding":false},{"id":1584530,"name":"Kaushal B. Nanavati","orcid":null,"position":2,"is_corresponding":false},{"id":648229,"name":"Jamie L. Romeiser","orcid":"0000-0003-0281-8933","position":3,"is_corresponding":false},{"id":1584529,"name":"McKenzie Watson","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The Use of Complementary Health Approaches Among U.S. Veterans from 2002 to 2022: a Prevalence and Sex-Stratified Analysis","abstract":"U.S. veterans experience higher rates of chronic diseases. Evidence supporting the use of complementary health approaches (CHA) to help manage these conditions has grown in recent years, and utilization has risen among veterans. The Department of Veteran’s Affairs (VA) has expanded CHA services since 2016, a decision based on veteran demand. However, CHA use can occur within or outside of VA facilities. Therefore, trends in CHA use are not completely understood. To help address these gaps, we leveraged nationally representative survey data to estimate changes in the prevalence of using CHA among veterans from 2002 to 2022. Given past reported differences in CHA usage rates between males and females, we further stratified by sex to investigate these differences. We used data from the 2002 and 2022 National Health Interview Survey (NHIS), an annual, publicly available, nationally representative cross-sectional survey. All veterans surveyed with valid data for CHA use were included in the analysis. Veterans were defined as ever serving on active duty in the US Armed Forces, military reserves, or National Guard. All CHAs were assessed as self-reported use in the past 12 months. Prevalence estimates were generated for use of any CHA, any mind–body approaches (yoga, guided imagery, meditation), and any manipulative approaches (chiropractor, acupuncture, massage), and for all 6 individual approaches. Analyses were conducted using multilevel survey procedures in SAS 9.4 software. Estimates were further stratified by sex. Survey weighted prevalence estimates were then age and sex standardized where appropriate, using the 2010 US census population to allow for time comparisons. Time periods were compared using Cochran-Mantel–Haenszel tests, controlling for age, at the p = 0.05 significance level. Absolute change and relative change in prevalence were calculated. There were 3,428 (weighted n = 11,785,016) and 2,365 (weighted n = 9,217,300) veterans surveyed in 2002 and 2022, respectively. The prevalence of using any CHA increased from 19.0% (95%CI 19.0%−21.0%) to 37.3% (95%CI 34.0%−40.5%) over time ( p < 0.001), (Fig. 1 ). Manipulative therapy use increased 9.0% (95%CI 6.0%−11.9%), while mind–body use rose 16.1% (95%CI 12.5%−19.7%). Prevalence of all 6 CHAs rose over time ( p < 0.001), with the largest absolute changes seen for yoga (10.8%, [95%CI 8.0%−13.5%]) and meditation (10.2%, [95%CI 7.0%−13.4%]). This was consistent for both males and females. Females had higher baseline CHA use than males (29.5% [95%CI 25.8–33.2%] vs 17.9% [95%CI 15.6%−20.1%]), but absolute change was similar over time (+ 18.9%, [95%CI 10.7%−27.0%] vs + 18% [95%CI 13.7%−22.3%]), (Fig. 2 ). Overall relative change was greater in males compared to females (100.7% vs. 64.1%). In males, relative change was highest for yoga (385%) and guided imagery (179%), whereas in females, relative change was highest for guided imagery (213.3%) and massage (159.4%). Complementary health approach use among veterans. Legend: Age and sex standardized prevalence estimates are presented for 2002 and 2022 for all veterans, and by sex. Cochran-Mantel–Haenszel tests (examining change by year while controlling for age) found significant differences in prevalence for all complementary health approaches ( p < 0.05), with the exception of acupuncture in men and acupuncture in women. Change in Veteran use of complementary health approaches. Legend: Relative and absolute changes were calculated from 2002 to 2022 for all veterans, and by sex.","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40394441","pmcid":"PMC12612347","openalex_id":"https://openalex.org/W4410537846","authors":[],"funders":[],"total_grants":0,"fwci":1.388,"citation_percentile":0.80634632,"influential_citations":0,"citation_trend":[{"year":2025,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://link.springer.com/content/pdf/10.1007/s11606-025-09620-5.pdf","host_type":"journal"},{"url":"https://link.springer.com/content/pdf/10.1007/s11606-025-09620-5.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1007/s11606-025-09620-5/fulltext.html","host_type":"publisher"},{"url":"https://doi.org/10.1007/s11606-025-09620-5","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40394441","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12612347","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12612347","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12612347?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Complementary and Alternative Medicine Studies","Musculoskeletal pain and rehabilitation","Pain Management and Placebo Effect"],"mesh_terms":[],"keywords":["Medicine","Demography","MEDLINE","Men who have sex with men","Cross-sectional study","Gerontology","Family medicine","Human immunodeficiency virus (HIV)","Pathology","Syphilis","Veterans","Integrative Medicine","Complementary Medicine","Complementary Health Approaches","Whole Health"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T17:38:46.282957Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}