Characteristics of respondents
Most study participants were white, women, and had attended college (Table 2). Most had had back problems for at least five years, had experienced back pain at least 90 days in last six months, had used medications in the prior week, and expected little change in their pain in a year.
Knowledge of, experience with, perceptions of, and willingness to try CAM therapies
Except for chiropractic, most participants reported little or no knowledge of these therapies (Table 3). In logistic regressions, prior use of a therapy consistently predicted high knowledge of that therapy (Table 4).
More than half of the participants had tried chiropractic compared with 38% who had tried massage and substantially fewer who had tried the other therapies (Table 3). No demographic characteristics were related consistently to use of these therapies (Table 4). Chiropractic and massage were also the most commonly used of the therapies specifically for low back pain. Users of massage rated treatment helpfulness higher than did users of other therapies (Table 3). Reports of harm or increased pain were highest for chiropractic (23%) and lowest for meditation (5%).
Respondents believed that massage would be most helpful for their current back pain (median rating of 7) and that meditation would be least helpful (median rating of 3) (Table 3). One quarter of all respondents were unable to rate their expectation of acupuncture or t'ai chi, compared to about 10% for the other therapies. Respondents 65 years of age or older were less optimistic than younger respondents about the helpfulness of acupuncture and massage (Table 4). High expectations of helpfulness of chiropractic were more common in those with high knowledge of this therapy and high expectations of helpfulness of acupuncture were more common among those who had tried it (Table 4).
More than half of the respondents said they would be "very likely" to try acupuncture, chiropractic, or massage if provided by their health plan for no additional cost and their physician felt it was reasonable. Fewer respondents said they would be "very likely" to try meditation training (27%) or t'ai chi (41%) under those circumstances (Table 3). In logistic regression models, the strongest predictors of being very likely to try a particular therapy were high expectations of a therapy and, for meditation, prior use of the therapy (Table 4). About 80% of those very likely to try acupuncture, chiropractic, or massage for no additional cost were also very likely to try it for a $10 per visit co-pay (Table 3). Paralleling the finding for free care, the strongest predictor of willingness to try a therapy for a $10 per visit co-pay was high expectations of success for that therapy. Respondents from Boston were more willing to try acupuncture. Those reporting harm or pain from chiropractic were less willing to try this therapy again.
Willingness to participate in a clinical trial
More than half of respondents were "definitely willing" to participate in each of two hypothetical clinical trials about which they were asked and less than 5% were definitely unwilling to participate (Table 5). When asked which of the treatments in each trial they would most prefer, respondents preferred massage and acupuncture in the trial of acupuncture, chiropractic, and massage and, in the second trial, strongly preferred massage to meditation. However, a significant fraction (24%) expressed a preference for t'ai chi. We found no demographic, back pain, or CAM characteristics associated with being "definitely willing" to participate in the hypothetical trial of acupuncture, chiropractic, and massage. People who were "definitely willing" to participate in the hypothetical trial of massage, meditation, and t'ai chi were more likely to have high expectations of meditation (OR = 3.1, 95% CI = 1.4 – 7.0).
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