Implicit reasons for disclosure of the use of Complementary Health Approaches (CHA): a consumer commitment perspective

Background: Disclosure of the use of complementary health approaches (CHA) is an important yet understudied health behaviour with important implications for patient care. Yet research into disclosure of CHA has been atheoretical and neglected the role of health beliefs. Purpose: Using a consumer commitment model of CHA use as a guiding conceptual framework, the current study tests the hypotheses that perceived positive CHA outcomes (utilitarian values) and positive CHA beliefs (symbolic values) are associated with disclosure of CHA to conventional-care providers in a nationally representative US sample. Methods: From a sample of 33,594 with CHA use information from the 2012 National Health Interview Survey (NHIS), a subsample of 7,348 who used CHA within the past 12 months was analysed. The 2012 NHIS is a cross-sectional survey of the non-institutionalized US adult population, which includes the most recent nationally representative CHA use data. Results: The 63.2 % who disclosed CHA use were older, less educated, and had visited a health-care provider in the past year. Weighted logistic regression analyses controlling for demographic variables revealed that those who disclosed were more likely to report experiencing positive psychological (improved coping and well-being) and physical outcomes (better sleep, improved health) from CHA, and hold positive CHA-related beliefs. Conclusions: CHA users who perceive physical and psychological benefits from CHA use, and who hold positive attitudes towards CHA are more likely to disclose their CHA use. Findings support the relevance of a consumer commitment perspective for understanding CHA disclosure, and suggest CHA disclosure as an important proactive health behaviour that warrants further attention.