{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:05:58Z","timestamp":1785942358891,"version":"3.56.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"crossref","award":["RCS 23-082"],"award-info":[{"award-number":["RCS 23-082"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"crossref","award":["PEC 16-354"],"award-info":[{"award-number":["PEC 16-354"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Integrative and Complementary Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Evidence-based complementary and integrative health (CIH) therapies are now in clinical practice guidelines for common pain and pain-related conditions. Primary care providers (PCPs) are often the first point of contact for discussing CIH therapies as non-pharmacological health management. Yet, little is known about their decisions to recommend CIH therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To understand: (1) which CIH therapies PCPs recommend and for what health conditions, (2) reasons for their recommendations or lack thereof, and (3) possible solutions to improve appropriateness of recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Semi-structured qualitative interviews were conducted with 40 PCPs from eight Veterans Health Administration (VA) hospitals offering eight evidence-based CIH therapies (acupuncture, medical massage therapy, yoga, Tai Chi, meditation\/mindfulness, biofeedback, clinical hypnosis, guided imagery). A rapid qualitative analysis was performed using a matrix approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>PCPs recommended patients use acupuncture, medical massage therapy, yoga, Tai Chi, and meditation\/mindfulness the most and biofeedback, clinical hypnosis, and guided imagery the least. Pain was the main condition for referrals to all CIH therapies except clinical hypnosis and guided imagery, which were most recommended for smoking cessation and mental health, respectively. Decisions to recommend were largely driven by PCP\u2019s knowledge of CIH therapies\u2019 effectiveness for particular health conditions. Other factors were PCP\u2019s own beliefs about CIH therapies, their perceptions about patients\u2019 beliefs, patients\u2019 positive experiences, and organizational factors (e.g., understanding what therapies are covered for which conditions and the local referral process). PCPs wanted brief educational information containing many types of content, ranging from therapy descriptions to clinical practice guidelines and information on institutional policies on CIH therapy provision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although some PCPs are appropriately recommending evidence-based CIH therapies, lack of knowledge is a critical barrier for many others. This could be addressed with the educational information tailored to the content and format that PCPs specifically requested.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27683605261441040","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T02:36:47Z","timestamp":1775702207000},"page":"752-760","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Primary Care Providers\u2019 Decisions to Recommend Complementary and Integrative Health Therapies: A Qualitative Analysis"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5555-6258","authenticated-orcid":false,"given":"Marlena H.","family":"Shin","sequence":"first","affiliation":[{"name":"Center for Health Optimization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"McGowan","sequence":"additional","affiliation":[{"name":"Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danna R.","family":"Kasom","sequence":"additional","affiliation":[{"name":"Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee J.S.","family":"Cross","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Healthcare System, Minneapolis, MN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana J.","family":"Burgess","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Healthcare System, Minneapolis, MN, USA."},{"name":"Department of Medicine, University of Minnesota, Minneapolis, MN, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juli","family":"Olson","sequence":"additional","affiliation":[{"name":"Office of Patient Centered Care and Cultural Transformation, US Department of Veterans Affairs, Washington, DC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Office of Patient Centered Care and Cultural Transformation, US Department of Veterans Affairs, Washington, DC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA."},{"name":"Department of Medicine, UCLA, Los Angeles, CA, USA."},{"name":"Department of Health Policy and Management, UCLA, Los Angeles, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2459"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"2.Skelly AC Chou R Dettori JR et al. Noninvasive nonpharmacological treatment for chronic pain: A systematic review update. Agency for healthcare research and quality (US); 2020. Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556229\/ [Last accessed: July31 2020].","DOI":"10.23970\/AHRQEPCCER227"},{"key":"e_1_3_4_4_1","unstructured":"3.Institute for Clinical and Economic Review (ICER). Cognitive and mind-body therapies for chronic low back and neck pain: Effectiveness and value. 2017. Available from: https:\/\/icer-review.org\/material\/back-and-neck-pain-evidence-report\/"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2367"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41142"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8986"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21397"},{"key":"e_1_3_4_9_1","unstructured":"8.Department of Veterans Affairs. 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