The REACH Center has a number of funded projects ongoing that aim to improve symptom management and whole person health using complementary and integrative health interventions. These projects are funded by external funders and by the Center itself through seed money for pilot grants.
Fatigue is one of the most debilitating symptoms experienced by people with multiple sclerosis (MS), particularly those with advanced disability. Mind-body therapies such as qigong (QG) show promise for addressing fatigue, yet standardized protocols tailored for advanced MS are lacking. The objective of this study is to develop and refine a virtual QG exercise protocol for advanced MS to inform future feasibility pilot testing.
Principal Investigator: Lita Buttolph, National University of Natural Medicine
This planning study aims to evaluate site readiness and to establish operational and data infrastructure to support a multi-site, pragmatic, feasibility trial of community-delivered acupuncture for chronic neck pain in older adults.
Principal Investigator: Lita Buttolph, National University of Natural Medicine
The primary objective of this project is to conduct a scoping review of the existing peer-reviewed literature on the mushroom Psilocybe cubensis. While a single compound in the mushroom, psilocybin, has shown promise for mental health conditions, research has predominantly utilized synthetic psilocybin, creating a knowledge gap regarding the whole mushroom preparations that are in much wider use globally and currently used in state regulated programs in Oregon and Colorado.
Principal Investigator: Matthew Hicks, National University of Natural Medicine
This project will develop a theoretical, model-based economic projection comparing health outcomes and healthcare costs under various scenarios for a hypothetical patient seeking care from the healthcare system with a new episode of low back pain. Similar modeling has been conducted in Canada to compare other strategies for reducing the population health burden of back pain. Our analysis will provide a one-year clinical and economic trajectory for adults presenting with a new episode of low back pain, reflecting typical decision-making patterns, care utilization, and the probability of progression to chronic pain. Direct costs of healthcare spending, adjustments to health outcomes (e.g., quality-adjusted life years or QALYs), and implications relative to provider choice will be estimated.
Principal Investigator: Michele Maiers, Northwestern Health Sciences University
This project will develop a theoretical, model-based economic projection comparing health outcomes and healthcare costs under various scenarios for a hypothetical patient seeking care from the healthcare system with a new episode of low back pain. Because we will have the best data available from the literature to model this period, the core of our model will provide a one-year clinical and economic trajectory for adults presenting with a new episode of low back pain, reflecting typical decision-making patterns, care utilization, and the probability of progression to chronic pain. Projections beyond the initial one-year period will be based on the portion of patients who continue on with chronic low back pain and will include additional costs for known longer-term impacts (e.g., opioid use disorder, failed back surgery syndrome) associated with some of the care pathways. Direct costs of healthcare spending, adjustments to health outcomes (e.g., quality-adjusted life years or QALYs), and implications relative to provider choice will be estimated.
Principal Investigator: Michele Maiers, Northwestern Health Sciences University
Our innovative scientific approach will use remote adapted nominal group technique (rNGT) to build consensus and understand areas of divergence among an international panel of WFC delegates, designees, and chiropractic leaders about their perspectives, priorities, and potential pitfalls and solutions to growing a patient safety culture in chiropractic. For this study, rNGT will be conducted through asynchronous individual feedback via REDCap and participation in one group session. rNGT does not require strict consensus decisions for topics that may not allow consensus and is preferred over the more commonly used electronic Delphi consensus process. Each rNGT participant will be engaged in one remote group session of idea generation (Step 2) and one, 90-minute nominal group session consisting of idea sharing (Step 3), discussion (Step 4), and voting/ranking (Step 5). Participants may review the final consensus document to provide additional feedback as an optional activity.
Principal Investigator: Kent Jason Stuber, Parker University
The Aims of this project are: 1) To determine if the CharmHealth EHR system, in use at 5 naturopathic clinics in a residency network, can provide de-identified clinical data, including for use by the EMERSE software tool, via appropriate APIs (application programming interfaces) so that both structured & unstructured (coded/numerical and narrative EHR data) can be used for the evaluation of Charm EHR data under HIPAA guidelines; and 2) To determine if the system can be used for practice description and preliminary investigations of effectiveness through analyses for representative question types that may be asked in the future.
Principal Investigator: Carlo Calabrese, National University of Natural Medicine
The aims of this project are: 1) To determine the needs, priorities, preferences, and recommendations of relevant stakeholders (minors with Juvenile Idiopathic Arthritis (JIA), parents/guardians of minors with JIA, pediatric rheumatology providers, yoga professionals) related to an online yoga intervention for minors with JIA; and 2) To develop an intervention protocol of online yoga for minors with JIA based on feedback from relevant stakeholders.
Principal Investigator: Steffany Moonaz, Southern California University of Health Sciences
This study aims to explore if or how Whole Health is addressed within a treatment encounter by CIH providers within federally funded community health clinics. The aims of this project are as follows: 1) Develop a literature-informed checklist of WH promotion practices, common to delivery of CIH; 2) Apply the checklist to observations of CIH treatment encounters, delivered by acupuncturists, chiropractors, and naturopathic physicians, in a range of federally funded community health clinics.
Principal Investigator: Andrea Albertson, Northwestern Health Sciences University
The principal objective of this project is to assess the impact of the new Centers for Medicare & Medicaid Services (CMS) decision to cover acupuncture for chronic low back pain (cLBP) upon patient outcomes. Thus, the first aim of the project will be to compare safety, efficiency of care, and costs of care for Medicare beneficiaries receiving acupuncture as compared to pharmacotherapy for management of cLBP. Because the CMS decision came with restrictions on coverage that could impact equitable access to care, important project objectives will also include measuring the availability of acupuncture providers under Medicare, describing patterns and trends in utilization of acupuncture by Medicare beneficiaries, and determining facilitators and barriers to the use of acupuncture for both providers and patients.
Principal Investigators: Jim Whedon and Todd MacKenzie; Southern California University of Health Sciences and Dartmouth
The aim of this project is to study provider adherence to the VA/DoD Low Back Pain Clinical Practice Guidelines across all provider types within the VA North Texas Health Care System Physical Medicine and Rehabilitation Department (PM&R) at the Fort Worth VA Clinic. Additionally, the study will determine to what extent veteran sociodemographic and socioeconomic factors influence provider adherence with VA guidelines.
Principal Investigators: Michael Moore and Gary Tam; Parker University
The aim of this project is to deliver a traumatic brain injury (TBI)-focused, mentored, evidence-synthesis training program. The successful execution of this program will provide the preliminary data and proof-of-concept needed to apply for a NINDS R25 research education grant.
Principal Investigator: Joshua Goldenberg; National University of Medicine
The aim of this project is to develop, and pilot test a collection process for capturing diet data and an approach for calculating diet cost to be used when comparing the cost implications of following different diet patterns. This process will be used in calculating the cost of a diet consumed by study participants prior to and during a subsequent dietary counselling intervention study.
Principal Investigator: Monique Aucoin; Canadian College of Naturopathic Medicine
Compare the effectiveness of spinal manipulative therapy versus prescription drug therapy in providing care for neck pain among elderly Medicare beneficiaries.
Principal Investigator: James Whedon, D.C., M.S., Southern California University of Health Sciences
Inform the design and conduct of an adverse event (AE) reporting system to systematically gather data on AE following chiropractic care.
Principal Investigator: Katie Pohlman, D.C., M.S., Ph.D., Parker University
Examine to what degree CIH providers in the U.S. are exposed to healthy and unhealthy working conditions and how their exposure compares to that of mainstream healthcare professionals.
Principal Investigator: Margaret Whitley, Ph.D., M.P.H., RAND
A team of experts in homeopathy and research methodology examined the literature that formed the basis of recent systematic reviews and drafted a report of the state-of-the-science.
Researchers employed a user-centered design methodology, incorporating feedback from active clinicians, in order to design and create a web-based clinical decision support tool tailored for back pain.
Manuscript currently under review.
Complementary and integrative health (CIH) providers, such as chiropractors and naturopathic doctors, were an underutilized public health asset in the response to the COVID-19 pandemic. Center researchers convened an expert panel of ten CIH and public health practitioners and researchers for a daylong discussion of how the CIH workforce could be better mobilized during future crises.
The project team developed and published a RAND Perspective, providing expert insight to policy makers on the timely issue of opioid settlement fund distribution. It argues that portions of the funds should be dedicated to increasing awareness of and access to evidence-based, non-pharmacologic pain interventions. Importantly, it also recommends, where appropriate, research funding to investigate the potential for the use of non-pharmacologic interventions to offset opioid use and as co-treatment for those with opioid use disorder (OUD).
The project team developed and published a toolkit for use by complementary and integrative healthcare stakeholders that provides instruction and materials to use when advocating for the allocation of opioid settlement funds to support non-pharmacological treatment options at the local, state, and national level. This toolkit was published by Northwestern Health Sciences University, Center for Healthcare Innovation and Policy.
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