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A Program Evaluation of an Academic Integrative Healthcare Center: Barriers to, and facilitators in, applying Integrative Medicine to Primary Care

  • Author(s): Khorsan, Raheleh
  • Advisor(s): Stokols, Daniel
  • Coulter, Ian D
  • et al.
Abstract

A number of earlier studies have evaluated various aspects of Integrative Health Care (IHC). However, little is known about specific parameters of IHC integration in academic institutions. This dissertation presents the findings from a two-year program evaluation conducted at a university-based academic medical center and clinic for IHC. A major objective of the research was to identify perceived barriers and facilitators of IHC and address potential models of successful integration. The study employed a mixed-methods approach incorporating qualitative observations and interviews conducted with key-stakeholders, patients and health care providers. In addition, quantitative analyses incorporating demographic data and participants’ responses to a patient satisfaction scale were conducted. The majority of the themes from the literature and interviews include structural factors, especially external barriers for IHC (i.e., costs, insurance payment and regulations) and internal barriers (i.e., lack of profits, clinic or appointment waiting time). Whereas shared values, culture, and communication to foster trust, empathy and knowledge exchange are essential for actualizing IHC integration. In addition, collaborative, and team-based approaches that influence the design of the integration and can influence the evolutionary path of IHC. Although signs of integration were apparent, significant challenges still remained that prevented IHC providers from operating as academic hospital providers. An integrated interdisciplinary change strategy is needed that engages the IHC providers in mainstream transdisciplinary healthcare, education and research opportunities. Successful IHC integration will need to continue to addresses wider structural and political barriers.

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