Using the Theory of Planned Behavior to Explain Hispanics Perception of Complementary and Alternative Medicine for Mental Health

Theoretical Background and research questions/hypothesis:  Mental disorders are the leading cause of disability in the U.S (Kessler, Chiu, Demler, Walters, 2005). Romer & Bock (2008) suggest that there are needs to identify communication strategies that can both combat the stigma associated with mental illness and the perception that treatment often is ineffective. Studies on race, age and gender demonstrate how many factors need to be considered when predicting behaviors to use Complementary and Alternative Medicine (CAM) for health prevention or treatment (Woodward et al., 2009 & NIH, 2007). Hispanic Americans used mental health services at about one-half the rate of whites (Duckworth, 2013). The Theory of Planned Behavior (TPB) uses three sections (1) attitude, (2) social norms and (3) perceived behavioral. Communication practitioners will benefit from learning the reasoning behind health choices among Hispanics.  Using the theory of planned behavior, what is the Hispanics perceptions of complementary and alternative medicine for mental health treatment?

Methods:  This study consisted of a one-time meeting with the study investigators that included the completion of 30 in-depth interviews. Questions included demographics as well as open-ended questions that explored attitude, subjective norms and perceived behavioral norms for using CAM for mental health. Eligibility criteria for participants consisted of individuals who associate as being Hispanic. 15 participants were from the Federation of Families (FOF), a family-run organization that supports families of youth with special needs requiring behavioral health services. These participants were between the ages of 40-60 and were all mothers of mentally ill youth. 15 participants were unassociated Hispanic individuals that personally knew the investigators, and they were between the ages of 20-30, all without children. 

Results:  (1) Attitude: Hispanics think CAM is good for mental health, and prefer CAM because it is chemical free. (2) Subjective Norm: Hispanic families pass down natural remedies through generations, and continue to encourage CAM usage within their family. However, Hispanics believe other Hispanics are uninformed about CAM. (3) Perceived Behavioral Norm: Hispanics face barriers accessing CAM such as lack of knowledge and cost. (4) Intention and Behavior: Hispanics currently use CAM for mental health, and intend to try new CAM in the future. (5) Media theme: CAM is not publicized in the mainstream media, however it is advertised locally, and Hispanics depend on the Internet, health stores or friend for resources. 

Conclusions:  Hispanics interviewed perceive CAM for mental health as positive, yet they think other Hispanics do not feel the same way. The subjective norm is that Hispanics are not open to trying CAM for mental health. This is contradicting to the results because every participant admitted to using CAM for mental health in their personal family. Hispanics would feel more capable to use other CAM if they had more information than the little they receive in local stores or through friends. 

Implications for research and/or practice:  The findings give guidance for health communication researchers, health care practitioners, and health education promoters in regard to the Hispanic population and complimentary and alternative medicine.