The relationship between experienced benefits and harms of using complementary and integrative health approaches and intention to maintain their use in Finland

The relationship between experienced benefits and harms of using complementary and integrative health approaches and intention to maintain their use in Finland | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The relationship between experienced benefits and harms of using complementary and integrative health approaches and intention to maintain their use in Finland Maija Pyykkönen, Salla Ahola, Pauliina Aarva, Matti Pasanen, Kaija Helin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4435651/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The estimated prevalence of the use of complementary and integrative health (CIH) approaches varies between 24–71% in adult populations worldwide. Little is known about the intention to maintain their use. This study aimed to examine whether the experienced benefits and harms of CIH use, and self-rated health (SRH) relate to the intention to use CIH in the future in current users. Methods A total of 1652 Finnish CIH users completed an online-survey in December 2022, out of which 58.8% intended to use CIH in the future. Binary logistic regression analyses were used to examine the relationship between the intention to use CIH, experienced benefits and harms of CIH use and SRH. Results Having experienced at least one type of benefit from CIH use compared to no experienced benefits was related to the intention to use CIH (OR = 19.3, 95%CI = 11.05 to 33.80). Conversely, having experienced at least one harm from CIH use compared to no harms was inversely related to the intention to use CIH (OR = 0.27, 95%CI = 0.20 to 0.35). Easing of pain or related ailment was found to be the most strongly related benefit to the intention to use CIH. SRH was not found to be statistically significantly related to the intention to use CIH. Conclusions This study highlights the importance of the benefits and harms CIH users experience on the continuation of CIH use. The intention to maintain use relates to everyday effectiveness of CIH experienced by users. complementary and integrative health complementary and alternative medicine CIH CAM Finland intention to use self-rated health Background Complementary and integrative health (CIH) approaches comprise a vast range of provider-led procedures, natural remedies, products and self-help practices, that are offered along with or outside of conventional healthcare worldwide 1 – 4 . Estimated prevalence of 12-month CIH use is found to vary between 24–71% depending on the study and country 5 . Recognising the varying terminology 4 , in this article the term CIH is used in referring to CIH approaches, and as a corresponding term to CAM (complementary and alternative medicine) and CAIM (complementary, alternative and integrative medicine). The most commonly reported reasons for the use of CIH are the perceived benefits and safety of CIH, and dissatisfaction with conventional medicine 6 . Reported benefits include management of pain 7 , perceived improvement of physical and emotional health and well-being and quality of life 6 , 8 , as well as CIH being reported by users as helpful 9 , 10 . The use of CIH has been attempted to be explained by having value fit with CIH use 11 and by beliefs in magical concepts regarding health 12 , or holistic health and healing beliefs 13 , 14 . Individuals with more modern health worries and paranormal beliefs have also been found more likely to find CIH as effective 14 . Reasons for the non-use of CIH include doubt of efficacy of and concerns about possible side-effects of CIH, and satisfaction with conventional medicine 6 . Reported perceived harms or adverse effects from CIH use include temporary discomfort or pain and high cost of CIH treatments 8 , 15 , 16 . Studies indicate that previous CIH use and having a positive attitude towards CIH 17 , family influence 17 , 18 , and belief in positive outcomes following from CIH use 18 are associated with the intention to use CIH in the future. Furthermore, improvement of general well-being and CIH being used as an addition to conventional medical treatment 19 have been found to be connected to the intention to continue CIH use. A recent publication by Fournier and Varet 20 included two vignette studies focusing on the intention to use conventional, complementary and alternative medicine during cancer treatment. Intention to use CIH was found positively correlated with conspiracy beliefs, and this correlation was found to be larger for the use of “unconventional medicine” as an alternative to chemotherapy, compared to complementary use 20 . Theoretical frameworks with which the intention to use CIH has been explained include the theory of planned behaviour 17 and the CIH-tailored consumer commitment model (CCM) 21 , 22 . CCM conceptualises commitment to CIH within a psychological and behavioural frame based on one hand on CIH users' values and on the other the experiences gained from use of CIH. The model assumes that commitment to future use, i.e. intention of CIH users to continue the use, is related to utilitarian and symbolic values 21 , 22 . According to Sirois et al. 21 , utilitarian values include positive outcomes of CIH use, containing physical, emotional and behavioural outcomes. Symbolic values refer to the perceived “fit” between the CIH user’s belief system and that of the CIH modalities they use, for example holistic health beliefs and emphasis on whole person treatments. In this article we conceptualise positive CIH outcomes as experienced benefits of CIH use, and negative CIH outcomes as experienced harms of CIH use. In Finland, the use of most CIH modalities falls under consumer legislation, making consumer perspective within CIH research relevant. Unlike the neighbouring countries of Sweden and Norway, there is no national policy for traditional and complementary medicine in Finland 23 . There is a possibility for serious adverse effects for the use of some CIH modalities, for example via herb-drug interactions 24 , and the 2023 Finnish government programme aims to assess the patient safety of alternative therapies offered outside health care 25 . The prevalence of CIH use in Finland is relatively high 2 , 10 , making it paramount for the national CIH policy development that the reasons behind continued use are better understood. To the authors’ knowledge the association between experienced benefits and harms and the intention to use CIH have not been researched earlier. CIH modalities are used for treatment of various health conditions, and for health promotion to maintain well-being 26 , 27 . Previous studies on the connection between self-rated health (SRH) and prevalence of CIH use offer inconsistent results 28 . Some studies report good SRH 19 and some poor SRH 2 being associated with higher rates of current CIH use. To the authors’ knowledge, the relationship between SRH and intention of CIH users to maintain their CIH use has not been studied. Aims This study aimed to investigate whether the experienced benefits and harms of CIH use are related to the intention to maintain CIH usage in the future. Thus, the hypotheses are: H1: Having experienced benefits from CIH use is related to the intention to maintain CIH use, and H2: Having experienced harms from CIH use is inversely related to the intention to maintain CIH use. In addition, CIH being used both for treatment of ailments and health promotion 2 , 27 , we explore whether there is an association between SRH and CIH users’ intention to continue CIH usage. Materials and methods Sampling and recruitment The data were collected from a commercial probability-based online panel (Kantar Public) in December of 2022 with an online survey questionnaire. A questionnaire was sent by email to 11507 randomly selected panellists aged 16 and above living in mainland Finland. A total of 3244 panellists completed the survey. This study was a part of a larger Finnish CIH research project. More details on sampling and recruitment are reported elsewhere 10 . Measures Measures of respondent characteristics Basic characteristics (gender, age, place of residence) were asked in the beginning of the survey. Age was calculated based on year of birth. Gender of the respondents was assessed via a categorical question (female; male). Residency was assessed by using the four designated NUTS (Nomenclature of Territorial Units for Statistics) level 2 areas of Finland (Helsinki-Uusimaa; South Finland; West Finland; North and East Finland). Information on household yearly income was collected with a categorical question, the answers of which were merged into the following categories used in the final analysis: low (35.000€ and below), middle (35.001-50.000€), and high (50.001€ and above). Highest form of obtained education was collected with six categories, which were merged into the following categories for the final analysis: primary and lower secondary school; upper secondary education and vocational college education; Bachelor’s degree or higher vocational degree; Master’s degree or higher. Use of CIH The usage of CIH was assessed with the Finnish version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q; 29 ). The survey includes modalities from three CIH categories: providers, natural remedies and self-help practices. The researcher-defined group of CIH users includes respondents who reported the usage of at least one CIH modality at least once within the 12 months prior to taking part in the survey. All modalities included in the definition are listed in Table 1 . The process is detailed in Authors 10 . Table 1 CIH modalities included in the definition of CIH user a in this study. CIH providers and therapists CIH Natural remedies CIH self-help practices Chiropractor Herbs and herbal medicine Meditation and mindfulness Homeopath Homoeopathic remedies Yoga Acupuncturist Other supplements (not vitamins and minerals) Tai Chi and Qigong Phytotherapist Relaxation techniques Bone setter Visualisation Energy healer Attending traditional healing ceremonies Reflexologist NLP b Aromatherapist Massage therapist (other, non-conv.) Naprapath Osteopath Art therapist Cuppist Hypnotherapist TCM practitioner b Anthroposophic therapist Ayurvedic practitioner Other a Using one or more of the included modalities at least once in the 12 months preceding the survey. b TCM = Traditional Chinese Medicine, NLP = Neurolinguistic Programming. Intention to use CIH Intention to use CIH in the future was assessed with the question: “Do you intend to use any complementary treatments in the future?”. The answer options were combined into three categories: ”Yes” (”Yes”/”Probably yes”), ”No” (”No”/”Probably no”) and ”I do not know or want to answer”. For the final analysis, the answer options were grouped into two categories: ”Yes” (”Yes/Probably yes”) and ”No/Unsure” (”No/Probably no/I do not know or want to answer”). Self-rated health (SRH) SRH was assessed via a multiple choice question, ”What is your state of health like at the moment?”. Six answer options were provided. In the final analysis, the answer options were merged into four categories in order to highlight differences between dimensions of good and poor SRH: ”Poor” (Very poor/Somewhat poor), ”Average”, ”Good” (Very good/somewhat good) and ”I do not know or want to answer”. Experienced benefits and harms of CIH use Experienced benefits were assessed with the question: ”Which of the mentioned benefits have you experienced resulting from using CIH (visiting providers, using natural remedies and self-help practices) during the last 12 months?”. Experienced harms were assessed with the question: ”Which of the mentioned harms have you experienced resulting from using CIH (visiting providers, using natural remedies and self-help practices) during the last 12 months?”. The respondent could choose all the options which applied, which was analysed as a ”Yes” response. The options which the respondent did not choose were analysed as a ”No” response. If the respondents chose the option ”No benefits” in the case of benefits, “No harms” in the case of harms, or ”I do not know” in either case, all other response options were automatically excluded by the data collection programme. The included experienced benefits and harms are listed in Table 2 . Table 2 Answer options for experienced benefits and harms from using CIH. Experienced benefits Experienced harms Eased pains, aches, tightness, or other ailments Money was wasted, as I did not get help Relieved stress, sleeplessness, depression, or anxiety I was cheated Increased mental well-being, energy, or everyday functionality Pains, aches, or ailments became worse Decreased medication use I felt hurt or treated inappropriately I felt heard and seen with my ailments and problems Other, harm what? Gave support, faith or hope in solving my problems No harms b Other, benefit what? I do not know b No benefits a I do not know a a If chosen by the respondent, all other options for experienced benefits were automatically excluded by the data collection programme. b If chosen by the respondent, all other options for experienced harms were automatically excluded by the data collection programme. The included benefits and harms were chosen based on earlier research 6 , 30 to explore the experienced benefits and harms at the population level. The answer options were formulated and finalised by the research team. To decrease the time burden of the full questionnaire, experienced benefits and harms were assessed for general CIH use instead of assessing them for each individual CIH modality. The original Finnish answer options of both experienced benefits and harms are presented in the supplementary materials (Supplementary Table 1). Open-ended ”Other, what?” responses for both experienced benefits (n = 53) and harms (n = 17) were read through by the research team. Most responses were classified as genuine answers (e.g., for benefits ”Maintaining mobility”; for harms ”The ailment eased only for a moment”). However, five respondents reported in their answers not having used CIH in the 12 months prior to taking part in the survey despite belonging to the researcher-defined CIH user-group, and thus were excluded from all of the following analysis. Statistics Data were weighted based on age, gender and region of residency. Between-group differences in respondent characteristics in relation to the intention to use CIH in the future were tested by using Pearson’s chi-square test (Table 3 ). Pearson’s correlations between experienced benefits and between experienced harms are presented in the supplementary materials (Supplementary table 2; Supplementary table 3). Association between intention to use CIH (no/unsure; yes) and SRH (good; average; poor; ”I do not know”), experienced benefits (no experienced benefits; at least one experienced benefit; ”I do not know”), experienced harms (no experienced harms; at least one experienced harm; ”I do not know”), and the individual experienced benefits and harms (no; yes) are described with proportions and odds ratios (ORs) with their 95% confidence intervals (95%CI) (Table 4 , Table 5 ). Table 3 Distribution of respondent characteristics in CIH users (n = 1652). n (%) of total n = 1652 %Intends to use CIH p Age In years Mean age in years (SD) 46.2 (18.3) Age 16–29 years 366 (22.1) 45.4 < .001 30–59 years 836 (50.6) 63.5 60 years and above 450 (27.3) 61.0 Gender Female 967 (58.5) 64.9 < .001 Male 685 (41.5) 50.1 Income a Low 482 (29.2) 54.8 < .001 Middle 278 (16.8) 65.1 High 648 (39.2) 59.6 I do not know 241 (14.6) 57.9 Highest obtained education b Primary and lower secondary school 112 (6.8) 54.5 .778 Upper secondary and vocational college education 814 (49.3) 59.1 Bachelor’s degree or higher vocational degree 409 (24.8) 57.5 Master’s degree or higher 302 (18.3) 62.6 Place of residence Helsinki-Uusimaa 512 (31.0) 54.1 .080 South Finland 317 (19.2) 61.2 West Finland 423 (25.6) 59.2 North and East Finland 399 (24.1) 62.6 a 2 respondents (0.1%) did not respond to the item asking about their income. b 15 respondents (0.9%) responded “Other” or did not report their educational information. Table 4 Results of the logistic regression analyses with unadjusted odds ratios (ORs) and 95% confidence intervals (CI95%). n % %Intends to use CIH OR CI95% p SRH .018 Good 876 53.0 60.2 1.00 Average 511 30.9 59.6 0.97 0.78 to 1.21 Poor 248 15.0 53.6 0.76 0.57 to 1.01 I do not know or want to answer 17 1.0 25.0 0.24 0.08 to 0.70 Experienced Benefits < .001 No 137 8.3 10.2 1.00 Yes, at least one 1320 79.9 69.3 19.3 11.05 to 33.80 I do not know 194 11.7 21.1 2.31 1.21 to 4.41 Experienced Benefits, individual items (No / Yes) Eased pains, aches, tightness, or other ailments 872/780 52.8/47.2 38.4/81.5 7.06 5.63 to 8.85 < .001 Relieved stress, sleeplessness, depression, or anxiety 1013/638 61.3/38.7 48.4/75.2 3.23 2.60 to 4.02 < .001 Increased mental well-being, energy, or everyday functionality 951/701 57.6/42.4 47.5/74.0 3.15 2.55 to 3.89 < .001 Decreased medication use 1445/205 87.6/12.4 55.5/82.0 3.72 2.56 to 5.40 < .001 I felt heard and seen with my ailments and problems 1471/180 89.1/10.9 55.7/83.4 4.04 2.69 to 6.07 < .001 Gave support, faith or hope in solving my problems 1392/260 84.3/15.7 55.0/78.8 3.05 2.23 to 4.19 < .001 Other, what? 1603/48 97.1/2.9 58.7/62.5 1.18 0.65 to 2.13 .589 Experienced harms < .001 No 1176 71.2 69.7 1.00 Yes, at least one 248 15.0 37.9 0.27 0.20 to 0.35 I do not know 227 13.8 24.7 0.14 0.10 to 0.20 Experienced Harms, individual items (No / Yes) Money was wasted, as I did not get help 1537/115 93.0/7.0 61.2/26.1 0.22 0.15 to 0.34 < .001 I was cheated 1594/54 96.7/3.3 59.8/27.8 0.27 0.15 to 0.49 < .001 Pains, aches, or ailments became worse 1592/59 96.4/3.6 58.8/58.3 0.99 0.58 to 1.67 .966 I felt hurt or treated inappropriately 1602/50 97.0/3.0 59.5/36.0 0.39 0.22 to 0.71 .002 Other, what? 1638/14 99.1/0.9 58.7/64.3 1.26 0.42 to 3.76 .681 Adjusted ORs for SRH were computed with binary logistic regression analyses. Gender, age, income, education and place of residence were used as adjusting variables. Backwards binary logistic regression analyses were used for both experienced benefits and harms, with SRH, gender, age, income, education and place of residence used as adjusting variables. Backwards selection was used to find the strongest indicators (experienced benefits and harms) related to the intention for future CIH use. P-value > 0.01 was used to reject variables from the models. All results reported in the Results-section (see below) are based on weighted data. The data were analysed using IBM SPSS Statistics (version 28). Results Basic respondent characteristics Out of the 3244 respondents who completed the survey, 1657 (51.1%) were categorised as CIH users, whereas 1587 (48.9%) were categorised as non-users. Five respondents, who were categorised as CIH users but who explicitly stated otherwise in their answers for open-ended questions, were excluded from the analysis (see: Experienced benefits and harms of CIH use in Methods). In the final CIH user group used in all analysis (n = 1652), women constituted 58.5% of the respondents. The mean age was 46.2 years (SD = 18.3) (Table 3 ). Intention to use CIH In the CIH user group, 58.8% of the respondents intended and 26.6% did not intend to use CIH in the future. Respondents who answered ”I do not know” constituted 14.6% of the CIH user group. In the non-user group, 24.7% intended and 56.3% did not intend to use CIH in the future. Respondents who answered ”I do not know” constituted 19.0% of the non-user group. All of the following analysis were conducted by using the CIH user respondents (n = 1652). The association between intention to use CIH, SRH, and experienced benefits and harms Out of the CIH user respondents, 53.0% reported being in good health, 30.9% in average health, 15.0% in poor health, and 1.0% responded ”I do not know or want to answer” (Table 4 ). Logistic regression analyses were conducted for the association between CIH users’ intention to maintain CIH use and SRH. Unadjusted ORs showed SRH to be associated with intention to use CIH (p = .018), which was due to the difference between the respondents who chose the "I do not know or want to answer" option and the other respondents. However, based on the adjusted ORs SHR was not found to be statistically significantly associated with intention to use CIH in the future (p = .070) (Table 5 ). Respondents who reported having experienced at least one of the included benefits comprised 79.9% of the total CIH users (Table 4 ). The rest of the respondents reported not having experienced any (8.3%) or were unsure about having experienced benefits from CIH use (11.7%). When asked about experienced harms, 15.0% of the respondents reported having experienced at least one, 71.2% reported not having experienced any harms, and 13.8% were unsure about experiencing harms from CIH use. Logistic regression analyses were conducted for the association between CIH users’ intention to maintain CIH use, and experienced benefits and harms relating to CIH use. Unadjusted ORs and confidence intervals were calculated between the intention to use CIH, and experienced benefits and harms (Table 4 ). Overall, having experienced at least one type of benefit from CIH use was related (OR = 19.3, 95%CI = 11.1 to 33.8) to the intention to use CIH in the future compared to those who had not experienced any benefits. Having experienced at least one type of harm from CIH use was inversely related (OR = 0.27, 95%CI = 0.20 to 0.35) to intention to use CIH in the future compared to those who had not experienced any harms. Out of the included experienced benefits, all but “Other, what?” were found to be associated to the intention to use CIH in the future. Experienced benefit “Eased pains, aches, tightness, or other ailments” (OR = 7.06, 95%CI = 5.63 to 8.85) had the strongest association to the intention to use CIH in the future. Three out of the included harms were found to be inversely associated to the intention to use CIH in the future. The strongest inverse association to the intention to use CIH in the future was with the experienced harm ”Money was wasted, as I did not get help” (OR = 0.22, 95%CI = 0.15 to 0.34). [Table 4 HERE] Adjusted ORs and confidence intervals were calculated between the intention to use CIH and experienced benefits and harms (Table 5 ). Out of the included experienced benefits, four were found to be statistically significantly associated with the intention to use CIH in the future. The benefit with strongest association was “Eased pains, aches, tightness or other ailments” (OR = 5.96, 95%CI = 4.67 to 7.61). Out of the included harms, only one (“Money was wasted, as I did not get help”; OR = 0.26, 95%CI = 0.17 to 0.40) was found to be statistically significantly associated with the intention to use CIH in the future. Table 5 Results of the logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). OR 95%CI p a) a SRH .070 Good 1.00 Average 0.93 0.74 to 1.17 Poor 0.74 0.55 to 0.99 I do not know 0.35 0.11 to 1.08 b) b Experienced benefits Eased pains, aches, tightness or other ailments < .001 No 1.00 Yes 5.96 4.67 to 7.61 Relieved stress, sleeplessness, depression or anxiety < .001 No 1.00 Yes 2.67 2.04 to 3.49 Increased mental well-being, energy or everyday functionality < .001 No 1.00 Yes 2.31 1.79 to 2.97 Gave support, faith or hope in solving my problems .002 No 1.00 Yes 1.82 1.24 to 2.67 c) b Experienced harms Money was wasted, as I did not get help < .001 No 1.00 Yes 0.26 0.17 to 0.40 a ORs adjusted for gender, age, place of residence, income and education. b Logistic regression analysis with backwards selection. Model includes experienced benefits/harms with p < 0.01. ORs adjusted for SRH, gender, age, place of residence, income and education. Additionally, to further assess the robustness of the findings, all the analyses detailed above were conducted with the respondents who chose the “I do not know or want to answer” option excluded. The results of these analyses are presented in the supplementary materials (Supplementary table 4; Supplementary table 5). Discussion This study sought to investigate the association between the intention to use CIH in the future and SRH, experienced benefits, and experienced harms of CIH use in a sample of Finnish CIH users. As hypothesised, having experienced at least one type of benefit from CIH use was associated with the intention to maintain CIH usage, whereas having experienced at least one type of harm was found to be inversely related to the intention to use CIH in the future. SRH was found not to be associated with the intention to use CIH in the future. The results show that the majority (58.8%) of the CIH users surveyed intended to maintain their CIH use regardless of their SRH status. Moreover, the continuation of CIH use was more likely to be associated with the experienced benefits and harms of CIH use than SRH of the user. The finding that SRH was not associated with continuation of CIH use could be explained by earlier research suggesting that CIH is used not only for treating illnesses or related symptoms 2 , 27 but also for non-medical reasons such as improving general well-being 10 , 19 , 27 . Using CIH for this type of ”health self-management” 22 thus encompasses more than using CIH for strictly medical purposes, possibly partly explaining why no clear association between SRH and intention to use CIH in the future could be found in this study. As the survey which was used in the current study focused on prevalence of use of CIH, health-related information was not collected with more detail (e.g., presence of chronic disease). Future research needs to detail further the association between health status and intention to use specific CIH modalities. Overall, having experienced at least one type of benefit from CIH use was strongly related to intention to continue CIH use compared to those who had not experienced any benefits. The most remarkable association was found for the experienced benefit ”Eased pains, aches, tightness or other ailments”, indicating that the intention to maintain CIH use was related to the CIH users´ strive for alleviation of pain and other physical ailments. The experienced benefit related to relieved stress, sleeplessness, depression or anxiety was also found to be related to intent to use CIH, whereas money going to waste due to CIH use being unhelpful was found to be inversely related to the intention to maintain CIH use. As shown in earlier studies, the perceived effectiveness or lack thereof seems an important factor in whether or not someone intends to maintain their CIH usage 17 , 18 , 21 . These experienced benefits and harms highlight the importance of the experienced everyday effectiveness of CIH. In line with CCM 21 , it seems that the respondents of this study base their intentions of CIH use maintenance at least partly on everyday outcomes of CIH. Our results showed how intention to maintain CIH use was related to experienced benefits of increased mental well-being, everyday functionality and CIH use giving support, faith and hope in solving one’s problems. In the current study, increased well-being and everyday functioning was the second most commonly reported experienced benefit (42%) after easing of pain or related ailment (47%). These results highlight the wide range of the experienced benefits of the respondents, as intention to use CIH in the future was not only found related to reduction of a symptom or an ailment. The benefits of increased well-being and getting support could be seen as resembling the symbolic values presented in CCM, particularly the idea of emphasising whole person treatments mentioned by Sirois et al. 21 , 22 . Examining continued CIH use through a health consumer lens in the case of the current study is suitable, as our results show that experiencing CIH as effective and not a waste of money is associated to the intention to maintain its use. Overall, our results offer indirect yet clear support to the usage of CCM in explaining the maintenance of CIH use. In our study 15% of the respondents reported having experienced at least one type of harm relating to their CIH use. In future studies it would be important to explore whether some CIH modalities are more likely to cause harm to its users than others. Most CIH modalities are not currently incorporated into the health care system in Finland, yet its users report helpfulness of the used modalities 10 and as according to our findings, 58.8% of CIH users intend to use CIH in the future. Thus, the possibilities of applying evidence-based CIH modalities for health promotion and pain management, and to limit the harm caused by CIH use should be further explored. Moreover, the finding that experienced everyday effectiveness of the used modalities of CIH has such a strong association with the intention to use CIH, suggests that both the economic and health consequences of CIH use deserve attention in public health research. Our study included 27 distinct CIH modalities, and an earlier study on the same data showed that the most important reason for use depended highly on the CIH modality in question 10 . The results of this study suggest that benefits experienced from CIH use seem strongly associated with continued use of CIH. It remains for future research to assess the associations between the experienced benefits and harms of specific CIH modalities and the intention to continue their use. Limitations The results of this study are not without limitations. It was outside of the scope of the survey to detail the experienced benefits and harms for each of the included CIH modalities. There are still clear difficulties in determining a ”CIH user”, as the definitions of which modalities are included into the umbrella term of CIH are dynamic. In this study, the researcher-defined “CIH user” could have excluded people who perceived themselves as CIH users but had not used CIH in the 12-months prior to taking the survey. Similarly, as evident from the open-ended answers to experienced benefits and harms, some people who were defined as CIH users did not perceive themselves as such. Additionally, the current study did not assess ethnicity, yet this should be considered in future CIH-use related studies in Finland. For example, more attention should have been paid to Sámi representation in designing the survey, as the survey did not detail any modalities of Sámi traditional medicine which differ from the surveyed CIH modalities (e.g., traditional helper) 31 . Lastly, recall bias might have influenced respondents’ answers in which CIH modalities they had used 32 or the benefits and harms they had experienced. Conclusions This study examined the relationship between CIH users’ intent to use CIH in the future, and SRH, experienced benefits and harms from CIH use in Finland. Having experienced benefits from CIH use was related to intention to maintain CIH usage, whereas having experienced harms was inversely related to the intention. Easing of pain or related ailment was found to be the most strongly related benefit to the intention to use CIH in the future, whereas money being wasted on CIH was found to be inversely related to the intention. CIH was used by both respondents of poor and good SRH. The intention to continue CIH use was not found to be associated to SRH, possibly due to CIH being used both for treatment of various health conditions, and for health promotion to maintain well-being. Our results suggest that the intention to use CIH is related to the experienced everyday effectiveness of the used CIH modalities. The results provide information for planning CIH policy and legislation in Finland. Declarations Acknowledgements . We acknowledge Kantar Public for collecting the data. Authors’ contributions PA, SA and KH conceived the study and translated the I-CAM-Q questionnaire from English and Norwegian to Finnish. MPy and MPa performed the initial and final analyses. MPy and PA drafted the initial version of the paper and all authors reviewed subsequent versions and read and approved the final manuscript. Funding The data collection of this study has been funded by Lapsi ja Luonto Säätiö (Child and Nature Fund), Helsinki, Finland. No further funding was received. Competing interests The authors have no competing interests. Availability of data and materials The dataset this paper has been based on has not been deposited in any repository. All dataset and materials are available from the corresponding author upon reasonable request. Ethics approval and consent to participate . An informed consent to participate in the survey was obtained from each respondent. This study does not cause any potential risks or harm to survey respondents, and it meets the ethical requirements of research with human participants according to The Finnish National Board on Research Integrity guidelines. The ethical approval was deemed unnecessary by the Academic Ethics Committee of the Tampere region. According to a statement from the Academic Ethics Committee of the Tampere region, ethical review is to be carried out prior to gathering data only if the research contains one or more of the following factors: 1) Participation in the research deviates from the principle of informed consent (participation is not, for example, voluntary, or the subject is not given sufficient or correct information about the research), 2) The research involves intervening in the physical integrity of research participants, 3) The focus of the research is on minors under the age of fifteen, without separate consent from a parent or carer, or without informing a parent or carer in a way that would enable them to prevent the child’s participation in the research, 4) Research that exposes participants to exceptionally strong stimuli, 5) Research that involves a risk of causing mental harm that exceeds the limits of normal daily life to the research participants or their family members or others closest to them, 6) Conducting the research could involve a threat to the safety of participants or researchers or their family members or others closest to them. Our research does not contain any of the aforementioned factors. Consent for publication Not applicable. References World Health Organization (WHO). WHO traditional medicine strategy: 2014–2023, Geneva. https://www.who.int/publications/i/item/9789241506096 (2013, accessed 17 May 2024). Kemppainen LM, Kemppainen TT, Reippainen JA, et al. Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scand J Public Health. 2018;46:448–55. Nahin RL, Rhee A, Stussman B. Use of Complementary Health Approaches Overall and for Pain Management by US Adults. JAMA . Epub ahead of print 25 January 2024. 10.1001/jama.2023.26775 . Ng JY, Dhawan T, Fajardo R-G, et al. The brief history of complementary, alternative, and integrative medicine terminology and the development and creation of an operational definition. Integr Med Res. 2023;12:100978. Lee EL, Richards N, Harrison J, et al. Prevalence of Use of Traditional, Complementary and Alternative Medicine by the General Population: A Systematic Review of National Studies Published from 2010 to 2019. Drug Saf. 2022;45:713–35. Tangkiatkumjai M, Boardman H, Walker D-M. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther. 2020;20:363. Bhoi D, Jain D, Garg R, et al. Complementary and Alternative Modalities (CAM) for pain management in musculoskeletal diseases (MSDs). J Clin Orthop Trauma. 2021;18:171–80. Wode K, Henriksson R, Sharp L, et al. Cancer patients’ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Altern Med. 2019;19:62. Kristoffersen AE, Quandt SA, Stub T. Use of complementary and alternative medicine in Norway: a cross-sectional survey with a modified Norwegian version of the international questionnaire to measure use of complementary and alternative medicine (I-CAM-QN). BMC Complement Med Ther. 2021;21:93. Pyykkönen M, Aarva P, Ahola S, et al. Use of complementary and integrative health in Finland: a cross-sectional survey. BMC Complement Med Ther. 2023;23:279. Astin JA. Why Patients Use Alternative Medicine. JAMA. 1998;279:1548. Lindeman M. Biases in intuitive reasoning and belief in complementary and alternative medicine. Psychol Health. 2011;26:371–82. Grzywacz JG, Neiberg R, Quandt SA, et al. Measuring differential beliefs in complementary therapy research: An exploration of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI). Complement Ther Med. 2012;20:54–60. Jeswani M, Furnham A. Are modern health worries, environmental concerns, or paranormal beliefs associated with perceptions of the effectiveness of complementary and alternative medicine? Br J Health Psychol. 2010;15:599–609. Oh B, Butow P, Mullan B, et al. The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia. Asia Pac J Clin Oncol. 2010;6:342–9. Mora DC, Kristoffersen AE, Overvåg G, et al. Safety of Complementary and Alternative Medicine (CAM) treatment among children and young adults who suffer from adverse effects of conventional cancer treatment: A systematic review. Integr Cancer Ther. 2022;21:153473542211055. Ben Natan M, Perelman M, Ben-Naftali G. Factors Related to the Intention of Israelis to Use Complementary and Alternative Medicine. J Holist Nurs. 2016;34:361–8. O’Connor EL, White KM. Intentions and willingness to use complementary and alternative medicines: What potential patients believe about CAMs. Complement Ther Clin Pract. 2009;15:136–40. Thomson P, Jones J, Browne M, et al. Psychosocial factors that predict why people use complementary and alternative medicine and continue with its use: A population based study. Complement Ther Clin Pract. 2014;20:302–10. Fournier V, Varet F. Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies. Br J Health Psychol . Epub ahead of print 25 October 2023. 10.1111/bjhp.12702 . Sirois FM, Salamonsen A, Kristoffersen AE. Reasons for continuing use of Complementary and Alternative Medicine (CAM) in students: a consumer commitment model. BMC Complement Altern Med. 2016;16:75. Sirois FM, Riess H, Upchurch DM. Implicit Reasons for Disclosure of the Use of Complementary Health Approaches (CHA): a Consumer Commitment Perspective. Ann Behav Med. 2017;51:764–74. World Health Organization (WHO). WHO global report on traditional and complementary medicine 2019 . Geneva, https://www.who.int/publications/i/item/978924151536 (16 May 2019, accessed 17 May 2024). Posadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med. 2013;13:7–12. 2023. Finnish Government. A strong and committed Finland, Programme of Prime Minister Petteri Orpo’s Government 20 June, Helsinki. https://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/165044/Programme-of-Prime-Minister-Petteri-Orpos-Government-20062023.pdf?sequence=4&isAllowed=y (2023, accessed 17 May 2024). Rhee TG, Pawloski PA, Parsons HM. Health-related quality of life among US adults with cancer: Potential roles of complementary and alternative medicine for health promotion and well‐being. Psychooncology. 2019;28:896–902. Upchurch DM, Rainisch BW. The importance of wellness among users of complementary and alternative medicine: findings from the 2007 National Health Interview Survey. BMC Complement Altern Med. 2015;15:362. Bishop FL, Lewith GT. Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use. Evid Based Complement Alternat Med. 2010;7:11–28. Quandt SA, Verhoef MJ, Arcury TA, et al. Development of an International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). J Altern Complement Med. 2009;15:331–9. Aarva P, Väänänen T, Kankkunen T-T. Elämäni on muuttunut kokonaan: Tutkimus perusteluista luontaishoitojen käytölle ja niistä saadulle avulle. Elore ; 29. Epub ahead of print 30 December 2022. 10.30666/elore.120898 . Ouma A, Jacobsson L, Nilsson L-M. Sámi traditional medicine and complementary and alternative medicine – a descriptive study of use within the Sámi population of Sweden. Int J Circumpolar Health ; 82. Epub ahead of print 31 December 2023. 10.1080/22423982.2023.2222908 . Jensen HAR, Ekholm O. Therapy-dependent inconsistencies in self-reported use of complementary and alternative medicine in the general population: findings from a longitudinal study. BMJ Open. 2021;11:e051647. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4435651","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309893642,"identity":"9212dfc0-a722-4849-a491-8251061febfa","order_by":0,"name":"Maija Pyykkönen","email":"data:image/png;base64,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","orcid":"","institution":"Socon – Social and Health Consultants Ltd","correspondingAuthor":true,"prefix":"","firstName":"Maija","middleName":"","lastName":"Pyykkönen","suffix":""},{"id":309893643,"identity":"ea76435b-f2db-400d-aad1-a1edbe013b30","order_by":1,"name":"Salla Ahola","email":"","orcid":"","institution":"Faculty of Management and Business, Tampere University","correspondingAuthor":false,"prefix":"","firstName":"Salla","middleName":"","lastName":"Ahola","suffix":""},{"id":309893644,"identity":"4341a93f-d7bf-4c47-a18d-d19dc61dff62","order_by":2,"name":"Pauliina Aarva","email":"","orcid":"","institution":"Faculty of Social Sciences, Tampere University","correspondingAuthor":false,"prefix":"","firstName":"Pauliina","middleName":"","lastName":"Aarva","suffix":""},{"id":309893645,"identity":"0c88c144-798d-417d-8817-e767a4c4b37f","order_by":3,"name":"Matti Pasanen","email":"","orcid":"","institution":"Consultant in statistics","correspondingAuthor":false,"prefix":"","firstName":"Matti","middleName":"","lastName":"Pasanen","suffix":""},{"id":309893646,"identity":"fd0c5de6-a86b-4b98-80d0-4d624528e01c","order_by":4,"name":"Kaija Helin","email":"","orcid":"","institution":"Finnish Society for Integrative Medicine","correspondingAuthor":false,"prefix":"","firstName":"Kaija","middleName":"","lastName":"Helin","suffix":""}],"badges":[],"createdAt":"2024-05-17 09:23:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4435651/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4435651/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67467274,"identity":"36388c18-b715-414c-af82-32cb2ad7abcc","added_by":"auto","created_at":"2024-10-25 10:53:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":803108,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4435651/v1/f46ea478-5eb9-427c-8fda-03cb32ae976b.pdf"},{"id":57772687,"identity":"db59d5b5-a97b-4427-912f-d2a2b34caafb","added_by":"auto","created_at":"2024-06-05 12:38:52","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":33526,"visible":true,"origin":"","legend":"","description":"","filename":"intentiontouseCIHinFinlandsupplementarytables.docx","url":"https://assets-eu.researchsquare.com/files/rs-4435651/v1/0f8fd86d068d8a55feb7b145.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The relationship between experienced benefits and harms of using complementary and integrative health approaches and intention to maintain their use in Finland","fulltext":[{"header":"Background","content":"\u003cp\u003eComplementary and integrative health (CIH) approaches comprise a vast range of provider-led procedures, natural remedies, products and self-help practices, that are offered along with or outside of conventional healthcare worldwide \u003csup\u003e\u003cspan additionalcitationids=\"CR2 CR3\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Estimated prevalence of 12-month CIH use is found to vary between 24\u0026ndash;71% depending on the study and country \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Recognising the varying terminology \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, in this article the term CIH is used in referring to CIH approaches, and as a corresponding term to CAM (complementary and alternative medicine) and CAIM (complementary, alternative and integrative medicine).\u003c/p\u003e \u003cp\u003eThe most commonly reported reasons for the use of CIH are the perceived benefits and safety of CIH, and dissatisfaction with conventional medicine \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Reported benefits include management of pain \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e, perceived improvement of physical and emotional health and well-being and quality of life \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e, as well as CIH being reported by users as helpful \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. The use of CIH has been attempted to be explained by having value fit with CIH use\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e and by beliefs in magical concepts regarding health\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e, or holistic health and healing beliefs \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Individuals with more modern health worries and paranormal beliefs have also been found more likely to find CIH as effective\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Reasons for the non-use of CIH include doubt of efficacy of and concerns about possible side-effects of CIH, and satisfaction with conventional medicine \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Reported perceived harms or adverse effects from CIH use include temporary discomfort or pain and high cost of CIH treatments \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eStudies indicate that previous CIH use and having a positive attitude towards CIH \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e, family influence \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, and belief in positive outcomes following from CIH use \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e are associated with the intention to use CIH in the future. Furthermore, improvement of general well-being and CIH being used as an addition to conventional medical treatment \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e have been found to be connected to the intention to continue CIH use. A recent publication by Fournier and Varet \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e included two vignette studies focusing on the intention to use conventional, complementary and alternative medicine during cancer treatment. Intention to use CIH was found positively correlated with conspiracy beliefs, and this correlation was found to be larger for the use of \u0026ldquo;unconventional medicine\u0026rdquo; as an alternative to chemotherapy, compared to complementary use\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTheoretical frameworks with which the intention to use CIH has been explained include the theory of planned behaviour \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e and the CIH-tailored consumer commitment model (CCM)\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. CCM conceptualises commitment to CIH within a psychological and behavioural frame based on one hand on CIH users' values and on the other the experiences gained from use of CIH. The model assumes that commitment to future use, i.e. intention of CIH users to continue the use, is related to utilitarian and symbolic values \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. According to Sirois et al. \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, utilitarian values include positive outcomes of CIH use, containing physical, emotional and behavioural outcomes. Symbolic values refer to the perceived \u0026ldquo;fit\u0026rdquo; between the CIH user\u0026rsquo;s belief system and that of the CIH modalities they use, for example holistic health beliefs and emphasis on whole person treatments. In this article we conceptualise positive CIH outcomes as experienced benefits of CIH use, and negative CIH outcomes as experienced harms of CIH use.\u003c/p\u003e \u003cp\u003eIn Finland, the use of most CIH modalities falls under consumer legislation, making consumer perspective within CIH research relevant. Unlike the neighbouring countries of Sweden and Norway, there is no national policy for traditional and complementary medicine in Finland \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. There is a possibility for serious adverse effects for the use of some CIH modalities, for example via herb-drug interactions \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e, and the 2023 Finnish government programme aims to assess the patient safety of alternative therapies offered outside health care \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. The prevalence of CIH use in Finland is relatively high \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e, making it paramount for the national CIH policy development that the reasons behind continued use are better understood. To the authors\u0026rsquo; knowledge the association between experienced benefits and harms and the intention to use CIH have not been researched earlier.\u003c/p\u003e \u003cp\u003eCIH modalities are used for treatment of various health conditions, and for health promotion to maintain well-being \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Previous studies on the connection between self-rated health (SRH) and prevalence of CIH use offer inconsistent results \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Some studies report good SRH \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e and some poor SRH \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e being associated with higher rates of current CIH use. To the authors\u0026rsquo; knowledge, the relationship between SRH and intention of CIH users to maintain their CIH use has not been studied.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eAims\u003c/h2\u003e \u003cp\u003eThis study aimed to investigate whether the experienced benefits and harms of CIH use are related to the intention to maintain CIH usage in the future. Thus, the hypotheses are:\u003c/p\u003e \u003cp\u003eH1: Having experienced benefits from CIH use is related to the intention to maintain CIH use, and\u003c/p\u003e \u003cp\u003eH2: Having experienced harms from CIH use is inversely related to the intention to maintain CIH use.\u003c/p\u003e \u003cp\u003eIn addition, CIH being used both for treatment of ailments and health promotion \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e, we explore whether there is an association between SRH and CIH users\u0026rsquo; intention to continue CIH usage.\u003c/p\u003e \u003c/div\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSampling and recruitment\u003c/h2\u003e \u003cp\u003eThe data were collected from a commercial probability-based online panel (Kantar Public) in December of 2022 with an online survey questionnaire. A questionnaire was sent by email to 11507 randomly selected panellists aged 16 and above living in mainland Finland. A total of 3244 panellists completed the survey. This study was a part of a larger Finnish CIH research project. More details on sampling and recruitment are reported elsewhere \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eMeasures of respondent characteristics\u003c/p\u003e \u003cp\u003eBasic characteristics (gender, age, place of residence) were asked in the beginning of the survey. Age was calculated based on year of birth. Gender of the respondents was assessed via a categorical question (female; male). Residency was assessed by using the four designated NUTS (Nomenclature of Territorial Units for Statistics) level 2 areas of Finland (Helsinki-Uusimaa; South Finland; West Finland; North and East Finland).\u003c/p\u003e \u003cp\u003eInformation on household yearly income was collected with a categorical question, the answers of which were merged into the following categories used in the final analysis: low (35.000\u0026euro; and below), middle (35.001-50.000\u0026euro;), and high (50.001\u0026euro; and above). Highest form of obtained education was collected with six categories, which were merged into the following categories for the final analysis: primary and lower secondary school; upper secondary education and vocational college education; Bachelor\u0026rsquo;s degree or higher vocational degree; Master\u0026rsquo;s degree or higher.\u003c/p\u003e \u003cp\u003eUse of CIH\u003c/p\u003e \u003cp\u003eThe usage of CIH was assessed with the Finnish version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q; \u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e). The survey includes modalities from three CIH categories: providers, natural remedies and self-help practices. The researcher-defined group of CIH users includes respondents who reported the usage of at least one CIH modality at least once within the 12 months prior to taking part in the survey. All modalities included in the definition are listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The process is detailed in Authors \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCIH modalities included in the definition of CIH user\u003csup\u003ea\u003c/sup\u003e in this study.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCIH providers and therapists\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCIH Natural remedies\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCIH self-help practices\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChiropractor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHerbs and herbal medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMeditation and mindfulness\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHomeopath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHomoeopathic remedies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYoga\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcupuncturist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther supplements (not vitamins and minerals)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTai Chi and Qigong\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhytotherapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRelaxation techniques\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBone setter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVisualisation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnergy healer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAttending traditional healing ceremonies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReflexologist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNLP\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAromatherapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMassage therapist (other, non-conv.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNaprapath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOsteopath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArt therapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCuppist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypnotherapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTCM practitioner\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnthroposophic therapist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAyurvedic practitioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Using one or more of the included modalities at least once in the 12 months preceding the survey.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e TCM\u0026thinsp;=\u0026thinsp;Traditional Chinese Medicine, NLP\u0026thinsp;=\u0026thinsp;Neurolinguistic Programming.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eIntention to use CIH\u003c/h2\u003e \u003cp\u003eIntention to use CIH in the future was assessed with the question: \u0026ldquo;Do you intend to use any complementary treatments in the future?\u0026rdquo;. The answer options were combined into three categories: \u0026rdquo;Yes\u0026rdquo; (\u0026rdquo;Yes\u0026rdquo;/\u0026rdquo;Probably yes\u0026rdquo;), \u0026rdquo;No\u0026rdquo; (\u0026rdquo;No\u0026rdquo;/\u0026rdquo;Probably no\u0026rdquo;) and \u0026rdquo;I do not know or want to answer\u0026rdquo;. For the final analysis, the answer options were grouped into two categories: \u0026rdquo;Yes\u0026rdquo; (\u0026rdquo;Yes/Probably yes\u0026rdquo;) and \u0026rdquo;No/Unsure\u0026rdquo; (\u0026rdquo;No/Probably no/I do not know or want to answer\u0026rdquo;).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSelf-rated health (SRH)\u003c/h2\u003e \u003cp\u003eSRH was assessed via a multiple choice question, \u0026rdquo;What is your state of health like at the moment?\u0026rdquo;. Six answer options were provided. In the final analysis, the answer options were merged into four categories in order to highlight differences between dimensions of good and poor SRH: \u0026rdquo;Poor\u0026rdquo; (Very poor/Somewhat poor), \u0026rdquo;Average\u0026rdquo;, \u0026rdquo;Good\u0026rdquo; (Very good/somewhat good) and \u0026rdquo;I do not know or want to answer\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eExperienced benefits and harms of CIH use\u003c/h2\u003e \u003cp\u003eExperienced benefits were assessed with the question: \u0026rdquo;Which of the mentioned benefits have you experienced resulting from using CIH (visiting providers, using natural remedies and self-help practices) during the last 12 months?\u0026rdquo;. Experienced harms were assessed with the question: \u0026rdquo;Which of the mentioned harms have you experienced resulting from using CIH (visiting providers, using natural remedies and self-help practices) during the last 12 months?\u0026rdquo;. The respondent could choose all the options which applied, which was analysed as a \u0026rdquo;Yes\u0026rdquo; response. The options which the respondent did not choose were analysed as a \u0026rdquo;No\u0026rdquo; response. If the respondents chose the option \u0026rdquo;No benefits\u0026rdquo; in the case of benefits, \u0026ldquo;No harms\u0026rdquo; in the case of harms, or \u0026rdquo;I do not know\u0026rdquo; in either case, all other response options were automatically excluded by the data collection programme. The included experienced benefits and harms are listed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnswer options for experienced benefits and harms from using CIH.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced benefits\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperienced harms\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEased pains, aches, tightness, or other ailments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoney was wasted, as I did not get help\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelieved stress, sleeplessness, depression, or anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI was cheated\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreased mental well-being, energy, or everyday functionality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePains, aches, or ailments became worse\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDecreased medication use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI felt hurt or treated inappropriately\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI felt heard and seen with my ailments and problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther, harm what?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGave support, faith or hope in solving my problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo harms\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther, benefit what?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo benefits \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI do not know \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e If chosen by the respondent, all other options for experienced benefits were automatically excluded by the data collection programme.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e If chosen by the respondent, all other options for experienced harms were automatically excluded by the data collection programme.\u003c/p\u003e \u003cp\u003eThe included benefits and harms were chosen based on earlier research \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e to explore the experienced benefits and harms at the population level. The answer options were formulated and finalised by the research team. To decrease the time burden of the full questionnaire, experienced benefits and harms were assessed for general CIH use instead of assessing them for each individual CIH modality. The original Finnish answer options of both experienced benefits and harms are presented in the supplementary materials (Supplementary Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003eOpen-ended \u0026rdquo;Other, what?\u0026rdquo; responses for both experienced benefits (n\u0026thinsp;=\u0026thinsp;53) and harms (n\u0026thinsp;=\u0026thinsp;17) were read through by the research team. Most responses were classified as genuine answers (e.g., for benefits \u0026rdquo;Maintaining mobility\u0026rdquo;; for harms \u0026rdquo;The ailment eased only for a moment\u0026rdquo;). However, five respondents reported in their answers not having used CIH in the 12 months prior to taking part in the survey despite belonging to the researcher-defined CIH user-group, and thus were excluded from all of the following analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatistics\u003c/h2\u003e \u003cp\u003eData were weighted based on age, gender and region of residency. Between-group differences in respondent characteristics in relation to the intention to use CIH in the future were tested by using Pearson\u0026rsquo;s chi-square test (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Pearson\u0026rsquo;s correlations between experienced benefits and between experienced harms are presented in the supplementary materials (Supplementary table 2; Supplementary table 3).\u003c/p\u003e \u003cp\u003eAssociation between intention to use CIH (no/unsure; yes) and SRH (good; average; poor; \u0026rdquo;I do not know\u0026rdquo;), experienced benefits (no experienced benefits; at least one experienced benefit; \u0026rdquo;I do not know\u0026rdquo;), experienced harms (no experienced harms; at least one experienced harm; \u0026rdquo;I do not know\u0026rdquo;), and the individual experienced benefits and harms (no; yes) are described with proportions and odds ratios (ORs) with their 95% confidence intervals (95%CI) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e, Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of respondent characteristics in CIH users (n\u0026thinsp;=\u0026thinsp;1652).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%) of total n\u0026thinsp;=\u0026thinsp;1652\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%Intends to use CIH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge In years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean age in years (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46.2 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026ndash;29 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e366 (22.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;59 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e836 (50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e450 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e967 (58.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e685 (41.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e482 (29.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e278 (16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e648 (39.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e241 (14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest obtained education\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary and lower secondary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.778\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUpper secondary and vocational college education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e814 (49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor\u0026rsquo;s degree or higher vocational degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e409 (24.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster\u0026rsquo;s degree or higher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e302 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHelsinki-Uusimaa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e512 (31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.080\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSouth Finland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e317 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWest Finland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e423 (25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNorth and East Finland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e399 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e 2 respondents (0.1%) did not respond to the item asking about their income.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e 15 respondents (0.9%) responded \u0026ldquo;Other\u0026rdquo; or did not report their educational information.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of the logistic regression analyses with unadjusted odds ratios (ORs) and 95% confidence intervals (CI95%).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%Intends to use CIH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCI95%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSRH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e59.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.78 to 1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.57 to 1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know or want to answer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.08 to 0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced Benefits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, at least one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1320\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.05 to 33.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.21 to 4.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced Benefits, individual items (No / Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEased pains, aches, tightness, or other ailments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e872/780\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.8/47.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38.4/81.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.63 to 8.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelieved stress, sleeplessness, depression, or anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1013/638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.3/38.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48.4/75.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.60 to 4.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncreased mental well-being, energy, or everyday functionality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e951/701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.6/42.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e47.5/74.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.55 to 3.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDecreased medication use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1445/205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.6/12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e55.5/82.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.56 to 5.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI felt heard and seen with my ailments and problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1471/180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.1/10.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e55.7/83.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.69 to 6.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGave support, faith or hope in solving my problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1392/260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.3/15.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e55.0/78.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.23 to 4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther, what?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1603/48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.1/2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.7/62.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.65 to 2.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.589\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced harms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, at least one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.20 to 0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.10 to 0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced Harms, individual items (No / Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoney was wasted, as I did not get help\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1537/115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.0/7.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e61.2/26.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.15 to 0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI was cheated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1594/54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96.7/3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e59.8/27.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.15 to 0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePains, aches, or ailments became worse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1592/59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96.4/3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.8/58.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.58 to 1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.966\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI felt hurt or treated inappropriately\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1602/50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.0/3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e59.5/36.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.22 to 0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther, what?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1638/14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.1/0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.7/64.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.42 to 3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.681\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAdjusted ORs for SRH were computed with binary logistic regression analyses. Gender, age, income, education and place of residence were used as adjusting variables. Backwards binary logistic regression analyses were used for both experienced benefits and harms, with SRH, gender, age, income, education and place of residence used as adjusting variables. Backwards selection was used to find the strongest indicators (experienced benefits and harms) related to the intention for future CIH use. P-value\u0026thinsp;\u0026gt;\u0026thinsp;0.01 was used to reject variables from the models.\u003c/p\u003e \u003cp\u003eAll results reported in the Results-section (see below) are based on weighted data. The data were analysed using IBM SPSS Statistics (version 28).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eBasic respondent characteristics\u003c/h2\u003e \u003cp\u003eOut of the 3244 respondents who completed the survey, 1657 (51.1%) were categorised as CIH users, whereas 1587 (48.9%) were categorised as non-users. Five respondents, who were categorised as CIH users but who explicitly stated otherwise in their answers for open-ended questions, were excluded from the analysis (see: \u003cem\u003eExperienced benefits and harms of CIH use\u003c/em\u003e in Methods). In the final CIH user group used in all analysis (n\u0026thinsp;=\u0026thinsp;1652), women constituted 58.5% of the respondents. The mean age was 46.2 years (SD\u0026thinsp;=\u0026thinsp;18.3) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eIntention to use CIH\u003c/h2\u003e \u003cp\u003eIn the CIH user group, 58.8% of the respondents intended and 26.6% did not intend to use CIH in the future. Respondents who answered \u0026rdquo;I do not know\u0026rdquo; constituted 14.6% of the CIH user group. In the non-user group, 24.7% intended and 56.3% did not intend to use CIH in the future. Respondents who answered \u0026rdquo;I do not know\u0026rdquo; constituted 19.0% of the non-user group. All of the following analysis were conducted by using the CIH user respondents (n\u0026thinsp;=\u0026thinsp;1652).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThe association between intention to use CIH, SRH, and experienced benefits and harms\u003c/h2\u003e \u003cp\u003eOut of the CIH user respondents, 53.0% reported being in good health, 30.9% in average health, 15.0% in poor health, and 1.0% responded \u0026rdquo;I do not know or want to answer\u0026rdquo; (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Logistic regression analyses were conducted for the association between CIH users\u0026rsquo; intention to maintain CIH use and SRH. Unadjusted ORs showed SRH to be associated with intention to use CIH (p\u0026thinsp;=\u0026thinsp;.018), which was due to the difference between the respondents who chose the \"I do not know or want to answer\" option and the other respondents. However, based on the adjusted ORs SHR was not found to be statistically significantly associated with intention to use CIH in the future (p\u0026thinsp;=\u0026thinsp;.070) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRespondents who reported having experienced at least one of the included benefits comprised 79.9% of the total CIH users (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The rest of the respondents reported not having experienced any (8.3%) or were unsure about having experienced benefits from CIH use (11.7%). When asked about experienced harms, 15.0% of the respondents reported having experienced at least one, 71.2% reported not having experienced any harms, and 13.8% were unsure about experiencing harms from CIH use.\u003c/p\u003e \u003cp\u003eLogistic regression analyses were conducted for the association between CIH users\u0026rsquo; intention to maintain CIH use, and experienced benefits and harms relating to CIH use. Unadjusted ORs and confidence intervals were calculated between the intention to use CIH, and experienced benefits and harms (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Overall, having experienced at least one type of benefit from CIH use was related (OR\u0026thinsp;=\u0026thinsp;19.3, 95%CI\u0026thinsp;=\u0026thinsp;11.1 to 33.8) to the intention to use CIH in the future compared to those who had not experienced any benefits. Having experienced at least one type of harm from CIH use was inversely related (OR\u0026thinsp;=\u0026thinsp;0.27, 95%CI\u0026thinsp;=\u0026thinsp;0.20 to 0.35) to intention to use CIH in the future compared to those who had not experienced any harms.\u003c/p\u003e \u003cp\u003eOut of the included experienced benefits, all but \u0026ldquo;Other, what?\u0026rdquo; were found to be associated to the intention to use CIH in the future. Experienced benefit \u0026ldquo;Eased pains, aches, tightness, or other ailments\u0026rdquo; (OR\u0026thinsp;=\u0026thinsp;7.06, 95%CI\u0026thinsp;=\u0026thinsp;5.63 to 8.85) had the strongest association to the intention to use CIH in the future. Three out of the included harms were found to be inversely associated to the intention to use CIH in the future. The strongest inverse association to the intention to use CIH in the future was with the experienced harm \u0026rdquo;Money was wasted, as I did not get help\u0026rdquo; (OR\u0026thinsp;=\u0026thinsp;0.22, 95%CI\u0026thinsp;=\u0026thinsp;0.15 to 0.34).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e[Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e HERE]\u003c/h2\u003e \u003cp\u003eAdjusted ORs and confidence intervals were calculated between the intention to use CIH and experienced benefits and harms (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Out of the included experienced benefits, four were found to be statistically significantly associated with the intention to use CIH in the future. The benefit with strongest association was \u0026ldquo;Eased pains, aches, tightness or other ailments\u0026rdquo; (OR\u0026thinsp;=\u0026thinsp;5.96, 95%CI\u0026thinsp;=\u0026thinsp;4.67 to 7.61). Out of the included harms, only one (\u0026ldquo;Money was wasted, as I did not get help\u0026rdquo;; OR\u0026thinsp;=\u0026thinsp;0.26, 95%CI\u0026thinsp;=\u0026thinsp;0.17 to 0.40) was found to be statistically significantly associated with the intention to use CIH in the future.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of the logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CI95%).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ea) \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSRH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.070\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.74 to 1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.55 to 0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.11 to 1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eb) \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperienced benefits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEased pains, aches, tightness or other ailments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.67 to 7.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelieved stress, sleeplessness, depression or anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.04 to 3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncreased mental well-being, energy or everyday functionality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.79 to 2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGave support, faith or hope in solving my problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.24 to 2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ec) \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperienced harms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMoney was wasted, as I did not get help\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.17 to 0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e ORs adjusted for gender, age, place of residence, income and education.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003e Logistic regression analysis with backwards selection. Model includes experienced benefits/harms with p\u0026thinsp;\u0026lt;\u0026thinsp;0.01. ORs adjusted for SRH, gender, age, place of residence, income and education.\u003c/p\u003e \u003cp\u003eAdditionally, to further assess the robustness of the findings, all the analyses detailed above were conducted with the respondents who chose the \u0026ldquo;I do not know or want to answer\u0026rdquo; option excluded. The results of these analyses are presented in the supplementary materials (Supplementary table 4; Supplementary table 5).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study sought to investigate the association between the intention to use CIH in the future and SRH, experienced benefits, and experienced harms of CIH use in a sample of Finnish CIH users. As hypothesised, having experienced at least one type of benefit from CIH use was associated with the intention to maintain CIH usage, whereas having experienced at least one type of harm was found to be inversely related to the intention to use CIH in the future. SRH was found not to be associated with the intention to use CIH in the future.\u003c/p\u003e \u003cp\u003eThe results show that the majority (58.8%) of the CIH users surveyed intended to maintain their CIH use regardless of their SRH status. Moreover, the continuation of CIH use was more likely to be associated with the experienced benefits and harms of CIH use than SRH of the user. The finding that SRH was not associated with continuation of CIH use could be explained by earlier research suggesting that CIH is used not only for treating illnesses or related symptoms \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e but also for non-medical reasons such as improving general well-being \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Using CIH for this type of \u0026rdquo;health self-management\u0026rdquo; \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e thus encompasses more than using CIH for strictly medical purposes, possibly partly explaining why no clear association between SRH and intention to use CIH in the future could be found in this study. As the survey which was used in the current study focused on prevalence of use of CIH, health-related information was not collected with more detail (e.g., presence of chronic disease). Future research needs to detail further the association between health status and intention to use specific CIH modalities.\u003c/p\u003e \u003cp\u003eOverall, having experienced at least one type of benefit from CIH use was strongly related to intention to continue CIH use compared to those who had not experienced any benefits. The most remarkable association was found for the experienced benefit \u0026rdquo;Eased pains, aches, tightness or other ailments\u0026rdquo;, indicating that the intention to maintain CIH use was related to the CIH users\u0026acute; strive for alleviation of pain and other physical ailments. The experienced benefit related to relieved stress, sleeplessness, depression or anxiety was also found to be related to intent to use CIH, whereas money going to waste due to CIH use being unhelpful was found to be inversely related to the intention to maintain CIH use. As shown in earlier studies, the perceived effectiveness or lack thereof seems an important factor in whether or not someone intends to maintain their CIH usage \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. These experienced benefits and harms highlight the importance of the experienced everyday effectiveness of CIH. In line with CCM \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, it seems that the respondents of this study base their intentions of CIH use maintenance at least partly on everyday outcomes of CIH.\u003c/p\u003e \u003cp\u003eOur results showed how intention to maintain CIH use was related to experienced benefits of increased mental well-being, everyday functionality and CIH use giving support, faith and hope in solving one\u0026rsquo;s problems. In the current study, increased well-being and everyday functioning was the second most commonly reported experienced benefit (42%) after easing of pain or related ailment (47%). These results highlight the wide range of the experienced benefits of the respondents, as intention to use CIH in the future was not only found related to reduction of a symptom or an ailment. The benefits of increased well-being and getting support could be seen as resembling the symbolic values presented in CCM, particularly the idea of emphasising whole person treatments mentioned by Sirois et al. \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Examining continued CIH use through a health consumer lens in the case of the current study is suitable, as our results show that experiencing CIH as effective and not a waste of money is associated to the intention to maintain its use. Overall, our results offer indirect yet clear support to the usage of CCM in explaining the maintenance of CIH use.\u003c/p\u003e \u003cp\u003eIn our study 15% of the respondents reported having experienced at least one type of harm relating to their CIH use. In future studies it would be important to explore whether some CIH modalities are more likely to cause harm to its users than others. Most CIH modalities are not currently incorporated into the health care system in Finland, yet its users report helpfulness of the used modalities \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and as according to our findings, 58.8% of CIH users intend to use CIH in the future. Thus, the possibilities of applying evidence-based CIH modalities for health promotion and pain management, and to limit the harm caused by CIH use should be further explored. Moreover, the finding that experienced everyday effectiveness of the used modalities of CIH has such a strong association with the intention to use CIH, suggests that both the economic and health consequences of CIH use deserve attention in public health research.\u003c/p\u003e \u003cp\u003eOur study included 27 distinct CIH modalities, and an earlier study on the same data showed that the most important reason for use depended highly on the CIH modality in question \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. The results of this study suggest that benefits experienced from CIH use seem strongly associated with continued use of CIH. It remains for future research to assess the associations between the experienced benefits and harms of specific CIH modalities and the intention to continue their use.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe results of this study are not without limitations. It was outside of the scope of the survey to detail the experienced benefits and harms for each of the included CIH modalities. There are still clear difficulties in determining a \u0026rdquo;CIH user\u0026rdquo;, as the definitions of which modalities are included into the umbrella term of CIH are dynamic. In this study, the researcher-defined \u0026ldquo;CIH user\u0026rdquo; could have excluded people who perceived themselves as CIH users but had not used CIH in the 12-months prior to taking the survey. Similarly, as evident from the open-ended answers to experienced benefits and harms, some people who were defined as CIH users did not perceive themselves as such. Additionally, the current study did not assess ethnicity, yet this should be considered in future CIH-use related studies in Finland. For example, more attention should have been paid to S\u0026aacute;mi representation in designing the survey, as the survey did not detail any modalities of S\u0026aacute;mi traditional medicine which differ from the surveyed CIH modalities (e.g., traditional helper)\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. Lastly, recall bias might have influenced respondents\u0026rsquo; answers in which CIH modalities they had used \u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e or the benefits and harms they had experienced.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study examined the relationship between CIH users\u0026rsquo; intent to use CIH in the future, and SRH, experienced benefits and harms from CIH use in Finland. Having experienced benefits from CIH use was related to intention to maintain CIH usage, whereas having experienced harms was inversely related to the intention. Easing of pain or related ailment was found to be the most strongly related benefit to the intention to use CIH in the future, whereas money being wasted on CIH was found to be inversely related to the intention. CIH was used by both respondents of poor and good SRH. The intention to continue CIH use was not found to be associated to SRH, possibly due to CIH being used both for treatment of various health conditions, and for health promotion to maintain well-being. Our results suggest that the intention to use CIH is related to the experienced everyday effectiveness of the used CIH modalities. The results provide information for planning CIH policy and legislation in Finland.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e. We acknowledge Kantar Public for collecting the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e PA, SA and KH conceived the study and translated the I-CAM-Q questionnaire from English and Norwegian to Finnish. MPy and MPa performed the initial and final analyses. MPy and PA drafted the initial version of the paper and all authors reviewed subsequent versions and read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003eThe data collection of this study has been funded by Lapsi ja Luonto S\u0026auml;\u0026auml;ti\u0026ouml; (Child and Nature Fund), Helsinki, Finland. No further funding was received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e The authors have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e The dataset this paper has been based on has not been deposited in any repository. All dataset and materials are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e. An informed consent to participate in the survey was obtained from each respondent. This study does not cause any potential risks or harm to survey respondents, and it meets the ethical requirements of research with human participants according to The Finnish National Board on Research Integrity guidelines. The ethical approval was deemed unnecessary by the Academic Ethics Committee of the Tampere region. According to a statement from the Academic Ethics Committee of the Tampere region, ethical review is to be carried out prior to gathering data only if the research contains one or more of the following factors: 1) Participation in the research deviates from the principle of informed consent (participation is not, for example, voluntary, or the subject is not given sufficient or correct information about the research), 2) The research involves intervening in the physical integrity of research participants, 3) The focus of the research is on minors under the age of fifteen, without separate consent from a parent or carer, or without informing a parent or carer in a way that would enable them to prevent the child\u0026rsquo;s participation in the research, 4) Research that exposes participants to exceptionally strong stimuli, 5) Research that involves a risk of causing mental harm that exceeds the limits of normal daily life to the research participants or their family members or others closest to them, 6) Conducting the research could involve a threat to the safety of participants or researchers or their family members or others closest to them. Our research does not contain any of the aforementioned factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO). WHO traditional medicine strategy: 2014\u0026ndash;2023, Geneva. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/9789241506096\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/9789241506096\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2013, accessed 17 May 2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKemppainen LM, Kemppainen TT, Reippainen JA, et al. Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. 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BMC Complement Altern Med. 2016;16:75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSirois FM, Riess H, Upchurch DM. Implicit Reasons for Disclosure of the Use of Complementary Health Approaches (CHA): a Consumer Commitment Perspective. Ann Behav Med. 2017;51:764\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO). \u003cem\u003eWHO global report on traditional and complementary medicine 2019\u003c/em\u003e. Geneva, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/978924151536\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/978924151536\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (16 May 2019, accessed 17 May 2024).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePosadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. 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J Altern Complement Med. 2009;15:331\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAarva P, V\u0026auml;\u0026auml;n\u0026auml;nen T, Kankkunen T-T. El\u0026auml;m\u0026auml;ni on muuttunut kokonaan: Tutkimus perusteluista luontaishoitojen k\u0026auml;yt\u0026ouml;lle ja niist\u0026auml; saadulle avulle. \u003cem\u003eElore\u003c/em\u003e; 29. Epub ahead of print 30 December 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.30666/elore.120898\u003c/span\u003e\u003cspan address=\"10.30666/elore.120898\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOuma A, Jacobsson L, Nilsson L-M. S\u0026aacute;mi traditional medicine and complementary and alternative medicine \u0026ndash; a descriptive study of use within the S\u0026aacute;mi population of Sweden. \u003cem\u003eInt J Circumpolar Health\u003c/em\u003e; 82. Epub ahead of print 31 December 2023. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/22423982.2023.2222908\u003c/span\u003e\u003cspan address=\"10.1080/22423982.2023.2222908\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJensen HAR, Ekholm O. Therapy-dependent inconsistencies in self-reported use of complementary and alternative medicine in the general population: findings from a longitudinal study. BMJ Open. 2021;11:e051647.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"complementary and integrative health, complementary and alternative medicine, CIH, CAM, Finland, intention to use, self-rated health","lastPublishedDoi":"10.21203/rs.3.rs-4435651/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4435651/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe estimated prevalence of the use of complementary and integrative health (CIH) approaches varies between 24\u0026ndash;71% in adult populations worldwide. Little is known about the intention to maintain their use. This study aimed to examine whether the experienced benefits and harms of CIH use, and self-rated health (SRH) relate to the intention to use CIH in the future in current users.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 1652 Finnish CIH users completed an online-survey in December 2022, out of which 58.8% intended to use CIH in the future. Binary logistic regression analyses were used to examine the relationship between the intention to use CIH, experienced benefits and harms of CIH use and SRH.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eHaving experienced at least one type of benefit from CIH use compared to no experienced benefits was related to the intention to use CIH (OR\u0026thinsp;=\u0026thinsp;19.3, 95%CI\u0026thinsp;=\u0026thinsp;11.05 to 33.80). Conversely, having experienced at least one harm from CIH use compared to no harms was inversely related to the intention to use CIH (OR\u0026thinsp;=\u0026thinsp;0.27, 95%CI\u0026thinsp;=\u0026thinsp;0.20 to 0.35). Easing of pain or related ailment was found to be the most strongly related benefit to the intention to use CIH. SRH was not found to be statistically significantly related to the intention to use CIH.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study highlights the importance of the benefits and harms CIH users experience on the continuation of CIH use. The intention to maintain use relates to everyday effectiveness of CIH experienced by users.\u003c/p\u003e","manuscriptTitle":"The relationship between experienced benefits and harms of using complementary and integrative health approaches and intention to maintain their use in Finland","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-05 12:38:47","doi":"10.21203/rs.3.rs-4435651/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2e3db1af-1986-4bf2-ae9a-d97f2f04b054","owner":[],"postedDate":"June 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-25T10:53:19+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-05 12:38:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4435651","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4435651","identity":"rs-4435651","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}