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Cora Collette Breuner, MD; Paul J. Barry, MSW; Kathi J. Kemper, MD, MPH

Arch Pediatr Adolesc Med. 1998;152:1071-1075.

Background  Mainstream health care for homeless youth is often fragmented or unavailable.

Objective  To evaluate the use of complementary and alternative medicine (CAM) by homeless youth who use our free clinic.

Design  Self-administered cross-sectional survey.

Subjects and Methods  Subjects included homeless youth between the ages of 14 and 21 years receiving care at the 45th Street Clinic Youth Program in Seattle, Wash, between January 29, 1998, and March 5, 1998. The self-administered survey included items on demographics, health issues, use frequency of different therapists or therapies, referral sources, and perceived effectiveness of treatment.

Results  The response rate by patients was 96.3% (157/163) with an average respondent age of 18.5 years (range, 14-21 years). Complementary and alternative medicine was used by 70.1% of the subjects. Referrals most often came from friends (52.7%). The most common reason for using CAM was because it was "natural" (43.9%). Most of those who used alternative therapies (87.3%) believed they had been helped "some" or "a lot." Given a choice of providers to visit when they were ill, 51.7% would seek care from a physician, 36.9% from a CAM provider, and 11.4% would treat themselves.

Conclusions  Care with CAM is frequently used and accepted by homeless youth. Cost-effectiveness and contributions to overall health care require additional evaluation. Integrating CAM into allopathic health centers may serve as an incentive to entice youth into mainstream health care.

From the Departments of Pediatrics (Dr Breuner) and Health Services (Dr Kemper), University of Washington; 45th Street Clinic Youth Program (Mr Barry); and the Family Medicine Residency at Swedish Medical Center (Drs Breuner and Kemper), Seattle, Wash.

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