Barriers and Facilitators to Integrating Acupuncture into the U.S. Health Care System: A Scoping Review


Author: Hongjin Li1,2, Juanita E Darby1, Ivy Akpotu1, Judith M Schlaeger1, Crystal L Patil3, Oana Danciu2, Andrew D Boyd4, Larisa Burke1, Miriam O Ezenwa5, Mitchell R Knisely6, Ta-Ya Lee7, Molly W Mandernach8, Victoria A de Martelly1, Robert E Molokie9, Nirmish Shah10, Diana J Wilkie5, Ardith Z Doorenbos1,2

Affiliation: <sup>1</sup> College of Nursing, University of Illinois Chicago, Chicago, IL, USA.

<sup>2</sup> University of Illinois Cancer Center, Chicago, IL, USA.

<sup>3</sup> School of Nursing, University of Michigan, Ann Arbo, MI, USA.

<sup>4</sup> College of Applied Health Science, University of Illinois Chicago, Chicago, IL, USA.

<sup>5</sup> College of Nursing, University of Florida, Gainesville, FL, USA.

<sup>6</sup> School of Nursing, Duke University, Durham, NC, USA.

<sup>7</sup> Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.

<sup>8</sup> School of Nursing, Duke University, Gainesville, FL, USA.

<sup>9</sup> Jesse Brown VA Medical Center, Chicago, IL, USA.

<sup>10</sup> Department of Medicine, Duke University, Durham, NC, USA.
Conference/Journal: J Integr Complement Med
Date published: 2024 Aug 2
Other:
  Special Notes: doi: 10.1089/jicm.2023.0603.   ,  Word Count: 252  
    Background: Acupuncture is a widely practiced complementary and integrative health modality that has multiple clinical applications. The use of acupuncture in the United States is rapidly increasing. Although studies have shown the efficacy and effectiveness of acupuncture for various ailments, the integration of acupuncture into the U.S. health care system remains a challenge. Little is known about the factors affecting this integration. Objective: To provide a systematic review of the barriers and facilitators affecting the integration of acupuncture into the U.S. health care system. Methods: Four electronic databases were searched. Three independent reviewers were involved in the screening and data charting processes. Findings were synthesized and categorized into four levels based on the Social Ecological Model. Results: A total of 22 studies were included in the final review. The barriers and facilitators affecting the integration of acupuncture were mapped into four levels (individual, interpersonal, organizational, and policy). The most frequently reported barriers and facilitators were mapped into the Social Ecological Model constructs within the "Individual" level (i.e., beliefs and attitudes of acupuncture, and practical issues) and the "Organizational" level (i.e., credentialing, space and facility, referral system). Conclusion: This review has identified and synthesized the breadth of evidence on the barriers and facilitators to the integration of acupuncture into the U.S. health care system. Results of this review will guide future implementation studies to develop and test implementation strategies to integrate acupuncture into the U.S. health care system.



Keywords: acupuncture; barriers; facilitators; implementation; integration; review.



PMID: 39093944 DOI: 10.1089/jicm.2023.0603