Complementary & Integrative Health

“Our studies have helped establish the evidence-base for many ‘complementary therapies’ that many Americans use to treat chronic pain and other conditions. This helps ensure that treatments are truly patient-centered.”

Karen J. Sherman, PhD, MPH
Senior Investigator, Kaiser Permanente Washington Health Research Institute

Research overview

Americans are increasingly using complementary and integrative medicine for pain and other health problems, according to national surveys. Kaiser Permanente Washington Health Research Institute (KPWHRI) has one of the nation's leading teams researching these approaches to healing. The team uses rigorous scientific methods to evaluate the effectiveness—and cost-effectiveness—of complementary and integrative therapies delivered as in real-world practice.

Many KPWHRI studies concern musculoskeletal conditions such as back pain, which accounts for a large portion of visits to alternative providers. National guidelines for treating back pain now include four complementary and integrative approaches: three of them—massage, yoga, and acupuncture—on the strength of Kaiser Permanente research.

"Our research has shown that massage, yoga, acupuncture, mindfulness-based stress reduction, and to a lesser extent spinal manipulation help relieve chronic low back pain," says KPWHRI Senior Investigator Dan Cherkin, PhD. "But the reasons why these treatments are helpful remain unclear."

The stress-reducing aspects of some treatments may be more important than the physical ones. Also, complementary and integrative practitioners often approach their patients with optimism, offer suggestions for ways they can achieve more balance in their lives, and coach them on becoming more involved in their own healing and self-care. “We’re very interested in self-care: things that people can do for themselves,” says Senior Investigator Karen Sherman, PhD, MPH.

"We are understanding better how the mind and body are intricately connected, with both important for healing to occur," Dr. Sherman says. "In primary care, we hope to harness the mind-body connection to enhance healing for various health problems that don't respond well to conventional treatments."

Drs. Sherman and Cherkin have worked with Clarissa Hsu, PhD, an assistant investigator at KPWHRI‘s Center for Community Health and Evaluation, on qualitative research for several projects. 

Recent publications on Complementary and Integrative Health

Kligler B, Bair MJ, Banerjea R, DeBar L, Ezeji-Okoye S, Lisi A, Murphy JL, Sandbrink F, Cherkin DC. Clinical policy recommendations from the VHA state-of-the-art conference on non-pharmacological approaches to chronic musculoskeletal pain. J Gen Intern Med. 2018 Apr 9. pii: 10.1007/s11606-018-4323-z. doi: 10.1007/s11606-018-4323-z. [Epub ahead of print]. PubMed

Becker WC, DeBar LL, Heapy AA, Higgins D, Krein SL, Lisi A, Makris UE, Allen KD. A research agenda for advancing non-pharmacological management of chronic musculoskeletal pain: findings from a VHA state-of-the-art conference. J Gen Intern Med. 2018 Apr 9. pii: 10.1007/s11606-018-4345-6. doi: 10.1007/s11606-018-4345-6. [Epub ahead of print]. PubMed

Suri P, Delaney K, Rundell SD, Cherkin DC. Predictive validity of the STarTback tool for risk of persistent disabling back pain in a United States primary care setting. Arch Phys Med Rehabil. 2018 Apr 3. pii: S0003-9993(18)30204-1. doi: 10.1016/j.apmr.2018.02.016. [Epub ahead of print]. PubMed

Saper RB, Lemaster C, Delitto A, Sherman KJ, Herman PM, Sadikova E, Stevans J, Keosaian JE, Cerrada CJ, Fernia AL, Roseen EJ, Gardiner P, Gergen-Barnett K, Faulkner C, Weinberg J. Yoga, physical therapy, or education for chronic low back pain: a randomized noninferiority trial. Ann Intern Med. 2017 Jun 20. doi: 10.7326/M16-2579. [Epub ahead of print]. PubMed

Johnson ES, Dickerson JF, Vollmer WM, Rowley AM, Ritenbaugh C, Deyo RA, DeBar L. The feasibility of matching on a propensity score for acupuncture in a prospective cohort study of patients with chronic pain. BMC Med Res Methodol. 2017 Mar 16;17(1):42. doi: 10.1186/s12874-017-0318-4. PubMed

Researchers in Complementary and Integrative Health

Daniel C. Cherkin, PhD

Senior Investigator (Emeritus)
206-287-2875
Dan.C.Cherkin@kp.org

Curriculum vitae (CV)

Karen J. Sherman, PhD

Senior Investigator
206-287-2426
Karen.J.Sherman@kp.org

Curriculum vitae (CV)

Katherine M. Newton, PhD

Senior Investigator (Emeritus)
206-287-2973
Katherine.M.Newton@kp.org

Curriculum vitae (CV)

Andrea J. Cook, PhD

Senior Investigator
206-287-4257
Andrea.J.Cook@kp.org

Curriculum vitae (CV)

Clarissa Hsu, PhD

Assistant Investigator
206-287-4276
Clarissa.W.Hsu@kp.org

Curriculum vitae (CV)

Ben Balderson, PhD

Research Associate
206-287-2803
Benjamin.H.Balderson@kp.org

Curriculum vitae (CV)

Eric Johnson, MS

Biostatistician
206-287-2105
Eric.Johnson@kp.org

Curriculum vitae (CV)

Robert D. Wellman, MS

Biostatistician
206-287-2557
Robert.D.Wellman@kp.org

Curriculum vitae (CV)

Lorella Palazzo, PhD

Research Associate
206-287-2173
Lorella.G.Palazzo@kp.org

Curriculum vitae (CV)

Marlaine Gray, PhD

Acting Assistant Investigator
206-287-2620
Marlaine.S.Figueroagray@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)

Affiliate researcher

Susan D. Reed, MD, MPH

Harborview Medical Center; University of Washington (UW) Department of Obstetrics and Gynecology