BackgroundComplementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate.Methods218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey©®.ResultsA total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator ®, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon.ConclusionsThis mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic, CAM professionals, and pediatric healthcare providers. The pediatric diplomate certificate was established in 1993 and provides didactic education over a 2 to 3 year span. The results of this study can be used for historical information as this specialty continues to grow.

Objective: To describe recruitment and enrollment experiences of 2 low back pain (LBP) randomized controlled trials (RCTs). Design: Descriptive report. Setting: Chiropractic research center in the midwest United States that is not a fee-for-service clinic. Participants: Both trials enrolled participants with subacute or chronic LBP without neurologic signs who had not received spinal manipulative care during the previous month. For study 1 we screened 1940 potential participants to enroll 192 participants (89 women and 103 men), mean age 40.0 Ϯ 9.4 years (range, 21-54 years). For study 2 we screened 1849 potential participants to enroll 240 participants (105 women and 135 men) at least 55 years old (mean, 63.1 Ϯ 6.7 years). Interventions: Study 1 randomly assigned participants to 2 weeks of 2 different chiropractic techniques or a wait list control group. Study 2 randomly assigned participants to 6 weeks of 2 different chiropractic techniques or medical care consisting of 3 provider visits for medications. Outcome measures: Recruitment source costs and yield, and baseline characteristics of enrolled versus nonparticipants were recorded. Results: We conducted 3789 telephone screens for both trials to enroll 432 (11%) participants, at a cost in excess of $156,000 for recruitment efforts. The cost per call for all callers averaged $41, ranging from $4 to $300 based on recruitment method; for enrolled participants, the cost per call was $361, ranging from $33 to $750. Direct mail efforts accounted for 62% of all callers, 57% for enrolled participants, and had the second lowest cost per call for recruitment efforts. Conclusions: It is important that complementary and alternative medicine (CAM) research can be successfully conducted at CAM institutions. However, the costs associated with recruitment efforts for studies conducted at CAM institutions may be higher than expected and many self-identified participants are users of the CAM therapy. Therefore, strategies for efficient recruitment methods and targeting nonusers of CAM therapies should be developed early for CAM trials. 983

Understanding patient responses across survey modes is critical for the cultivation of quality business intelligence within college teaching clinic settings. This study bridges measurement evidence from three popular data collection modalities and offers support for higher levels of quality for web-based data collection.

Objective : Changes in small business and insurance present challenges for newly graduated chiropractors. Technology that reaches identified, diverse learning styles may assist the chiropractic student in business classes to meet course outcomes better. Thus, the purpose of our study is to determine if the use of technology-based instructional aids enhance students' mastery of course learning outcomes. Methods : Using convenience sampling, 86 students completed a survey assessing course learning outcomes, learning style, and the helpfulness of lecture and computer-assisted learning related to content mastery. Quantitative analyses occurred. Results : Although respondents reported not finding the computer-assisted learning as helpful as the lecture, significant relationships were found between pre- and post-assisted learning measures of the learning outcomes 1 and 2 for the visual and kinesthetic groups. Surprisingly, however, all learning style groups exhibited significant pre- and post-assisted learning appraisal relationships with learning outcomes 3 and 4. Conclusion : While evidence exists within the current study of a relationship between students' learning of the course content corollary to the use of technologic instructional aids, the exact nature of the relationship remains unclear.

PurposeFifty to 80% of pregnant women suffer from low back pain (LBP), a condition commonly treated by doctors of chiropractic (DC). Holzer Clinic, an Appalachian integrative health facility with 140 multispecialty physicians, utilizes both conventional prenatal and chiropractic care for their pregnant patients. This study assessed the feasibility to conduct a prospective case series of LBP patients receiving concurrent conventional prenatal and chiropractic care overseen by an off-site project manager (PM). MethodsWomen age 21 and over receiving conventional prenatal care at Holzer Clinic who were referred to chiropractic care for LBP complaints were invited to participate in this IRB-approved study. The PM conducted a phone screen interview to determine eligibility. Completed baseline and 4 week questionnaires were mailed to the PM. Assessments included the Bournemouth Disability Questionnaire (BDQ), Numerical Rating Scale (NRS) for LBP, global improvement (GI) and adverse events (AE). ResultsThirty-nine women consented to participate in the study; 17 met all eligibility criteria. Exclusions were for age, LBP before pregnancy and no DC visit. Of the 13 participants who completed both questionnaires, all were white with a mean age of 28.4 (SD 1.1) and a median gestational age of 11.0 weeks (range 2-30). After 4 weeks of care the mean GI was 72%; mean improvement in BDQ was 5.8 (16%); and mean improvement in pain 2.3 (SD 2.18). AEs were mild (e.g. muscle soreness of less than 48 hours). ConclusionAlthough patient outcomes were favorable in this small study, recruitment and follow-up data collection were challenging. It is important to investigate the effectiveness of integrative care for LBP during pregnancy; however, it will require the commitment of adequate resources and collaborations.