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 Group Health 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

Cherkin DC, Anderson ML, Sherman KJ, Balderson BH, Cook AJ, Hansen KE, Turner JA. Two-year follow-up of a randomized clinical trial of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care for chronic low back pain. JAMA. 2017;317(6):642-644. doi: 10.1001/jama.2016.17814. PubMed

Cherkin DC, Sherman KJ, Balderson BH, Cook AJ, Anderson ML, Hawkes RJ, Hansen KE, Turner JA. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016 Mar 22-29;315(12):1240-9. doi: 10.1001/jama.2016.2323. PubMed

Keosaian JE, Lemaster CM, Dresner D, Godersky ME, Paris R, Sherman KJ, Saper RB. "We're all in this together": A qualitative study of predominantly low income minority participants in a yoga trial for chronic low back pain. Complement Ther Med. 2016 Feb;24:34-9. doi: 10.1016/j.ctim.2015.11.007. Epub 2015 Dec 2. PubMed

Cherkin D, Balderson B, Brewer G, Cook A, Estlin KT, Evers SC, Foster NE, Hill JC, Hawkes R, Hsu C, Jensen M, LaPorte AM, Levine MD, Piekara D, Rock P, Sherman K, Sowden G, Wellman R, Yeoman J. Evaluation of a risk-stratification strategy to improve primary care for low back pain: the MATCH cluster randomized trial protocol. BMC Musculoskelet Disord. 2016 Aug 24;17(1):361. doi: 10.1186/s12891-016-1219-0. PubMed

Chubak J, Hawkes R. Animal-assisted activities in pediatric oncology: results from a survey of top-ranked pediatric oncology hospitals. J Pediatr Oncol Nurs. 2015 Nov 20. pii: 1043454215614961. [Epub ahead of print].

Researchers in Complementary and Integrative Health

Daniel C. Cherkin, PhD

Senior Investigator (Emeritus)
206-287-2875
cherkin.d@ghc.org

Curriculum vitae (CV)

Karen J. Sherman, PhD

Senior Investigator
206-287-2426
sherman.k@ghc.org

Curriculum vitae (CV)

Katherine M. Newton, PhD

Senior Investigator (Emeritus)
206-287-2973
newton.k@ghc.org

Curriculum vitae (CV)

Andrea J. Cook, PhD

Senior Investigator
206-287-4257
cook.aj@ghc.org

Curriculum vitae (CV)

Clarissa Hsu, PhD

Assistant Investigator
206-287-4276
hsu.c@ghc.org

Curriculum vitae (CV)

Ben Balderson, PhD

Research Associate
206-287-2803
balderson.b@ghc.org

Curriculum vitae (CV)

Eric Johnson, MS

Biostatistician
206-287-2105
johnson.ex@ghc.org

Curriculum vitae (CV)

Robert D. Wellman, MS

Biostatistician
206-287-2557
wellman.r@ghc.org

Curriculum vitae (CV)

Lorella Palazzo, PhD

Research Associate
206-287-2173
palazzo.l@ghc.org

Curriculum vitae (CV)

Marlaine Gray, PhD

Research Associate
206-287-2620
gray.m@ghc.org

Curriculum vitae (CV)

Affiliate researcher

Susan D. Reed, MD, MPH

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