Health promotion activities include any health-related intervention that has been designed to enhance health; they incorporate all strategies related to health. Given that most complementary and alternative medicine (CAM) therapies, or complementary and alternative practices and products (CAPPs), have an underlying philosophy rooted in promotion and maintenance of health, these may be considered closely related to health promotion strategies for individuals, families, and communities. 1 Despite evidence of the effectiveness of health promotion in extending healthy life and minimizing health care costs, 2 conventional health care practices do not often integrate CAPPs as preventive strategies. This can potentially translate into higher costs-in both dollars and quality of life-to individuals, families, and communities.

There is no longer debate about the high popularity of CAPPs in the United States. 3 The increased use of CAPPs by the American public is an opportunity for family and community health care practitioners to explore and refine their knowledge about these modalities and therapies. The purpose of this special issue of Family and Community Health (26:1) is to discuss the relationship between health promotion and complementary therapies as they relate to community health issues. Given the widespread use of CAPPs by persons in the United States and the potential ties of the practices and products to health promotion, this issue focuses on four conditions in which the authors demonstrate the potential for CAPPs to effectively promote and maintain health of those individuals and families experiencing these chronic illnesses: diabetes mellitus, breast cancer, cardiovascular disease, and rheumatoid arthritis. In addition, the issue also addresses women using hormone replacement therapy for menopausal symptoms.

The relatively few manuscript submissions for this special issue indicate a need for further studies in the area of CAPPs in family and community health. Despite the limited number of articles, our goal will have been met if the issue serves only to raise readers' level of consciousness about complementary therapies and foster further inquiry in topics important to health promotion and symptom reduction in chronic illnesses seen across the life span. Regardless of the reasons that individuals and families turn to CAPPs, in many instances the modalities may have little or limited rigorous, evidence-based information. Even in conventional health care, however, this is often the case, as treatments may be based not on scientific evidence but on empirical experience. Thus, the time is right for family and community health care researchers and practitioners to explore scientifically the use of CAPPs. Providing an atmosphere that supports research will facilitate exploration of this vast area of study.

At the University of Virginia School of Nursing, the Center for the Study of Complementary and Alternative Therapies (CSCAT), established in 1995, is one of the original National Institutes of Health (NIH)-funded centers to examine the potential role of selected CAPPs in bringing about improved physical and psychological functioning and quality of life for individuals. The center serves as a mechanism to stimulate CAPP research of scientific and technical merit and to create linkages and collaboration with other researchers to support the National Center for Complementary and Alternative Medicine's (NCCAM) goal of scientifically and programmatically evaluating the efficacy, safety, and cost of CAPPs. Toward this end, the center offers predoctoral and postdoctoral trainees opportunities to conduct research in CAPPs. The training program, supported by an NIH-funded grant, prepares nurses, physicians, and allied scientists to do clinical research related to CAPPs as well as preclinical research needed to create the foundation for clinical studies.

The training program is interdisciplinary and involves the Schools of Nursing, Medicine, Engineering and Applied Science (specifically the Department of Biomedical Engineering), and the Sports Medicine Program in the Curry School of Education. The center has established collaborative relationships with more than 15 clinical departments and divisions within the University of Virginia Health System. Current postdoctoral trainees include three nurses, two medical doctors, a doctor of naturopathy, three individuals with doctoral degrees in psychology, and an individual trained in clinical pharmacology and psychology. Eight predoctoral trainees also are focusing their dissertation research in the area of CAPPs. The training program for each trainee is highly individualized depending on her or his background and interests. In addition to CAPP-related mentored research projects, a set of core courses also is available to all trainees. These include Fundamentals of Epidemiology, Introduction to Biostatistics, Statistical Computing and Graphics, Biostatistical Modeling, and Clinical Trials Methodology. To further enhance the training experience, the center promotes information exchange among trainees and faculty and fosters interdisciplinary research through a wide range of seminars.

An increasing number of practitioners desire education and training for total health care and seek to learn new knowledge and skills related to the integration of CAPPs with conventional health strategies. We anticipate that this special issue of Family & Community Health will add to the existing understanding of CAPPs in health care, heighten awareness of the need for more research in this field, and strengthen the close tie of health promotion to many evidence-based complementary practices and products.

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