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Herbal Supplements as an Alternative to Medical Consultation: Exploring the

Pervasive Use of Non-FDA Approved Herbal Food Supplements and Its Influence
on the Public's Healthcare Decision-Making

A Documentation
Presented to the Faculty of
Nursing Department – College of Arts and Sciences Notre
Dame of Marbel University
Alunan Avenue, City of Koronadal

Presented by:
Maryelle Juhannah D. Conejar
Riki Denise M. Flores
Jayson P. Jalbuna
Jireh S. Torreres

In Partial Fulfillment of the

Requirements in

NCM - N 111
Nursing Research

Kristle Chiara Delos Santos RN, MAN

December 2023

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
INTRODUCTION

The landscape of healthcare is always changing as people look for new and different

ways to improve and preserve their health. The widespread usage of herbal supplements—

often marketed as a substitute for conventional medical consultation—is one new trend that

has drawn a lot of attention. In the unique setting of Koronadal City, this study explores the

field of herbal dietary supplements and aims to understand how the public forms healthcare

decisions.

In recent years, using herbal supplements has grown in popularity as a substitute for

traditional pharmaceutical interventions and medical consultations. Due to this change in

the way healthcare decisions are made, there is an increasing dependence on herbal dietary

supplements with non-therapeutic claims. These supplements are readily available and

frequently thought to be safe and natural. But the widespread usage of these supplements

raises questions about how they might affect people's ability to make decisions about their

own health and the general public's health.

This research seeks to investigate how popular use of herbal dietary supplements

with non-therapeutic claims affects the public's healthcare decision-making in Koronadal

City. This study aims to shed light on the implications of this trend for public health and

healthcare policy in the particular context of Koronadal City by investigating the factors

that lead people to choose herbal supplements over medical consultation, as well as the

possible risks and benefits associated with their use.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
Additionally, the research Department
will examine the information sources that influence the

public's decision-making on the use of herbal supplements. Their popularity has been

boosted by the prevalence of social media, internet platforms, and firsthand accounts in the

information-sharing process regarding these supplements. It is critical to assess if these sites

offer reliable, fact-based information or if they spread false information that could

jeopardise the health of consumers. This study will investigate the reasons for using herbal

supplements, the items' perceived efficacy, and how using them affects people's decisions

about healthcare in the neighbourhood through a qualitative research approach and

interviews. Further, this study will investigate the regulatory framework governing herbal

supplements in Koronadal City, as well as the potential risks associated with their

consumption, such as adverse reactions and interactions with conventional medications.

Furthermore, this study intends to shed light on Koronadal City's increasing reliance

on herbal food supplements in place of medical advice and to guide public health

programmes and regulations that support responsible and knowledgeable healthcare

decision-making in the neighbourhood. The purpose of this study is to contribute to the

development of evidence-based strategies for managing the increasing prevalence of these

products in the healthcare landscape within this particular setting by gaining an

understanding of the factors driving the use of herbal supplements and their potential

impact on public health in Koronadal City.

The research will also look at the size of the market, sales patterns, and consumer

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
spending on herbal goods in relation to theDepartment
herbal supplement industry's economic impact

on Koronadal City. This will clarify the financial importance of herbal supplements and

how they support the local economy. The study will look into any possible interactions

between prescription drugs and herbal supplements, as well as how common polypharmacy

is among patients receiving both kinds of care. Healthcare professionals must comprehend

these relationships in order to guarantee patients receive safe and efficient treatment plans.

The study will investigate the ethical and sustainable aspects of producing and procuring

herbal supplements in Koronadal City.

Lastly, the findings of this research will not only contribute to the existing body of

knowledge on herbal supplement use but also provide practical recommendations for

healthcare providers, policymakers, and regulatory agencies in Koronadal City to address

the challenges posed by the widespread use of non-FDA approved herbal food supplements.

By identifying the motivations behind their use, assessing their perceived effectiveness, and

understanding their potential risks, this research aims to facilitate informed decision-making

and promote safe and effective healthcare practices within the local community.

Review of Related Literature

The review of related literature (RRL) provides a comprehensive examination of

existing knowledge, theories, and research findings relevant to the subject under

investigation. In this context, the RRL serves as a foundation for understanding the

historical development, key concepts, and gaps in the current understanding of the

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
pervasive use of non-FDA approved Department
herbal food supplements and its implications on

healthcare decision-making, particularly within the local context of Koronadal City,

Philippines.

Herbal Medicine

The Philippines, blessed with abundant regions of nutrient-rich soil, boasts diverse

landscapes such as lush forests, vast plains, and mountains, fostering impressive

biodiversity. A staggering 13,500 plant species thrive in this environment, with 3,500

considered indigenous. Among these, a modest 120 have undergone scientific validation for

both safety and efficacy, emphasizing the vast untapped potential in the country's flora.

Despite the richness in plant species, there is a pressing need for further exploration and

discovery of medicinal herbs that could prove beneficial to human health. The existing

knowledge, though substantial, only scratches the surface of the potential medicinal value

residing in the Philippines' diverse plant life. Remarkably, only 10 plants have been

endorsed by the Department of Health (DOH) as medicinal, a classification endorsed by the

Philippine Institute for Traditional and Alternative Health Care (PITAHC) in both 1993 and

1997. This limited endorsement underscores the gap in support for exploring the medicinal

potential of other plant species, hindering their market potential. (Marquez et al., 2019)

The practice of herbal medicine in the Philippines has a long-standing history rooted

in the folkloric use of herbal plants by ancestors. In recent decades, there has been a

growing interest in validating these traditional claims through scientific research. The

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
government has shown support Nursing Department
by identifying and recommending certain medicinal plants

for their potential health benefits. However, the lack of scientific evidence has hindered the

popular acceptance of these plants. Despite these challenges, the field of herbal medicine in

the Philippines has seen significant progress. In the past decade, three herbal drugs,

including Vitex negundo (lagundi) for cough and mild asthma, Momordica charantia

(ampalaya) for diabetes, and Blumea balsamifera (sambong) for kidney stones, have

emerged in the market, offering a glimmer of hope for the integration of herbal medicine

into mainstream healthcare practices.

A major breakthrough occurred in 2012 with the launch of the "Tuklas Lunas"

program by the Department of Science and Technology (DOST). This program aimed to

develop standardized herbal drugs through extensive research and development activities.

As a result, 28 herbal drugs have been created and are currently undergoing clinical testing.

The "Tuklas Lunas" program represents a significant step forward in the validation and

integration of herbal medicine into conventional healthcare practices in the Philippines.

Through ongoing clinical trials, these herbal drugs have the potential to provide evidence-

based alternatives for various health conditions. The progress made in herbal medicine

research and development, coupled with government support, signifies a promising future

for the utilization of herbal remedies in the healthcare system of the Philippines. (Tupas, G.,

2012)

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Regulatory FrameworkNursing Department
for Herbal Supplements

Herbal medicines, with a longstanding history, face diverse regulatory approaches

across different regions, ranging from established frameworks to recent regulations.

Emotional and cultural connections often exist, particularly within families and

communities, influencing the utilization of traditional remedies. The marketing of herbal

and dietary supplements often relies on health claims, but without proper education, this

may lead to their inappropriate substitution for pharmaceutical drugs, posing potential risks

(Zhu et al., 2019). Concerns about adverse effects, including hepatotoxicity and

carcinogenicity, emphasize the critical safety considerations for regulatory authorities. The

gap between increasing use and limited knowledge about risks underscores the need for

global regulatory discussions, exploring the role of emerging technologies and big data in

creating a more unified and improved regulatory framework for the safe application of

dietary supplements and herbal medicines.

The distinction between natural substances being viewed as either health

supplements or medicines varies significantly worldwide based on regulatory practices. The

absence of a global consensus on product definition and categorization poses a primary

challenge in initiating regulatory conversations, driven by the diverse and independent

decisions made within different jurisdictional regulatory schemes (Borins, 1998; Kayne,

2010).

The Global Coalition for Regulatory Science Research (GCRSR) was established in

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
2013, led by the US Food and Drug Department
Administration (FDA), and includes regulatory bodies

from ten countries, such as the European Union (EU). This coalition focuses on fostering

international collaborations and partnerships that leverage emerging technologies and big

data science to enhance regulatory science research, particularly in the assessment of the

safety and efficacy of foods and drugs. Its overarching goal is to facilitate the development

of regulatory science research as a practical tool for advancing public health objectives

related to the safety of food and therapeutic products. Since its inception, GCRSR has

organized the annual GSRS conference, starting in 2013, to promote enhanced

communication among international regulators (Slikker et al., 2018; Tong et al., 2015).

The 2018 GSRS conference, the 8th consecutive summit, took place from September

26 to 27 in Beijing, China, hosted at the National Institutes for Food and Drug Control.

During this event, discussions revolved around the risks and benefits associated with dietary

supplements and herbal medicines. Presenters representing ten countries, including China,

Korea, Japan, India, the EU, USA, Canada, and Australia, shared insights. The summit

commenced with an exploration of the global regulatory structure for dietary supplements

and herbal medicines, acknowledging that a substantial portion, over 80%, of the world's

population utilizes these products.

According to the Regulatory Policies on and Benefits of Herbal Medicine in the

Philippines, (Zarsuelo, M., 2018) The DTI and the Chamber of Herbal Industries of the

Philippines, Inc. (CHIPI) work together to oversee the production of herbal products in the

Philippines. Together with the Department of Science and Technology (DOST), CHIPI also
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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
conducts research and development Department
for the herbal products industry.4 Herbal products

include a broad range of herbal supplements, medications, and other relevant items used in

alternative health care, in addition to the plant-based materials from which they were

derived.

The passage discusses the enactment of the Traditional and Alternative Medicine

Act in 1997 (RA 8423) in the Philippines, marking a significant development in the global

legal framework for herbal medicines. While lagging behind countries like India,

Bangladesh, and Indonesia, which passed similar regulations earlier, RA 8423 preceded the

World Health Organization's (WHO) Guidelines for the Appropriate Use of Herbal

Medicines (1998) and the European Union's Directive on Traditional Herbal Medicine

Products (2004). The WHO guidelines aim to provide general and flexible steps to support

countries in promoting, developing, and regulating herbal medicines, emphasizing their

appropriate integration into mainstream health services. Meanwhile, the EU's Directive

outlines regulatory approval processes for herbal products among its member states,

including clear definitions for terms like "herbal substance" and "traditional herbal

medicine products." RA 8423 establishes the legal foundation for enhancing healthcare

services in the Philippines through the development of traditional and alternative health

care, with objectives that include formulating standards, guidelines, and ethical codes, as

well as defining "herbal medicine." The Act also led to the creation of the Philippine

Institute of Traditional and Alternative Health Care (PITAHC), tasked with research,

development, promotion, and advocacy of traditional and complementary medicine,

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
ensuring accessibility, availability, Department
sustainability, and integration into the national health

care system.

RA 8423 further brings about the establishment of the Philippine Institute of

Traditional and Alternative Health Care (PITAHC), positioned under the Department of

Health (DOH) and governed by the Board of Trustees. Comprising representatives from

various government departments and sectors involved in traditional and alternative

healthcare, the Board oversees PITAHC's corporate powers and activities. The institute

plays a pivotal role in advancing research, development, and standards in traditional and

complementary medicine, aiming to integrate these practices effectively into the national

healthcare system. The diverse composition of the Board reflects the interdisciplinary

nature of traditional and alternative healthcare, with representatives from fields such as

environmental organizations, academia, non-physician practitioners, and the natural and/or

organic food industry, among others.

Non-FDA approved supplements in the Philippines

The Philippines, known for its rich biodiversity, recognizes the importance of

developing alternative medicines derived from plant sources. The regulation of these health

products falls under the jurisdiction of the Food and Drug Administration (FDA). However,

the current regulatory system faces challenges, particularly in addressing the proliferation

of unregistered and variable-quality herbal products. To ensure public safety and harmonize

regulatory processes within the ASEAN region, the Philippines needs to strengthen its

regulatory framework by aligning FDA regulations with national laws, such as the

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
Traditional and Alternative Medicines ActDepartment
(TAMA). This involves identifying gaps and

weaknesses in the implementation of existing regulations through consultations with

stakeholders, including FDA representatives, the Philippine Institute of Alternative

Healthcare (PITAHC), scientists, academicians, professional organizations, medical

practitioners, and consumer groups.

In a preliminary study, qualitative methods were employed to review policies on

traditionally-used herbal products, herbal medicines, and food supplements. Key informant

interviews with FDA and PITAHC representatives, as well as focus group discussions

(FGDs) with various stakeholders, were conducted. The study aimed to gather perspectives

on the gaps in the regulatory system and recommendations for improvement. Nine FGDs

were conducted across different regions of the Philippines to ensure representation from

Luzon, Visayas, and Mindanao. By addressing the identified weaknesses and aligning

regulations with TAMA, the goal is to enhance the local food supplement and herbal

medicine industry's ability to meet the country's health needs while protecting both regional

and national interests.

Integration of Herbal Medicine into Mainstream Healthcare

According to Dr. Lazarte, C., 2020, The Philippine healthcare system grapples with

persistent challenges, notably the exorbitant cost of both branded and generic drugs,

exceeding international reference prices by 22 and 4 times, respectively. Despite legislative

efforts like the Cheaper Medicines Act of 2008 and the Generics Act of 1988, individuals in

lower-income brackets still face difficulties affording essential medications for chronic

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
conditions and antibiotics. Access Department
to healthcare services, particularly for those in

geographically isolated and disadvantaged areas, remains a significant hurdle due to

physical and economic barriers.

Traditional Filipino medicine, deeply rooted in centuries-old practices, particularly

herbal medicine, is widely embraced in rural areas. However, validating the efficacy of

traditional medicinal plants through research is crucial for establishing evidence-based

practices. The key research areas identified include herbal medicine quality and

standardization, preclinical pharmacological assessments and action mechanisms, and

clinical efficacy and safety assessments. These research endeavors aim to develop safe,

effective, and cost-efficient herbal medicines specific to the Philippines, offering a potential

long-term solution to the healthcare obstacles mentioned earlier. Despite being a valuable

resource with diverse applications for both non-communicable and communicable diseases,

limited research in this field has been ongoing in the Philippines. The impetus for increased

support came with the passage of the Traditional and Alternative Medicine Act of 1997,

signifying the government's commitment to fostering the support and development of

traditional medicine, including herbal medicine.

Statement of the Problem

The general objective of this study is to qualitatively investigate the pervasive use of

non-FDA approved herbal food supplements in Koronadal City. Through an in-depth

exploration of local perspectives, cultural influences, regulatory dynamics, individual health

experiences, and their collective impact on decision-making, the research aims to provide a
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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
comprehensive understanding ofNursing Department
the factors contributing to the widespread use of non-FDA

approved herbal supplements. This overarching objective seeks to offer valuable insights

into the qualitative dimensions of herbal supplement practices within the local context of

Koronadal City such as the following specific objectives:

1. What are the factors contributing to the pervasive use of non-FDA approved herbal

food supplements as an alternative to medical consultation?

2. How does the lack of regulation and standardization for herbal supplements impact

public health and safety?

3. What is the extent of consumer awareness and education regarding the risks and

benefits associated with non-FDA approved herbal supplements?

4. What are the potential health risks and side effects associated with the unregulated

use of herbal supplements, particularly in the absence of medical consultation?

5. How does the pervasive use of herbal supplements without medical consultation

affect healthcare systems, resource allocation, and the overall efficacy of healthcare

delivery?

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Theoretical Framework Nursing Department

The theoretical framework is employed in this study to provide a structured and

conceptual basis for understanding and interpreting the complex phenomena related to the

pervasive use of non-FDA approved herbal food supplements in Koronadal City. It serves

as a guiding framework that helps researchers organize and integrate various factors,

variables, and relationships relevant to the research topic. The theoretical framework

establishes a foundation for the study by drawing on existing theories and concepts related

to cultural influences, regulatory dynamics, and individual health experiences.

Enhancing Trust and Market Potential for Herbal Medicines in the Philippines

In the context of the Philippines' rich biodiversity and the vast potential of its plant

species, this theoretical framework focuses on the factors influencing the trust and market

potential of herbal medicines. Cultural perceptions, bolstered by the vast array of

indigenous plants, play a pivotal role in shaping societal attitudes toward herbal remedies.

The limited endorsement of medicinal plants by health authorities highlights the untapped

potential in the herbal medicine market. Despite the comparatively modest market value of

herbal drugs, constituting approximately 1% of total drug sales, there is a significant

opportunity for growth. Trust is identified as a critical element, as consumer confidence in

herbal medicines can drive the pharmaceutical industry and academia to explore, develop,

and promote additional herbal remedies, contributing to the expansion of treatment options

and economic viability in the long term.

This theoretical framework envisions an interconnected relationship between cultural

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
perceptions, market potential, and Department
consumer trust. The study, set in the National Capital

Region (NCR), seeks to uncover the extent to which consumers trust and prefer herbal

medicines for health-related purposes. The findings aim to serve as a foundation for

understanding the untapped potential of herbal medicines in the market, encouraging

industry diversification and motivating academic research for the discovery and refinement

of medicinal substances in plants. As subsequent studies unfold, there is potential for

further exploration, fostering improvements in the herbal drug trade through the

formulation of new herbal medicines and the identification of additional plants with

medicinal properties. The research's focus on community perceptions and preferences offers

a valuable starting point for delving into the widespread use of herbal drugs and the pivotal

role they play in healthcare decisions within the Filipino context.

Factors Influencing the Use of Herbal Medicine in Germany

The increasing popularity of complementary and alternative medicine (CAM),

particularly herbal medicine (HM), necessitates an in-depth exploration of the factors

shaping its use. Existing literature highlights the growth of CAM, with a specific focus on

HM, but inconsistencies arise due to diverse methodologies, encompassing various

therapies under the 'CAM umbrella.' To address this, a clear and well-defined terminology

is essential. The current study aims to unravel the factors influencing the utilization of HM

in Germany. Drawing on Eisenberg et al.'s benchmark prevalence rates, the study focuses

on the socio-demographic characteristics and health status of typical HM users,

acknowledging potential variations across countries due to legal, health-insurance, and

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
cultural differences. By specifically Department
delving into the use of HM, the research aims to

overcome the limitations of generic CAM studies and provide nuanced insights into

Germany's unique context. The exploration of factors influencing the use of herbal

medicine in Germany aligns with the overarching research title, "Herbal Supplements as an

Alternative to Medical Consultation: Exploring the Pervasive Use of Non-FDA Approved

Herbal Food Supplements and Its Influence on the Public's Healthcare Decision-Making."

This theoretical framework offers a tailored perspective on HM, a specific subcategory of

herbal supplements, aiming to uncover unique patterns, motivations, and sources of

information among the German population. The study addresses the need for a focused

examination of HM use, contributing valuable insights that can inform the broader

discourse on herbal supplements and their impact on healthcare decision-making.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department

Figure 1 Theoretical Framework

Cultural and Social Influences

Regulatory Environment

Consumer and Awareness Education

Pervasive use of Health Care Health Risk and

Non-FDA Decision Making Benefits
approved Herbal
Supplements

Market Potential

Government Endorsement 17
 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department

This theoretical framework explores the various factors or variables influencing the

pervasive use of herbal supplements and their impact on healthcare decision-making.

Cultural influences, encompassing beliefs and practices related to herbal supplements,

shape individuals' attitudes and preferences. The regulatory environment, comprising the

legal framework, sets rules governing herbal supplements, influencing consumer behavior.

Consumer awareness and education act as a mediating factor, translating cultural influences

and regulatory aspects into knowledge and understanding. The pervasive use of herbal

supplements, a dependent variable, is influenced by cultural factors, the regulatory

environment, and consumer awareness. This, in turn, affects healthcare decision-making,

reflecting the broader impact of herbal supplement use on individuals' health-related

choices. Health risks and benefits, market potential, and government endorsement are

contextual variables that can both influence and be influenced by various components

within the framework. Arrows denote directional relationships, emphasizing the

interconnectedness of these variables, while the mediating role of consumer awareness and

education illustrates how knowledge mediates the impact of cultural and regulatory factors

on behavior.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Significance of the StudyNursing Department
The significance of the study lies in its exploration of a crucial and timely subject

within the context of Koronadal City, Philippines. As the pervasive use of non-FDA

approved herbal food supplements continues to grow, understanding the cultural, regulatory,

and individual factors influencing this phenomenon becomes paramount. This research

strives to fill a notable gap in existing knowledge, providing valuable insights that can

inform public health policies, regulatory frameworks, and community healthcare practices.

Community, This study holds significance for the community of Koronadal City by

providing insights into the factors influencing the prevalent use of herbal supplements.

Understanding these dynamics can empower community members with knowledge about

the potential risks and benefits, fostering informed decision-making regarding their health

and well-being.

Barangay Health Workers and Officials, the findings of this study can serve as a

resource for barangay health workers and officials in Koronadal City. It may enhance their

awareness of the local practices, beliefs, and health-seeking behaviors related to herbal

supplement use, enabling them to tailor health education programs and interventions that

align with the community's preferences and needs.

Family, the study's outcomes can benefit families in Koronadal City by shedding

light on the qualitative aspects of individual health experiences and decision-making related

to herbal supplement use. This knowledge can promote family discussions about health

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
choices, encouraging open dialogues Department
that incorporate cultural perspectives and informed

decision-making.

School, the insights generated by this study can be utilized by educational

institutions in Koronadal City, providing a basis for curriculum development that

incorporates cultural aspects of health practices. Schools can use this information to enhance

the relevance and contextual applicability of health-related courses

Nursing Students, for nursing students, this study offers a unique opportunity to

delve into the qualitative dimensions of healthcare practices within a specific cultural

context. It can contribute to their understanding of community health dynamics, cultural

competence, and the importance of considering local beliefs in healthcare delivery.

Future Researchers, this research lays the groundwork for future studies by

providing a qualitative framework for investigating herbal supplement practices in diverse

cultural settings. It offers a foundation for researchers to build upon, encouraging further

exploration into the intersection of cultural practices, healthcare decision-making, and

community health.

Hypothesis

The formulation of hypotheses is an essential step in structuring scientific inquiry

and guiding the investigation process. In this study focused on the pervasive use of non-

FDA approved herbal food supplements in Koronadal City, Philippines, the hypotheses

serve as guiding propositions to be tested and analyzed.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
H0 Nursing Department

Consumer awareness and education levels regarding the risks and benefits of non-

FDA approved herbal supplements do not significantly influence their utilization as an

alternative to medical consultation.

If the null hypothesis holds true, it suggests that consumer education and awareness

campaigns about the risks and benefits of herbal supplements may not be effective in

curbing their pervasive use without medical consultation. This could imply that other

factors such as cultural influences, regulatory dynamics, or individual beliefs might be

stronger drivers of the observed behavior. Alternatively, it might indicate a gap in the

current educational strategies, prompting a reevaluation of approaches to ensure that

information about herbal supplements is communicated effectively and has a discernible

impact on consumer choices

Ha

Higher levels of consumer awareness and education regarding the risks and

benefits of non-FDA approved herbal supplements are associated with a reduced likelihood

of their pervasive use without medical consultation

If the alternative hypothesis is supported, it highlights the critical role of consumer

education in influencing healthcare decision-making related to herbal supplements. This

finding could have implications for public health interventions, emphasizing the importance

of targeted educational campaigns. It may suggest that empowering consumers with

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
knowledge about the potential risks Department
and benefits of herbal supplements can contribute to

more informed and cautious choices, ultimately promoting safer health practices within the

community.

Scope and Limitation

This qualitative research focuses exclusively on Koronadal City, Philippines,

exploring the pervasive use of non-FDA approved herbal food supplements within the

community over the past five years. The study includes individuals actively utilizing these

supplements, employing interviews, focus group discussions, and thematic analysis to delve

into cultural influences, regulatory dynamics, and individual health experiences shaping

decision-making processes. The research is delimited to exclude other herbal practices,

limiting generalizability to the specific context of Koronadal City. Quantitative data is not

incorporated, and the study does not extend to interventions but seeks to provide nuanced

qualitative insights into the complex factors influencing herbal supplement practices within

this localized setting. Data collection and analysis will be conducted in English and/or the

local language, specifically Hiligaynon or Visayan, ensuring accurate representation of

participants' perspectives.

Definition of Terms

The study used numerous terms which further accurately represent circumstances

and procedures followed in order to carry out the study. The following are the said terms:

Cultural Influences: Cultural influences encompass the set of beliefs, customs, traditions,

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
and social norms within a specific Department
community or society. These factors shape individuals'

attitudes, behaviors, and decision-making processes related to various aspects of life,

including the use of herbal food supplements.

For the purposes of this study, cultural influences specifically refer to the local

customs, traditions, and beliefs within Koronadal City that shape attitudes and practices

related to the use of herbal food supplements

Decision-Making: Decision making refers to the cognitive process of selecting a course of

action or choosing from available alternatives based on an individual's preferences, values,

and goals. It involves assessing information, weighing pros and cons, and making a choice

to address a specific situation or achieve a desired outcome.

Decision-making in this study pertains to the process by which individuals in

Koronadal City choose to use herbal food supplements without seeking formal medical

consultation, considering factors such as cultural influences, personal beliefs, and available

information sources.

Herbal Food Supplements: Herbal food supplements are dietary products containing plant-

derived ingredients, such as herbs, botanicals, and other natural substances, formulated to

supplement the diet and provide potential health benefits. These supplements often include a

variety of vitamins, minerals, and bioactive compounds sourced from medicinal plants, with

the aim of promoting well-being and addressing specific health concerns.

For the purpose of this study, herbal food supplements will specifically include non-

FDA approved products commonly used in Koronadal City, encompassing a range of

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
locally available plant-derived nutritional or health-promoting substances.

Pervasive Use: "Pervasive use" refers to the widespread and prevalent utilization of a

particular phenomenon.

In the context of this study, pervasive use refers to the common and frequently

observed utilization of non-FDA approved herbal food supplements by individuals within

the community of Koronadal City.

Traditional Medicine: Traditional medicine encompasses a broad range of healing

practices, knowledge, and beliefs that have been passed down through generations within a

particular culture. It often involves the use of natural remedies, plant-based treatments,

rituals, and traditional healing methods to address various health issues.

Traditional medicine in this study refers to the longstanding cultural practices,

particularly the use of herbal remedies, prevalent in Koronadal City. The study utilizes an

exploration of traditional medicine to understand its role in influencing the pervasive use of

non-FDA approved herbal food supplements and their impact on healthcare decision-

making among the local population.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department

METHODOLOGY
Research Design

The research design selected for the study on the pervasive use of non-FDA

approved herbal food supplements in Koronadal City is phenomenological research. This

qualitative approach is chosen for its suitability in exploring the lived experiences and

perceptions of individuals regarding herbal supplement practices. Phenomenology allows

for an in-depth examination of cultural influences, regulatory dynamics, and individual

health experiences, providing a holistic understanding of the complex factors contributing to

the widespread utilization of herbal supplements without FDA approval. The emphasis on

context, meaning, and the flexibility of the phenomenological approach aligns with the

study's objective of knowing the reason behind the intricate dynamics within the local

community, shedding light on the cultural influences that shape healthcare decisions related

to herbal supplementation.

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
Figure 2 Research Design

Herbal Supplements as an Alternative to Medical Consultation: Exploring the

Pervasive Use of Non-FDA Approved Herbal Food Supplements and Its Influence
on the Public's Healthcare Decision-Making

What are the factors contributing to the LOCALE OF THE STUDY

pervasive use of non-FDA approved herbal food
supplements as an alternative to medical
Koronadal City, South
consultation? Cotabato

How does the lack of regulation and PARTICIPANTS OF THE

standardization for herbal supplements impact STUDY
public health and safety?
Adult Consumers of
What is the extent of consumer awareness and Koronadal City, South
education regarding the risks and benefits Cotabato
associated with non-FDA approved herbal (18 years old and above)
supplements?
RESEARCH INSTRUMENT
What are the potential health risks and side
effects associated with the unregulated use of In-Depth Interview
herbal supplements, particularly in the absence
of medical consultation?
DATA GATHERING
PROCEDURE
How does the pervasive use of herbal
supplements without medical consultation affect Purposive Sampling
healthcare systems, resource allocation, and
the overall efficacy of healthcare delivery?
DATA ANALYSIS

Thematic Analysis

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
Locale of the Study

This qualitative phenomenological study is situated in the landscape of Koronadal

City, Philippines, where the pervasive use of non-FDA approved herbal food supplements

has become a notable facet of the local healthcare landscape. The topography of Koronadal

City, surrounded by mountain ranges and featuring predominantly flat terrain, presents an

environment conducive to the cultivation and exploration of diverse medicinal herbs. The

rich biodiversity in the mountainous areas offers potential sources of herbal remedies

traditionally used by local communities, reflecting a cultural reliance on natural resources

for healthcare. This unique landscape not only supports the integration of herbal cultivation

with traditional agriculture but also opens avenues for the development of a local herbal

industry, providing economic opportunities for the community. Moreover, initiatives

promoting health and wellness through the utilization of herbal products, alongside

community health programs and educational workshops, could further enhance the city's

identity as a hub for herbal resources, aligning cultural practices with sustainable economic

and health-related endeavors

27
 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
Figure Department
3 Setting of the Map

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
Respondents of the Study

The respondents of this study will comprise individuals of 18 years older and above or the

adult consumers residing in Koronadal City who actively engage in the pervasive use of

non-FDA approved herbal food supplements as an alternative to seeking formal medical

consultation. Selected through purposive sampling, the participants will represent diverse

backgrounds in terms of age, gender, socio-economic status, and health conditions. Their

inclusion aims to capture a comprehensive range of perspectives, beliefs, and experiences

related to herbal supplement practices within the unique cultural context of Koronadal City.

Through in-depth interviews and focus group discussions, the study seeks to unveil the

intricate factors influencing their decision-making processes, shedding light on the

qualitative dimensions of healthcare choices within this specific community.

Sampling Procedure

The researchers will employ a purposive sampling technique in their investigation into the

pervasive use of non-FDA approved herbal food supplements in Koronadal City. This

deliberate sampling approach is designed to select participants based on specific criteria

crucial to the research objectives, including individuals with specialized expertise such as

traditional healers and herbalists. By purposively selecting participants from diverse

backgrounds in terms of age, gender, and the study aims to comprehensively capture a

spectrum of perspectives on herbal supplement use, ensuring a nuanced understanding of the

cultural, regulatory, and individual factors influencing healthcare decisions in the

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing
community. This targeted sampling alignsDepartment
with the qualitative nature of the research,

facilitating an in-depth exploration of participants' experiences, beliefs, and decision-

making processes related to herbal supplement use. In essence, the use of purposive

sampling by the researchers enhances the depth and relevance of the study's findings,

allowing for intentional selection of individuals who can provide context-specific insights

into the intricate dynamics of herbal practices in Koronadal City.

Data Gathering Procedure

In conducting this study on the pervasive use of non-FDA approved herbal food

supplements and its impact on healthcare decision-making in Koronadal City, the

researchers will employ a comprehensive data gathering approach aligned with the

purposive sampling technique. The process initiates with the researchers developing a cover

letter to elucidate the study's purpose and ethical considerations, seeking approval from

relevant ethical review boards, and obtaining informed consent from participants. To ensure

a diverse representation, the researchers will come into contact with community leaders and

local organizations in participant recruitment, considering factors such as age, gender,

socioeconomic status, and geographical location.

The primary data collection method will center on in-depth interviews with

individuals from the community. These interviews, designed to be semi-structured, will

allow flexibility in exploring participants' perspectives, experiences, and decision-making

processes concerning herbal supplement use. The researchers will establish criteria for

participant selection, specifically catered to those who are using Non-FDA approved herbal
30
 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
supplements, and saturation willNursing Department
be considered achieved when repeated information

emerges, ensuring a comprehensive understanding of the phenomenon. Probing questions

will be tailored to uncover cultural influences, awareness levels, and healthcare choices

related to herbal supplements. With participants' consent, the interviews will be audio-

recorded and later transcribed verbatim to guarantee accurate representation of the collected

data.

Research Instrumentation

The researchers will utilize in-depth interviews as the primary instrumentation for

collecting data in this study on the pervasive use of non-FDA approved herbal food

supplements and its impact on healthcare decision-making in Koronadal City. In-depth

interviews are chosen for their ability to provide a rich, detailed exploration of participants'

perspectives and experiences, allowing the researchers to uncover insights into the cultural,

regulatory, and individual factors influencing herbal supplement practices. This qualitative

approach enables the researchers to delve deeply into the lived experiences of individuals,

knowing the ideas of decision-making processes related to herbal supplement use. Through

the in-depth interviews, the researchers will employ probing questions tailored to uncover

cultural influences, awareness levels, and healthcare choices, ensuring a comprehensive

understanding of the phenomenon within the local context. The flexibility of the in-depth

interview format aligns with the study's qualitative nature, facilitating a dynamic and

participant-centered exploration of the pervasive use of herbal supplements in Koronadal

City.

31
 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Data Analysis Nursing Department

The researchers will employ a qualitative analysis technique to extract

meaningful patterns and themes from the collected data, which aligns with the

phenomenological nature of the study on the pervasive use of non-FDA approved

herbal food supplements in Koronadal City. The purposive sampling technique, used

to deliberately select participants based on specific criteria, will contribute to the

richness and diversity of the data. In-depth interviews, as the primary data collection

method, will yield detailed insights into participants' lived experiences and

perspectives related to herbal supplement use. The researchers will conduct a

thematic analysis, a suitable approach for phenomenological studies, to identify,

analyze, and interpret recurring themes within the data. This process involves open

coding, generating initial codes, searching for themes, reviewing themes, defining and

naming themes, and producing a final report. Through this qualitative analysis

technique, the researchers aim to uncover the intricate interplay of cultural,

regulatory, and individual factors shaping the pervasive use of herbal supplements in

Koronadal City, contributing to a holistic understanding of the phenomenon

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
References Nursing Department

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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department
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 JMJ Marist Brothers
Notre Dame of Marbel
University City of Koronadal,
South Cotabato
COLLEGE OF ARTS AND SCIENCES
Nursing Department