already interested and active in this field and those that we feel ought to be interested because of mutual concerns. • Fund developmental grants to support the time it takes people to develop conceptually elegant experiments with sufficient statistical power to allow a definitive outcome. • Disseminate this agenda as widely as possible to inform and stimulate interest among the health care research community. • Fund, through the AMTA and/or AMTA Foundation, high priority studies that will both advance the knowledge in the field and establish the viability of massage as an area of inquiry. 2. FUND RESEARCH INTO SAFETY & EFFICACY OF MASSAGE THERAPY Studies must be funded to identify those applications of massage therapy that are safe and have identifiable benefit and those that are not reliably effective and/or carry associated risk. The MRAW recommended as highest priority studies of the comparative efficacy of different kinds of massage therapy/bodywork in relation to a particular condition or goal, and then the utilization of the most effective massage protocol in clinical trials comparing massage with standard medical, chiropractic or other forms of care for the same conditions. The following considerations went into identifying the specific safety and efficacy studies recommended below: • Studies must preserve public health and safety. • Studies must alleviate human suffering and associated costs. 5 • Studies should be undertaken when the expectation that massage therapy/ bodywork will be beneficial in a particular situation rests on good anecdotal evidence, pilot data, and/or on a firm theoretical basis. • Studies receive a higher priority when the current usual treatment is unacceptable in one or more ways including high cost, adverse side effects or pain and/or inconvenience of the treatment itself. • The condition being studied should be sufficiently prevalent that the study will address a situation affecting many people’s lives. • Study subjects should be readily available. • Study must have a clearly defined massage intervention and unambiguous outcomes /endpoints and also must be of import to stakeholders. • The treatment, if successful, should be relatively easy to adopt. It was acknowledged that high impact efficacy studies might focus on either primary or secondary prevention, within a clinically oriented pathology model, or draw more upon a “wellness agenda.” Illustrative examples were generated during preliminary design sessions that utilized small teams including at least one massage therapist, one clinical researcher and one basic science researcher. 2A. SUGGESTED PRIMARY PREVENTION STUDIES Workplace-Based Primary Prevention Massage therapists often hear from clients that regular massage provides a host of benefits both in mood and physical health. Yet the effects of regular massage on a “healthy” population have never been studied. The MRAW endorsed as a priority a study that would examine (as key outcomes) the potential for regular massage to effect the frequency, duration and associated cost of injuries and illnesses common to a particular workplace, as well as exploring a range of promising outcomes including worker satisfaction with job, mental health outcomes, satisfaction with home life, etc. Massage To Prevent Congestive Heart Failure This was offered as an example of a condition-specific primary care study. The goal of such a study would be to examine the potential for massage to prevent congestive heart failure among people who appear at high risk. Subjects might be patients 40+ years of age, diagnosed with moderate to severe hypertension and perhaps receiving medication for high blood pressure. They would be under the care of a physician and maintain regular visits to monitor their condition. Exclusion criteria would need to be developed and might include concurrent chronic diseases such as diabetes, kidney or liver failure, COPD, etc. Ideally the sample population would be ethnically diverse and include both males and females with sufficient sample size to allow for gender comparison. Subjects would be randomized to defined conditions such as a) normal care, b) normal care plus weekly massage, and c) a 6 control group receiving normal care plus some other form of high contact care. Length of treatment would be determined by an examination of what is already known about the ability of massage to affect blood pressure. The principal outcomes would be BP, medication use, and of course, incidence of congestive heart failure. Massage and Musculoskeletal Disorders Such As Scoliosis The lack of research on the use of massage in relation to musculoskeletal disorders is striking. In fact, musculoskeletal conditions may be the most promising arena for primary prevention investigations. Based on the experience of practitioners present at the MRAW, scoliosis was recommended as one study possibility. The goal of such a study would be the prevention of a need for scoliosis surgery. It was stressed that this study should be done as a comparison of massage and usual care only after the within-massage/bodywork studies have been done to determine the most beneficial treatments for this condition. Subjects would be adolescents aged 12-18, recruited from a scoliosis clinic at the point when they are designated as candidates for future surgery. The length of