scholarly journals Development and Validation of a Multivariable Prediction Model for Missed HIV Healthcare Provider Visits in a Large United States Clinical Cohort

2021 ◽  
Author(s):  
April C Pettit ◽  
Aihua Bian ◽  
Cassandra O Schember ◽  
Peter F Rebeiro ◽  
Jeanne C Keruly ◽  
...  
Keyword(s):  
Prediction Models ◽  
Community Level ◽  
Research Network ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Individual Level ◽  
Visit Adherence ◽  
Level Data ◽  
Missed Visits ◽  
The Individual

Abstract Background Identifying individuals at high risk of missing HIV care provider visits could support proactive intervention. Previous prediction models for missed visits have not incorporated data beyond the individual-level. Methods We developed prediction models for missed visits among people living with HIV (PLWH) with ≥1 follow-up visit in the Center for AIDS Research Network of Integrated Clinical Systems from 2010-2016. Individual-level (medical record data and patient-reported outcomes), community-level (American Community Survey), HIV care site-level (standardized clinic leadership survey), and structural-level (HIV criminalization laws, Medicaid expansion, and state AIDS Drug Assistance Program budget) predictors were included. Models were developed using random forests with 10-fold cross-validation; candidate models with highest area under the curve (AUC) were identified. Results Data from 382,432 visits among 20,807 PLWH followed for a median of 3.8 years were included; median age was 44 years, 81% were male, 37% were Black, 15% reported injection drug use, and 57% reported male-to-male sexual contact. The highest AUC was 0.76 and strongest predictors were at the individual-level (prior visit adherence, age, CD4+ count) and community-level (proportion living in poverty, unemployed, and of Black race). A simplified model, including readily accessible variables available in a web-based calculator, had a slightly lower AUC of 0.700. Conclusions Prediction models validated using multi-level data had a similar AUC to previous models developed using only individual-level data. Strongest predictors were individual-level variables, particularly prior visit adherence, though community-level variables were also predictive. Absent additional data, PLWH with previous missed visits should be prioritized by interventions to improve visit adherence.

Examining the Impact of Individual, Community, and Market Factors on Methamphetamine Use: A Tale of Two Cities

2005 ◽  
Vol 35 (4) ◽  
pp. 665-693 ◽  
Author(s):  
Nancy Rodriguez ◽  
Charles Katz ◽  
Vincent J. Webb ◽  
David R. Schaefer
Keyword(s):  
Drug Market ◽  
Community Level ◽  
Policy Implications ◽  
Individual Level ◽  
Methamphetamine Use ◽  
Level Data ◽  
Two Cities ◽  
Market Factors ◽  
The Individual ◽  
The Impact

Although prior studies have monitored the trends in methamphetamine use and reported its increase over the years, few studies have considered how community-level characteristics affect the use of methamphetamine. In this study, we utilize data from the Arrestee Drug Abuse Monitoring (ADAM) program from two cities to examine how individual-level, community-level, and drug market factors influence methamphetamine use. Results indicate that both individual and community-level data significantly influence methamphetamine use. Also, findings show that predictors of methamphetamine use (at the individual and community-level) differ significantly from marijuana, cocaine, and opiate use. Policy implications regarding law enforcement suppression and the treatment of methamphetamine users are discussed.

Individual and contextual socioeconomic determinants of knowledge of the ABC approach of preventing the sexual transmission of HIV in Nigeria: a multilevel analysis

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 522 ◽  
Author(s):  
Olalekan A. Uthman ◽  
Gbenga A. Kayode ◽  
Victor.T. Adekanmbi
Keyword(s):  
Sexual Transmission ◽  
Wealth Index ◽  
Community Level ◽  
People Living With Hiv ◽  
Linear Regression Models ◽  
Individual Level ◽  
Sexual Transmission Of Hiv ◽  
The Individual ◽  
Multilevel Linear Regression ◽  
Hiv Aids

Background Nigeria has the highest number of people living with HIV/AIDS in the world after India and South Africa. HIV/AIDS places a considerable burden on society’s resources, and its prevention is a cost-beneficial solution to address these consequences. To the best of our knowledge, there has been no multilevel study performed to date that examined the separate and independent associations of individual and community socioeconomic status (SES) with HIV prevention knowledge in Nigeria. Methods: Multilevel linear regression models were applied to the 2008 Nigeria Demographic and Health Survey on 48 871 respondents (Level 1) nested within 886 communities (Level 2) from 37 districts (Level 3). Results: Approximately one-fifth (20%) of respondents were not aware of any of the Abstinence, Being faithful and Condom use (ABC) approach of preventing the sexual transmission of HIV. However, the likelihood of being aware of the ABC approach of preventing the sexual transmission of HIV increased with older age, male gender, greater education attainment, a higher wealth index, living in an urban area and being from least socioeconomically disadvantaged communities. There were significant community and district variations in respondents’ knowledge of the ABC approach of preventing the sexual transmission of HIV. Conclusion: The present study provides evidence that both individual- and community-level SES factors are important predictors of knowledge of the ABC approach of preventing the sexual transmission of HIV in Nigeria. The findings underscore the need to implement public health prevention strategies not only at the individual level, but also at the community level.

Missing Data in Research on Youth and Family Programs

2021 ◽  
pp. 003329412110268
Author(s):  
Jaime Ballard ◽  
Adeya Richmond ◽  
Suzanne van den Hoogenhof ◽  
Lynne Borden ◽  
Daniel Francis Perkins
Keyword(s):  
Missing Data ◽  
Statistical Methods ◽  
Self Report ◽  
Program Participation ◽  
Multilevel Data ◽  
Individual Level ◽  
Level Data ◽  
Before And After ◽  
Post Test ◽  
The Individual

Background Multilevel data can be missing at the individual level or at a nested level, such as family, classroom, or program site. Increased knowledge of higher-level missing data is necessary to develop evaluation design and statistical methods to address it. Methods Participants included 9,514 individuals participating in 47 youth and family programs nationwide who completed multiple self-report measures before and after program participation. Data were marked as missing or not missing at the item, scale, and wave levels for both individuals and program sites. Results Site-level missing data represented a substantial portion of missing data, ranging from 0–46% of missing data at pre-test and 35–71% of missing data at post-test. Youth were the most likely to be missing data, although site-level data did not differ by the age of participants served. In this dataset youth had the most surveys to complete, so their missing data could be due to survey fatigue. Conclusions Much of the missing data for individuals can be explained by the site not administering those questions or scales. These results suggest a need for statistical methods that account for site-level missing data, and for research design methods to reduce the prevalence of site-level missing data or reduce its impact. Researchers can generate buy-in with sites during the community collaboration stage, assessing problematic items for revision or removal and need for ongoing site support, particularly at post-test. We recommend that researchers conducting multilevel data report the amount and mechanism of missing data at each level.

scholarly journals Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu
Keyword(s):  
Health Survey ◽  
Exclusive Breastfeeding ◽  
Household Wealth ◽  
Community Level ◽  
Wealth Status ◽  
Individual Level ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
The Individual ◽  
Low Coverage

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

scholarly journals Cohort Profile: The China Multi-Ethnic Cohort (CMEC) Study

2020 ◽  
Author(s):  
Xing Zhao ◽  
Feng Hong ◽  
Jianzhong Yin ◽  
Wenge Tang ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Disease Incidence ◽  
Data Access ◽  
Population Based ◽  
Baseline Survey ◽  
Individual Level ◽  
Long Term Storage ◽  
Level Data ◽  
The Individual ◽  
Study Participants

AbstractCohort purposeThe China Multi-Ethnic Cohort (CMEC) is a community population-based prospective observational study aiming to address the urgent need for understanding NCD prevalence, risk factors and associated conditions in resource-constrained settings for ethnic minorities in China.Cohort BasicsA total of 99 556 participants aged 30 to 79 years (Tibetan populations include those aged 18 to 30 years) from the Tibetan, Yi, Miao, Bai, Bouyei, and Dong ethnic groups in Southwest China were recruited between May 2018 and September 2019.Follow-up and attritionAll surviving study participants will be invited for re-interviews every 3-5 years with concise questionnaires to review risk exposures and disease incidence. Furthermore, the vital status of study participants will be followed up through linkage with established electronic disease registries annually.Design and MeasuresThe CMEC baseline survey collected data with an electronic questionnaire and face-to-face interviews, medical examinations and clinical laboratory tests. Furthermore, we collected biological specimens, including blood, saliva and stool, for long-term storage. In addition to the individual level data, we also collected regional level data for each investigation site.Collaboration and data accessCollaborations are welcome. Please send specific ideas to corresponding author at: [email protected].

scholarly journals Welsh Government Flying Start Programme Evaluation Using Linked Data

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Sarah Lowe ◽  
Laura McGinn ◽  
Marcos Quintela ◽  
Luke Player ◽  
Karen Tingay
Keyword(s):  
Evidence Base ◽  
Development Project ◽  
Early Years ◽  
Local Authorities ◽  
Parenting Support ◽  
Individual Level ◽  
Level Data ◽  
Part Time ◽  
The Individual ◽  
Families With Children

BackgroundFlying Start (FS) is the Welsh Government’s (WG) flagship Early Years programme for families with children aged less than 4 years of age. Running since 2006, the four entitlements are: Free part-time childcare for 2-3 year olds Enhanced Health Visiting Parenting support Speech, language, and communication support ObjectivesCurrently, while we know which areas in Wales are receiving FS support, individual-level data on which child received what entitlements is not available. Area-level outcomes can be used as proxy indicators but the individual impact of receiving FS support cannot be examined.The project aims to evaluate FS by linking the FS cohort to a range of outcomes including health, education and social care. MethodsA Dataflow Development Project (DDP) has been launched to install SAIL (Secure Anonymised Information Linkage) appliances into 6 pilot Local Authorities in Wales which will test acquiring and linking the individual level FS data from pilot Local Authorities with other datasets in SAIL. FindingsThe project will report some emerging findings from the analysis of pilot data. ImplicationsThere is a growing interest in using linked administrative data to evaluate government initiatives, and mounting enthusiasm in Local Government. If successful, this model is likely to be adopted by related WG programmes; improving the evidence base, facilitating effective evaluation, and adding to the data available for re-use in Wales.

scholarly journals Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036519 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta
Keyword(s):  
Family Planning ◽  
Cross Sectional Study ◽  
Married Women ◽  
Community Level ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Individual Level ◽  
Pastoralist Community ◽  
The Individual

ObjectiveThe study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia.DesignA community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient.Setting and participantsAfar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years.Primary outcome measuresFP use or non-use.ResultsThe current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects.ConclusionFP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors.Trail registrtion numberNCT03450564

Agricultural entrepreneurship orientation: is academic training a missing link?

2017 ◽  
Vol 59 (7/8) ◽  
pp. 856-870 ◽  
Author(s):  
Soodeh Mohammadinezhad ◽  
Maryam Sharifzadeh
Keyword(s):  
Content Type ◽  
Individual Level ◽  
Configuration Theory ◽  
University Courses ◽  
Level Data ◽  
Academic Courses ◽  
The Individual ◽  
Agricultural Entrepreneurship ◽  
Hierarchy Process ◽  
Practical Implications

Purpose The purpose of this paper is to investigate the importance of academic courses on agricultural entrepreneurship. Design/methodology/approach Modified global entrepreneurship and development index (GEDI) was used to determine entrepreneurial dimensions among 19 graduated students of agricultural colleges resided in Iran. Fuzzy analytical hierarchy process was applied to understand agricultural graduates’ preferences on effectiveness of university courses (core, free elective and restricted elective). Findings Results suggested the importance of professional restricted elective courses to provide students with necessary skills. These courses were successful in providing a context for entrepreneurial profile. Research limitations/implications Innate talent or acquired skills were always the place of debate on entrepreneurial development. The paper builds on the premise that entrepreneurs are made through education and continuing reconstruction of experience, further research is required as the field develops in experience and complexity. Practical implications The paper provides strategies to effectively modify practical route in higher education to enhance entrepreneurial orientation among students. Originality/value The paper is innovative at a conceptual level in modifying GEDI elements in individual-level variables based on GEDI configuration theory. This approach is particularly useful in addressing the bottleneck problems of entrepreneurship profile and focusses on the information interpreted at weights of the individual-level data.

On the Issues Surrounding Economic Voting

1987 ◽  
Vol 20 (1) ◽  
pp. 3-33 ◽  
Author(s):  
JOHN R. HIBBING
Keyword(s):  
United States ◽  
United Kingdom ◽  
Voting Behavior ◽  
Economic Voting ◽  
The United States ◽  
Individual Level ◽  
The United Kingdom ◽  
Level Data ◽  
Election Results ◽  
The Individual

This is an analysis of the effects of economic factors on voting behavior in the United Kingdom. Aggregate- and individual-level data are used. When the results are compared to findings generated by the United States case, some intriguing differences appear. To mention just two examples, unemployment and inflation seem to be much more important in the United Kingdom than in the United States, and changes in real per capita income are positively related to election results in the United States and negatively related in the United Kingdom. More generally, while the aggregate results are strong and the individual-level results weak in the United States, in the United Kingdom the situation is practically reversed.

Area-level relative deprivation and alcohol use in Denmark: Is there a relationship?

2018 ◽  
Vol 47 (4) ◽  
pp. 428-438 ◽  
Author(s):  
Kim Bloomfield ◽  
Gabriele Berg-Beckhoff ◽  
Abdu Kedir Seid ◽  
Christiane Stock
Keyword(s):  
Alcohol Use ◽  
Relative Deprivation ◽  
Health Behaviours ◽  
Area Deprivation ◽  
Individual Level ◽  
Level Data ◽  
Housing Component ◽  
Disorder Identification ◽  
The Individual ◽  
The Impact

Aims: Greater area-level relative deprivation has been related to poorer health behaviours, but studies specifically on alcohol use and abuse have been equivocal. The main purpose of the present study was to investigate how area-level relative deprivation in Denmark relates to alcohol use and misuse in the country. Methods: As individual-level data, we used the national alcohol and drug survey of 2011 ( n= 5133). Data were procured from Statistics Denmark to construct an index of relative deprivation at the parish level ( n=2119). The deprivation index has two components, which were divided into quintiles. Multilevel linear and logistic regressions analysed the influence of area deprivation on mean alcohol use and hazardous drinking, as measured by the Alcohol Use Disorder Identification Test. Results: Men who lived in parishes designated as ‘very deprived’ on the socioeconomic component were more likely to consume less alcohol; women who lived in parishes designated as ‘deprived’ on the housing component were less likely to drink hazardously. But at the individual level, education was positively related to mean alcohol consumption, and higher individual income was positively related to mean consumption for women. Higher-educated men were more likely to drink hazardously. Conclusions: Area-level measures of relative deprivation were not strongly related to alcohol use, yet in the same models individual-level socioeconomic variables had a more noticeable influence. This suggests that in a stronger welfare state, the impact of area-level relative deprivation may not be as great. Further work is needed to develop more sensitive measures of relative deprivation.

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