Multilevel Analysis Research Papers - Academia.edu (original) (raw)

To determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status. Cross sectional multilevel study. Data were collected on income... more

To determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status. Cross sectional multilevel study. Data were collected on income distribution in each of the 50 states in the United States. The Gini coefficient was used to measure statewide inequalities in income. Random probability samples of individuals in each state were collected by the 1993 and 1994 behavioural risk factor surveillance system, a random digit telephone survey. The survey collects information on an individual's income, education, self rated health and other health risk factors. All 50 states. Civilian, non-institutionalised (that is, non-incarcerated and non-hospitalised) US residents aged 18 years or older. Self rated health status. When personal characteristics and household income were controlled for, individuals living in states with the greatest inequalities in income were 30% more likely to report their health as fair or poor than individuals living in states with the smallest inequalities in income. Inequality in the distribution of income was associated with an adverse impact on health independent of the effect of household income.

Criminal sentencing is, along with arresting and prosecuting, among the most important of formal social control decisions. In this study we use hierarchical modeling to test hypotheses about contextual level influences and cross level... more

Criminal sentencing is, along with arresting and prosecuting, among the most important of formal social control decisions. In this study we use hierarchical modeling to test hypotheses about contextual level influences and cross level interaction effects on local court decisions. Most of the explanatory “action,” our analysis shows, is at the individual case level in criminal sentencing. We also find evidence that local contextual features–such as court organizational culture, court caseload pressure, and racial and ethnic composition–affect sentencing outcomes, either directly or in interaction with individual factors. We conclude by discussing theoretical implications of our findings, and how our study points out some dilemmas among civil rights, local autonomy and organizational realities of criminal courts.

Past research on low birthweight has focused on individual-level risk factors. We sought to assess the contribution of macrolevel social factors by using census tract-level data on social stratification, community empowerment, and... more

Past research on low birthweight has focused on individual-level risk factors. We sought to assess the contribution of macrolevel social factors by using census tract-level data on social stratification, community empowerment, and environmental stressors. Census tract-level information on social risk was linked to birth certificate records from Baltimore, Md, for the period 1985 through 1989. Individual level factors included maternal education, maternal age, medical assistance health insurance (Medicaid), and trimester of prenatal care initiation. Methods of multilevel modeling using two-stage regression analyses were employed. Macrolevel factors had both direct associations and interactions with low birthweight. All individual risk factors showed interaction with macrolevel variables; that is, individual-level risk factors for low birthweight behaved differently depending upon the characteristics of the neighborhood of residence. For example, women living in high-risk neighborhoods benefited less from prenatal care than did women living in lower-risk neighborhoods. Multilevel modeling is an important tool that allows simultaneous study of macro- and individual-level risk factors. Multilevel analyses should play a larger role in the formulation of public health policies.

The Randomized,Response Technique (RRT) is a survey method,especially developed to improve the accuracy of answers to questions on threatening topics. This paper reports the results of two meta-analyses on RRT studies, the first on the... more

The Randomized,Response Technique (RRT) is a survey method,especially developed to improve the accuracy of answers to questions on threatening topics. This paper reports the results of two meta-analyses on RRT studies, the first on the results of six individual validation studies, and the second on 31 comparative studies. The focus of these meta- analyses was on the performance,of RRTs

Objectives To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN). Methods The KIDSCREEN-52... more

Objectives To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN). Methods The KIDSCREEN-52 questionnaire was filled in by 21,590 children and adolescents aged 8–18 from 12 countries. We used multilevel regression analyses to model the hierarchical structure of the data. In addition, effect sizes were computed to test for gender differences within each age group. Results Children generally showed better HRQOL than adolescents (P < 0.001). While boys and girls had similar HRQOL at young age, girls’ HRQOL declined more than boys’ (P < 0.001) with increasing age, depending on the HRQOL scale. There was significant variation between countries both at the youngest age and for age trajectories. Conclusions For the first time, gender and age differences in children’s and adolescents’ HRQOL across Europe were assessed using a comprehensive and standardised instrument. Gender and age differences exist for most HRQOL scales. Differences in HRQOL across Europe point to the importance of national contexts for youth’s well-being.

Cortisol measures often are used to examine variation in hypothalamic-pituitary-adrenal axis (HPA) activity as well as broader patterns of differential health. However, substantial within-individual variation renders single cortisol... more

Cortisol measures often are used to examine variation in hypothalamic-pituitary-adrenal axis (HPA) activity as well as broader patterns of differential health. However, substantial within-individual variation renders single cortisol measurements unreliable as estimates for probing differences between individuals and groups. A standard practice to clarify between-individual differences involves collecting multiple samples from each participant and then deriving person-specific averages. By ignoring information about variation at between- and within-individual levels, this technique impedes cross-study comparison of results, ignores data useful for future study design, and hinders the analysis of cross-level interactions. This report describes how multilevel approaches can simultaneously model between- and within-individual variation in diurnal cortisol levels without using crude averages. We apply these models to data from children in Nepal (n=29, 11-15 samples per child), Mongolia (...

This paper reports the quality of life (QoL) of a large cohort of Australian women three and twelve months after surgery for early stage breast cancer (ESBC), and shows that the impact of disease and treatment on QoL differed by age,... more

This paper reports the quality of life (QoL) of a large cohort of Australian women three and twelve months after surgery for early stage breast cancer (ESBC), and shows that the impact of disease and treatment on QoL differed by age, education and marital status. Eighty-three percent of eligible patients were recruited; 86% had breast conserving surgery and 14% mastectomy. Response rates were 93% (n = 305) at three months and 88% (n = 291) at one year. Quality of life was measured with the EORTC core questionnaire (QLQ-C30) and an ESBC-specific questionnaire. Multilevel analysis was used to estimate the effects and interactions of time, treatment and patient characteristics. Most symptoms declined between three months and one year, but arm and menopausal symptoms persisted. Emotional, social and role functioning improved over time, and fear of disease recurrence diminished. Younger women faired worse than older women on a broad range of QoL dimensions. Single women and those with less education faired worse on a number of dimensions. The negative impact of mastectomy on body image was greatest among married women, particularly young married women. These sociodemographic distinctions are relevant when discussing treatment options with women facing a diagnosis of ESBC.

Suicide is a public health crisis with limited treatment options. The authors conducted a systematic review and individual participant data meta-analysis examining the effects of a single dose of ketamine on suicidal ideation. Individual... more

Suicide is a public health crisis with limited treatment options. The authors conducted a systematic review and individual participant data meta-analysis examining the effects of a single dose of ketamine on suicidal ideation. Individual participant data were obtained from 10 of 11 identified comparison intervention studies that used either saline or midazolam as a control treatment. The analysis included only participants who had suicidal ideation at baseline (N=167). A one-stage, individual participant data, meta-analytic procedure was employed using a mixed-effects, multilevel, general linear model. The primary outcome measures were the suicide items from clinician-administered (the Montgomery-Åsberg Depression Rating Scale [MADRS] or the Hamilton Depression Rating Scale [HAM-D]) and self-report scales (the Quick Inventory of Depressive Symptomatology-Self Report [QIDS-SR] or the Beck Depression Inventory [BDI]), obtained for up to 1 week after ketamine administration. Ketamine r...