JMASM 32: Multiple Imputation of Missing Multilevel, Longitudinal Data: A Case When Practical Considerations Trump Best Practices?

A pedagogical tool is presented for applied researchers dealing with incomplete multilevel, longitudinal data. It explains why such data pose special challenges regarding missingness. Syntax created to perform a multiply-imputed growth modeling procedure in Stata Version 11 (StataCorp, 2009) is also described

Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

Contains fulltext : 97806.pdf (publisher's version ) (Open Access)BACKGROUND: Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators. METHODS: A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. RESULTS: The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients--and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. CONCLUSIONS: An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare

Toward a neighborhood resource-based theory of social capital for health: Can Bourdieu and sociology help?

Within the past several years, a considerable body of research on social capital has emerged in public health. Although offering the potential for new insights into how community factors impact health and well being, this research has received criticism for being undertheorized and methodologically flawed. In an effort to address some of these limitations, this paper applies Pierre Bourdieu's (1986) [Bourdieu, P. (1986). Handbook of theory and research for the sociology of education (pp. 241-258). New York: Greenwood] social capital theory to create a conceptual model of neighborhood socioeconomic processes, social capital (resources inhered within social networks), and health. After briefly reviewing the social capital conceptualizations of Bourdieu and Putnam, I attempt to integrate these authors' theories to better understand how social capital might operate within neighborhoods or local areas. Next, I describe a conceptual model that incorporates this theoretical integration of social capital into a framework of neighborhood social processes as health determinants. Discussion focuses on the utility of this Bourdieu-based neighborhood social capital theory and model for examining several under-addressed issues of social capital in the neighborhood effects literature and generating specific, empirically testable hypotheses for future research.Social capital Social epidemiology Theory Social determinants Neighborhoods Bourdieu

Actual or potential neighborhood resources and access to them: Testing hypotheses of social capital for the health of female caregivers

This study considers three commonly overlooked aspects of neighborhood social capital: actual or potential network resources, access to such resources, and their potentially negative implications, as they bear on the health of adult female caregivers of children. Drawing upon Bourdieu's social capital theory and urban and community sociology research, two sets of related hypotheses are formulated and tested. The first set examines specific resources that inhere within neighborhood social relations by testing hypotheses concerning four forms of social capital (social support, social leverage, informal social control, and neighborhood organization participation) and their respective associations with daily smoking and perceived health. The second set assesses the importance of one's access to the neighborhood networks that possess such resources by testing hypotheses regarding how residents' neighborhood attachment moderates the association between social capital forms and these health outcomes in positive and negative ways. Analyses of the Los Angeles Family and Neighborhood Survey (L.A.FANS) linked with tract level census data indicate that specific social capital forms were directly associated with positive and negative health outcomes. Neighborhood attachment significantly moderated relationships between several social capital forms and health, indicating that a female caregiver's degree of network integration matters in both health promoting and health damaging ways. In addition to illustrating the utility of a Bourdieusian perspective for formulating explicit, testable hypotheses regarding how social capital may matter for health, these findings suggest that future public health studies of neighborhood social capital need to consider (1) the actual or potential resources that inhere within relationships, and (2) the role of access to such resources for promoting or compromising health.Social capital Neighborhood effects Bourdieu Los Angeles Family and Neighborhood Survey (L.A.FANS) Community Social determinants of health USA Caregivers

Public Conceptions of Serious Mental Illness and Substance Abuse, Their Causes and Treatments: Findings from the 1996 General Social Survey

Objectives. We examined the degree to which lay beliefs about the causes of disorders may predict beliefs about what constitutes appropriate treatment. Methods. We analyzed randomized vignette data from the MacArthur Mental Health Module of the 1996 General Social Survey (n=1010). Results. Beliefs in biological causes (i.e., chemical imbalance, genes) were significantly associated with the endorsement of professional, biologically focused treatments (e.g., prescription medication, psychiatrists, and mental hospital admissions). Belief that the way a person was raised was the cause of a condition was the only nonbiologically based causal belief associated with any treatment recommendations (talking to a clergy member). Conclusions. Lay beliefs about the biological versus nonbiological causes of mental and substance abuse disorders are related to beliefs regarding appropriate treatment. We suggest areas for further research with regard to better understanding this relationship in an effort to construct effective messages promoting treatment for mental health and substance abuse disorders

Neighborhood social organization exposures and racial/ethnic disparities in hypertension risk in Los Angeles.

Despite a growing evidence base documenting associations between neighborhood characteristics and the risk of developing high blood pressure, little work has established the role played by neighborhood social organization exposures in racial/ethnic disparities in hypertension risk. There is also ambiguity around prior estimates of neighborhood effects on hypertension prevalence, given the lack of attention paid to individuals' exposures to both residential and nonresidential spaces. This study contributes to the neighborhoods and hypertension literature by using novel longitudinal data from the Los Angeles Family and Neighborhood Survey to construct exposure-weighted measures of neighborhood social organization characteristics-organizational participation and collective efficacy-and examine their associations with hypertension risk, as well as their relative contributions to racial/ethnic differences in hypertension. We also assess whether the hypertension effects of neighborhood social organization vary across our sample of Black, Latino, and White adults. Results from random effects logistic regression models indicate that adults living in neighborhoods where people are highly active in informal and formal organizations have a lower probability of being hypertensive. This protective effect of exposure to neighborhood organizational participation is also significantly stronger for Black adults than Latino and White adults, such that, at high levels of neighborhood organizational participation, the observed Black-White and Black-Latino hypertension differences are substantially reduced to nonsignificance. Nonlinear decomposition results also indicate that almost one-fifth of the Black-White hypertension gap can be explained by differential exposures to neighborhood social organization

Measures of personal social capital over time: A path analysis assessing longitudinal associations among cognitive, structural, and network elements of social capital in women and men separately

Studies on personal social capital and health have relied on several key measures of social capital – trust, participation, network capital – all with the aim of capturing the resources to which individuals or groups might have access through their social networks. As this work has evolved, researchers have sought to differentiate among key measures, often arguing that each represents a different type of social capital. Despite the importance of this work, few studies have examined (a) whether these measures are in fact distinct constructs, particularly over time, (b) if these relationships are causal, and (c) whether gender patterns the ways these measures are related. Using a probability-based sample of adults with 1–3 observations per respondent, we apply generalized structural equation modeling to assess in women and men separately whether generalized trust, trust in neighbors, network diversity, social isolation, and social participation are associated with each other, hypertension, and self-reported health over a five-year period. The initial response rate was 38.7%, with cooperation rates of 60.4% and 56.3% at waves two and three. Findings highlight stability in the longitudinal relationship of the same measure across waves. They also suggest that social capital measures operate differently for men and women, with key measures of one type of social capital more often associated with another type in women than men. Nevertheless, the strengths of the associations remain weak in women and men, particularly over time, suggesting that these measures (especially generalized trust) may be inadequate proxies for each other. Lastly, social capital seemed more salient for women's than men's health. Future research on social capital might consider more deeply the role and meaning of gender in interpreting the results of studies linking social capital to health. Further consideration of trust, participation, and network capital as distinct constructs is also warranted