O'Campo P, Gielen A C, Faden R R, Xue X, Kass N, Wang M C
Department of Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Md 21205, USA.
Am J Public Health. 1995 Aug;85(8 Pt 1):1092-7. doi: 10.2105/ajph.85.8_pt_1.1092.
Many contextual analyses that bridge the micro-level-macro-level gap in identifying risk factors for adverse outcomes have not used methods appropriate for multilevel data. The purpose of this paper is to illustrate the application of appropriate multi-level analytic methods and discuss their implications for public health.
A previously published individual-level model of physical violence perpetrated by male partners during the childbearing year was reanalyzed to include variables describing the neighborhoods where the women resided. Logistic regression with estimation methods of the generalized estimating equation was used for the contextual analysis. To assess the advantages of the generalized estimating equation over conventional logistic regression, both were used for the two-level model.
The regression coefficients from the contextual model differed from the betas obtained in the individual-level model. Not only were neighborhood-level variables related to the risk of partner-perpetrated violence, but the presence of these macro-level variables in the models modified the relationships of the individual-level variables to the risk of violence.
Two-level models that include individual- and community-level factors may be beneficial for purposes of explanation in public health research.
许多在识别不良结局风险因素时弥合微观层面与宏观层面差距的情境分析,并未采用适用于多层面数据的方法。本文旨在说明适当的多层次分析方法的应用,并讨论其对公共卫生的意义。
对先前发表的关于生育年份男性伴侣实施身体暴力的个体层面模型进行重新分析,纳入描述女性居住社区的变量。采用广义估计方程估计方法的逻辑回归进行情境分析。为评估广义估计方程相对于传统逻辑回归的优势,两者均用于二级模型。
情境模型的回归系数与个体层面模型获得的β系数不同。不仅社区层面变量与伴侣实施暴力的风险相关,而且模型中这些宏观层面变量的存在改变了个体层面变量与暴力风险的关系。
包含个体和社区层面因素的二级模型可能有助于公共卫生研究中的解释目的。