Murray D M, Short B
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455, USA.
J Stud Alcohol. 1995 Nov;56(6):681-94. doi: 10.15288/jsa.1995.56.681.
Alcohol intervention studies that allocate intact social groups to study conditions require adjustment to the usual analytic methods to account for the positive intraclass correlation that exists in such groups. This article presents intraclass correlations for measures related to alcohol use among young adults and discusses the use of those estimates to plan new studies.
Young adults aged 18-20 were selected at random from driver's license lists in each of the 15 communities participating in the Communities Mobilizing for Change on Alcohol project. Respondents were surveyed by telephone to assess their drinking habits and other factors related to alcohol use. Community-level intraclass correlations were computed for those measures, both prior to and after adjustment for person- and community-level covariates.
The community-level intraclass correlations tend to be small, with larger values for belief and attitude items than for self-reported behaviors. Even so, correlations of this magnitude can have important deleterious effects on the power to detect important treatment effects in an otherwise well-designed and well-executed study. Adjustment for person-level covariates often reduced those correlations, and adjustment for community-level covariates often reduced them substantially.
There is measurable variation in measures related to alcohol use among young adults that is attributable to their community of residence. With adjustment for selected person- and community-level covariates, the magnitude of these correlations can be sharply reduced allowing the investigator to plan a more efficient community trial.
将完整社会群体分配到研究条件中的酒精干预研究需要对常规分析方法进行调整,以考虑此类群体中存在的正组内相关性。本文呈现了与年轻人酒精使用相关测量指标的组内相关性,并讨论了利用这些估计值来规划新研究。
从参与“酒精问题社区动员变革”项目的15个社区的驾照名单中随机选取18至20岁的年轻人。通过电话对受访者进行调查,以评估他们的饮酒习惯及其他与酒精使用相关的因素。针对这些测量指标计算社区层面的组内相关性,包括在对个人和社区层面协变量进行调整之前和之后。
社区层面的组内相关性往往较小,信念和态度项目的相关性值大于自我报告行为的相关性值。即便如此,这种程度的相关性在一项设计良好且执行良好的研究中,可能会对检测重要治疗效果的效能产生重要的有害影响。对个人层面协变量进行调整通常会降低这些相关性,而对社区层面协变量进行调整往往会大幅降低它们。
年轻人中与酒精使用相关的测量指标存在可测量的差异,这可归因于他们居住的社区。通过对选定的个人和社区层面协变量进行调整,这些相关性的大小可大幅降低,从而使研究者能够规划更有效的社区试验。