Experiences in Using Computerized Sales Data to Evaluate a Nutrition Intervention Program

This study was primarily designed as a pilot to ascertain the feasibility of collecting and reducing sales data into manageable form for evaluation purposes.Twenty-one months of weekly sales data from two grocery stores were acquired through a marketing research firm. Grocery sales data appear to be useful in evaluating the impact of community-wide nutrition intervention programs. It is extremely resource intensive to use computerized sales data for evaluation purposes; however, advances in technology are making this process less burdensome. The complexities of assigning universal product coded (UPC) foods to specified study categories require careful attention. Use of outside resources is recommended. These include an intermediate processing center and a computerized database of UPC foods and their nutritional values.     

Building Community Partnerships: Using Social Network Analysis to Strengthen Service Networks Supporting a South Carolina Program for Pregnant and Parenting Teens

In 2013, South Carolina implemented a multi-year program providing support services for pregnant and parenting teens. Local lead sites were responsible for coordinating service delivery in partnership with other multidisciplinary community-based organizations. We used social network theory and analyses (SNA) to examine changes in partnerships over time. Using two-stage purposeful sampling, we identified three lead sites and their self-reported community partners. We administered two web-based surveys grounded in social network theory that included questions about partnership relationships and organizational characteristics. We calculated selected whole-network measures (size, cohesion, equity, diversity). Following the Year 1 surveys, we reviewed our findings with the lead sites and suggested opportunities to strengthen their respective partnerships. Following the Year 3 surveys, we observed changes across the networks. Survey response rates were 91.5% (43/47) in Year 1 and 68.2% (45/66) in Year 3. By Year 3, the average network size increased from 15.6 to 20.3 organizations. By Year 3, one lead site doubled its measure of network cohesion (connectedness); another lead site doubled in size (capacity). A third lead site, highly dense in Year 1, increased in size but decreased in cohesion by Year 3. Innovative use of SNA findings can help community partnerships identify gaps in capacity or services and organizations needed to fulfill program aims. SNA findings can also improve partnership function by identifying opportunities to improve connectedness or reduce redundancies in program work. The ability of lead sites to strategically reconfigure partnerships can be important to program success and sustainability.     

Using Generalized Linear Mixed Models to Evaluate Inconsistency within a Network Meta-Analysis

BackgroundNetwork meta-analysis compares multiple treatments by incorporating direct and indirect evidence into a general statistical framework. One issue with the validity of network meta-analysis is inconsistency between direct and indirect evidence within a loop formed by three treatments. Recently, the inconsistency issue has been explored further and a complex design-by-treatment interaction model proposed.ObjectiveThe aim of this article was to show how to evaluate the design-by-treatment interaction model using the generalized linear mixed model.MethodsWe proposed an arm-based approach to evaluating the design-by-treatment inconsistency, which is flexible in modeling different types of outcome variables. We used the smoking cessation data to compare results from our arm-based approach with those from the standard contrast-based approach.ResultsBecause the contrast-based approach requires transformation of data, our example showed that such a transformation may yield biases in the treatment effect and inconsistency evaluation, when event rates were low in some treatments. We also compared contrast-based and arm-based models in the evaluation of design inconsistency when different heterogeneity variances were estimated, and the arm-based model yielded more accurate results.ConclusionsBecause some statistical software commands can detect the collinearity among variables and automatically remove the redundant ones, we can use this advantage to help with placing the inconsistency parameters. This could be very useful for a network meta-analysis involving many designs and treatments.     

Peer Reviewed: Using the RE-AIM Framework to Evaluate a Physical Activity Intervention in Churches

Introduction

Health-e-AME was a 3-year intervention designed to promote physical activity at African Methodist Episcopal churches across South Carolina. It is based on a community-participation model designed to disseminate interventions through trained volunteer health directors.

Methods

We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate this intervention through interviews with 50 health directors.

Results

Eighty percent of the churches that had a health director trained during the first year of the intervention and 52% of churches that had a health director trained during the second year adopted at least one component of the intervention. Lack of motivation or commitment from the congregation was the most common barrier to adoption. Intervention activities reached middle-aged women mainly. The intervention was moderately well implemented, and adherence to its principles was adequate. Maintenance analyses showed that individual participants in the intervention''s physical activity components continued their participation as long as the church offered them, but churches had difficulties continuing to offer physical activity sessions. The effectiveness analysis showed that the intervention produced promising, but not significant, trends in levels of physical activity.

Conclusion

Our use of the RE-AIM framework to evaluate this intervention serves as a model for a comprehensive evaluation of the health effects of community programs to promote health.     

Effectiveness of Facebook Groups to Boost Participation in a Parenting Intervention

Prevention Science - Although family-based prevention programs have been shown to be effective at reducing adolescent substance use, it is often difficult and costly to recruit and retain parents...     

利用指数因素分析法评价住院收入影响因素

目的通过指数因素分析法分析某科室住院收入的变动情况,评价不同因素在住院收入中的作用。方法以2007年为基期,2008年为报告期,分析某科室出院人次、平均住院日和人日均费用对住院收入的影响及其交互作用。结果该科室2008年住院收入的变化主要取决于人日均费用的变化,其次是出院人次。结论因素分配分析法适用于评价科室住院收入的影响因素,有助于评价科室的运行效率。     

Peer Influence on Academic Performance: A Social Network Analysis of Social-Emotional Intervention Effects

Longitudinal social network analysis (SNA) was used to examine how a social-emotional learning (SEL) intervention may be associated with peer socialization on academic performance. Fifth graders (N?=?631; 48 % girls; 9 to 12 years) were recruited from six elementary schools. Intervention classrooms (14) received a relationship building intervention (RBI) and control classrooms (8) received elementary school as usual. At pre- and post-test, students nominated their friends, and teachers completed assessments of students’ writing and math performance. The results of longitudinal SNA suggested that the RBI was associated with friend selection and peer influence within the classroom peer network. Friendship choices were significantly more diverse (i.e., less evidence of social segregation as a function of ethnicity and academic ability) in intervention compared to control classrooms, and peer influence on improved writing and math performance was observed in RBI but not control classrooms. The current findings provide initial evidence that SEL interventions may change social processes in a classroom peer network and may break down barriers of social segregation and improve academic performance.     

Using Social Network Analysis to Clarify the Role of Obesity in Selection of Adolescent Friends

Objectives. We used social network analysis to examine how weight status affects friend selection, with an emphasis on homophily and the social marginalization of overweight youths.Methods. We used an exponential random graph model to assess the effects of body mass index (BMI) on friend selection while controlling for several alternative selection processes. Data were derived from 58 987 students in 88 US middle and high schools who took part in the 1994 to 1996 National Longitudinal Study of Adolescent Health.Results. On average, overweight youths were less likely than nonoverweight youths to be selected as a friend; however, this effect differed according to the BMI of the person initiating the friendship. Nonoverweight youths were 30% more likely to select a nonoverweight friend than an overweight friend, whereas overweight youths were largely indifferent to the weight status of their friends. Friendship ties from overweight youths to nonoverweight peers were more likely than ties in the reverse direction.Conclusions. We found evidence consistent with homophily and social marginalization but only for the selection behavior of nonoverweight youths. We conclude that avoidance of overweight friends is the primary determinant of friendship patterns related to BMI.Social network analysis offers a tool to understand the complex social and biological relationships that contribute to health.1–3 A tenet of the social network paradigm is that individual behaviors are interdependent owing to processes such as normative influences, social learning, and contagion.4–6 At the same time, network structure is not independent of behavior. Networks are dynamic, complex systems in which ties (e.g., friendships) are constantly evolving in conjunction with individual behaviors.Network selection processes are in part driven by individuals’ health,7 often including the very health behaviors that researchers treat as outcomes.8–10 However, several other processes also contribute to network structures. Friendships are more likely when individuals share commonalities with respect to sociodemographic attributes (i.e., homophily11), organizational affiliations,12 spatial proximity,13 and social connections (i.e., transitivity14). Also, individuals systematically vary in their sociability and popularity.15 Fully understanding health behavior thus requires an examination of network structures and the processes that create them.Several explanations have been invoked to understand the complex role of obesity in structuring friendships among young people. Two explanations in particular have received concerted attention. First, overweight adolescents are socially marginalized and less likely to be selected as a friend than their nonoverweight peers.9,16–18 This is troubling given that friendships are important sources of support and companionship throughout the life span.19 Not having or losing friends is associated with increased depression and decreased self-worth among young people, which could exacerbate the health problems associated with being overweight.20 These negative repercussions of friendlessness may be more pronounced in middle school and high school, when intimacy and fitting into peer groups are critical.20,21Second, adolescents tend to develop friendships with peers who have a similar body mass index (BMI).8,16,22,23 Friendships that are homophilous with respect to weight create the possibility for peer influence on behaviors and beliefs associated with weight. Friendships among overweight adolescents may reinforce unhealthy behaviors that further exacerbate weight problems.24Investigations of social marginalization and homophily have often been pursued independently, which we argue is a mistake. These patterns represent different perspectives on the more general question of how weight shapes friendship patterns. By adopting a network perspective, we recognize that the friend selection process depends on both the person initiating friendship (ego) and the friendship target (alter). Friendship likelihood can differ depending on the combination of ego and alter weight status. Assuming, for the sake of simplicity, that weight status is dichotomous, there are 4 types of friend selection dyads: overweight ego selecting overweight alter, nonoverweight ego selecting nonoverweight alter, overweight ego selecting nonoverweight alter, and nonoverweight ego selecting overweight alter.Examining marginalization requires that researchers compare friendship ties directed toward overweight versus nonoverweight alters, which disregards the ego’s weight status. By contrast, focusing solely on homophily entails comparing friendship dyads that are similar versus dissimilar, without considering whether the adolescents are overweight or nonoverweight. Examining either mechanism in isolation risks misidentifying the process underlying friend selection behaviors.A network approach demonstrates the interrelation between marginalization and homophily. Although the mechanism behind each pattern differs (e.g., avoidance of as opposed to preference for similarity), both predict that nonoverweight adolescents are more likely to befriend nonoverweight peers than overweight peers (

Using Venn Diagrams to Evaluate Digital Contact Tracing: Panel Survey Analysis

BackgroundMitigation of the spread of infection relies on targeted approaches aimed at preventing nonhousehold interactions. Contact tracing in the form of digital proximity tracing apps has been widely adopted in multiple countries due to its perceived added benefits of tracing speed and breadth in comparison to traditional manual contact tracing. Assessments of user responses to exposure notifications through a guided approach can provide insights into the effect of digital proximity tracing app use on managing the spread of SARS-CoV-2.ObjectiveThe aim of this study was to demonstrate the use of Venn diagrams to investigate the contributions of digital proximity tracing app exposure notifications and subsequent mitigative actions in curbing the spread of SARS-CoV-2 in Switzerland.MethodsWe assessed data from 4 survey waves (December 2020 to March 2021) from a nationwide panel study (COVID-19 Social Monitor) of Swiss residents who were (1) nonusers of the SwissCovid app, (2) users of the SwissCovid app, or (3) users of the SwissCovid app who received exposure notifications. A Venn diagram approach was applied to describe the overlap or nonoverlap of these subpopulations and to assess digital proximity tracing app use and its associated key performance indicators, including actions taken to prevent SARS-CoV-2 transmission.ResultsWe included 12,525 assessments from 2403 participants, of whom 50.9% (1222/2403) reported not using the SwissCovid digital proximity tracing app, 49.1% (1181/2403) reported using the SwissCovid digital proximity tracing app and 2.5% (29/1181) of the digital proximity tracing app users reported having received an exposure notification. Most digital proximity tracing app users (75.9%, 22/29) revealed taking at least one recommended action after receiving an exposure notification, such as seeking SARS-CoV-2 testing (17/29, 58.6%) or calling a federal information hotline (7/29, 24.1%). An assessment of key indicators of mitigative actions through a Venn diagram approach reveals that 30% of digital proximity tracing app users (95% CI 11.9%-54.3%) also tested positive for SARS-CoV-2 after having received exposure notifications, which is more than 3 times that of digital proximity tracing app users who did not receive exposure notifications (8%, 95% CI 5%-11.9%).ConclusionsResponses in the form of mitigative actions taken by 3 out of 4 individuals who received exposure notifications reveal a possible contribution of digital proximity tracing apps in mitigating the spread of SARS-CoV-2. The application of a Venn diagram approach demonstrates its value as a foundation for researchers and health authorities to assess population-level digital proximity tracing app effectiveness by providing an intuitive approach for calculating key performance indicators.     

成本效用分析在艾滋病行为干预效果评价中的应用

预防艾滋病的卫生资源是有限的，为了使这些有限的卫生资源获得最大的效果，需要从经济学角度对备选干预方案进行评价，选择最经济的方案。着重介绍了目前国外应用较多和较成熟的评价艾滋病行为干预效果的成本效用分析方法。     

Using Anthropometric Parameters to Evaluate Nutritional Status

No abstract available for this article.     

Preferences for Parenting Programs in Head Start: Using Conjoint Analysis to Understand Engagement in Parenting Health Promotion Programs

Prevention Science - The impact of evidence-based parenting health promotion programs is threatened by limited enrollment and attendance. We used a discrete choice experiment (DCE) to examine how...     

Utilizing Tenets of Inoculation Theory to Develop and Evaluate a Preventive Alcohol Education Intervention

With the advent of the Surgeon General's Report, Healthy People, a renewed interest in and concern for the health-risky practices of the school aged has emerged. Moreover, because the mortality rates for the 15 to 24 year age group continues to increase while the mortality rates for every other age group continues to decline, a school health education imperative has become prevention-based interventions. The experimental, prevention-based alcohol education program reported here describes one such intervention directed at 9th grade students. The program was grounded on the principles of Inoculation Theory and evaluated using a Solomon Four-Group Design. Results indicate that the formulation of preventive alcohol education programs utilizing Inoculation Theory in a school setting is both feasible and productive in achieving designated objectives. Longitudinal assessment of the subjects with regard to their alcohol-related behavior is continuing throughout their high school careers.     

Using GIS to Evaluate a Fire Safety Program in North Carolina

Evaluating program impact is a critical aspect of public health. Utilizing Geographic Information Systems (GIS) is a novel way to evaluate programs which try to reduce residential fire injuries and deaths. The purpose of this study is to demonstrate the application of GIS within the evaluation of a smoke alarm installation program in North Carolina. This approach incorporates national fire incident data which, when linked with program data, provides a clear depiction of the 10 years impact of the Get Alarmed, NC! program and estimates the number of potential lives saved. We overlapped Get Alarmed, NC! program installation data with national information on fires using GIS to identify homes that experienced a fire after an alarm was installed and calculated potential lives saved based on program documentation and average housing occupancy. We found that using GIS was an efficient and quick way to match addresses from two distinct sources. From this approach we estimated that between 221 and 384 residents were potentially saved due to alarms installed in their homes by Get Alarmed, NC!. Compared with other program evaluations that require intensive and costly participant telephone surveys and/or in-person interviews, the GIS approach is inexpensive, quick, and can easily analyze large disparate datasets. In addition, it can be used to help target the areas most at risk from the onset. These benefits suggest that by incorporating previously unutilized data, the GIS approach has the potential for broader applications within public health program evaluation.     

Changing Friend Selection in Middle School: A Social Network Analysis of a Randomized Intervention Study Designed to Prevent Adolescent Problem Behavior

Adolescent friendships that promote problem behavior are often chosen in middle school. The current study examines the unintended impact of a randomized school-based intervention on the selection of friends in middle school, as well as on observations of deviant talk with friends 5 years later. Participants included 998 middle school students (526 boys and 472 girls) recruited at the onset of middle school (age 11–12 years) from three public middle schools participating in the Family Check-up model intervention. The current study focuses only on the effects of the SHAPe curriculum—one level of the Family Check-up model—on friendship choices. Participants nominated friends and completed measures of deviant peer affiliation. Approximately half of the sample (n?=?500) was randomly assigned to the intervention, and the other half (n?=?498) comprised the control group within each school. The results indicate that the SHAPe curriculum affected friend selection within school 1 but not within schools 2 or 3. The effects of friend selection in school 1 translated into reductions in observed deviancy training 5 years later (age 16–17 years). By coupling longitudinal social network analysis with a randomized intervention study, the current findings provide initial evidence that a randomized public middle school intervention can disrupt the formation of deviant peer groups and diminish levels of adolescent deviance 5 years later.     

Maternal Alcohol Consumption During the Perinatal and Early Parenting Period: A Longitudinal Analysis

Objectives Despite potential health risks for women and children, one in five women report alcohol use during pregnancy and a significant proportion of those who quit during pregnancy return to drinking post-delivery. This study seeks to understand the longitudinal patterns of alcohol consumption before, during pregnancy and post-delivery, and the role of maternal characteristics for purposes of informing prevention design. Methods General growth mixture models were used to describe the average developmental patterns of maternal weekly drinking quantity at six time points, from preconception through child entering kindergarten, as well as heterogeneity in these patterns among 9100 mothers from the Early Childhood Longitudinal Study representing the 2001 US national birth cohort. Results Four distinct classes of mothers were defined by their longitudinal alcohol consumption patterns: Low Probability Drinkers (50.3 %), Escalating Risk Drinkers (12.0 %), Escalating Low Risk Drinkers (27.4 %), and Early Parenting Quitters (10.2 %). Heterogeneous covariate associations were observed. For example, mothers who gave birth after age 36 were twice as likely to be Escalating Risk Drinkers and Escalating Low Risk Drinkers (vs Low Probability Drinkers), but not more likely to be Early Parenting Quitters, when compared to mothers who gave birth between the ages of 26 and 35. Conclusions for practice There is significant heterogeneity in maternal longitudinal alcohol use patterns during the perinatal period. Baseline maternal characteristics and behavior associated with these heterogeneous patterns provide valuable tools to identify potential risky drinkers during this critical time period and may be synthesized to tailor pre- and postnatal clinical counseling protocols.