Abstract
BackgroundBehaviour risk factor surveillance (BRFS) data can be an important source of information for studying changes in various health outcomes and risk factors. Results obtained from surveillance data analysis are vital for informing health policy interventions, particularly with regards to evolutionary aspects. The objective of this analysis was to recommend a method that can be used for analysing trends in the association among variables from large public health data sets. This was demonstrated by examining the changing effects of various covariates, representing different sub-populations, on smoking status over time.MethodsIn our work, we propose the use of varying coefficient models (VCM) with non-parametric techniques to catch the dynamics of the evolutionary processes under study. This is a useful method, which allows coefficients to vary with time using smooth functions. Italian BRFS data from 2008-2012 was used with a sample size of 185,619 observations. In the application, a time VCM is fit for a smoking status binary outcome variable using the P-spline estimation method. The model includes ten independent variables comprising socio-demographic, health risk and behaviour variables.ResultsThe VCM fit for the data indicates that the coefficients for some of the categories for the age and the alcohol consumption variables varied with time. The main results show that Italians aged 18-29 and 40-49 had higher odds of being smokers compared to those aged 60-69; however, these odds significantly decreased in the period 2008-2012. In addition, those who do not drink had lower odds for being a smoker compared to high risk drinkers and these odds decreased further during the observation period.ConclusionThe application of the VCM to the BRFS data in Italy has shown that this method can be useful in detecting which sub-populations require interventions. Although the results have shown a decrease in the odds of being a smoker for certain age groups and non-drinkers, other sub-populations have not decreased their odds and health inequalities remain. This observation indicates that efforts and interventions are still required to target these non-changing sub-populations in order to modify their smoking behaviour.
Highlights
Behaviour risk factor surveillance (BRFS) data can be an important source of information for studying changes in various health outcomes and risk factors
The data collected can vary from one country to another, where some collect detailed health risk and behaviour information related to non-communicable disease such as the United States of America Behavioural Risk Factor Surveillance System (US BRFSS), and the designed Progressi delle Aziende Sanitarie per la Salute (PASSI) Italian surveillance system
Surveillance systems can be considered to be another form of big data which is proving to be an important source of information, when statistical well-thought methods [4] can take advantage of the availability of this rich data, which is very informative especially for evolutionary analysis
Summary
Behaviour risk factor surveillance (BRFS) data can be an important source of information for studying changes in various health outcomes and risk factors. Results obtained from surveillance data analysis are vital for informing health policy interventions, with regards to evolutionary aspects. The objective of this analysis was to recommend a method that can be used for analysing trends in the association among variables from large public health data sets. This was demonstrated by examining the changing effects of various covariates, representing different sub-populations, on smoking status over time. The Italian PASSI surveillance system, initiated in 2007, collects data on a monthly basis and is ongoing These types of surveillance systems are producing data that are continuously increasing in sample size. Surveillance systems can be considered to be another form of big data which is proving to be an important source of information, when statistical well-thought methods [4] can take advantage of the availability of this rich data, which is very informative especially for evolutionary analysis
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