Adjusted Wald Tests Research Articles

Public and Opinion Leader Willingness to Fund Obesity-Focused Policies in Kansas.

Obesity increases the risk for leading causes of death, including cardiovascular disease and some cancers. Midwestern and southern states have the highest obesity rates-in Kansas, one in every three adults is obese. We compared the willingness of Kansas adults and opinion leaders to pay more in taxes to fund obesity prevention policies. In 2014, we asked a representative sample of 2,203 Kansas adults (response rate 15.7%) and 912 opinion leaders (response rate 55%) drawn from elected office and other sectors, including business and health, whether they would pay an additional $50 in annual taxes to support five policies that improve access to healthy foods and opportunities for physical activity. We used adjusted Wald tests to compare public and opinion leaders' responses, and regression analysis to assess whether differences in respondents' gender, age, location (urban/rural), race/ethnicity, and political stance affected results. Adjusting for demographic differences, Kansas adults were more willing than opinion leaders to pay $50 in taxes for each of the five policy interventions. This study demonstrates a willingness among residents of a fiscally conservative state to pay increased taxes for policies that could reduce population obesity rates. Health professionals, including nurses, can use these findings to educate policy makers in Kansas and geopolitically similar states about widespread public support for obesity prevention policies. Public health and other nurses could also apply our methods to assess support for obesity prevention policies in their jurisdictions.

Frequency and duration of physical activity bouts in school-aged children: A comparison within and between days.

Understanding how physical activity (PA) patterns vary within and between days may guide PA promotion in young people. We aimed to 1) describe and compare the frequency (bouts/day) and duration (min/bout) of bouts of moderate-to-vigorous intensity PA (MVPA) on weekdays vs. weekends and in-school vs. out-of-school, and 2) assess associations of bout frequency and duration in these time-segments with overall PA. We used cross-sectional accelerometer data from 2737 children (aged 6–19 years) in the United States National Health and Nutrition Examination Survey (NHANES) 2003–2006. A bout was defined as MVPA (≥ 2000 counts per minute [cpm]) lasting ≥ 3 min. Adjusted Wald tests were used to assess differences in bout characteristics between time-segments. Linear regression was used to examine the association of time-segment specific bout characteristics with daily minutes of MVPA and PA volume (average cpm). Bout frequency was higher on weekdays than weekends (median [IQR] 4.3 [2.2–7.2] vs. 3.0 [1.0–6.5] bouts/day, p < 0.001); however, bout duration did not differ (4.7 [4.0–5.7] vs. 4.5 [3.7–5.8] min/bout, p = 0.33). More bouts were accumulated out-of-school compared with in-school (2.2 [1.0–4.0] vs. 1.8 [0.8–3.2] bouts/day, p < 0.001), but bout duration was similar (4.7 [3.8–5.8] vs. 4.5 [3.8–5.7] min/bout, p = 0.158). For all time-segments, the frequency and duration of bouts of MVPA were independently and positively associated with overall MVPA and PA volume. In conclusion, the characteristics of children's PA vary within and between days; accounting for this in intervention design may improve future interventions. However, increasing bout frequency or duration in any time-segment may be beneficial for overall PA.

Demand Analysis for Non-Alcoholic Beverages Consumptin in the United States

This research analyzes the demand for non-alcoholic beverages (non-diet carbonated beverages, diet carbonated beverages, non-carbonated caloric beverages, water, and unsweetened coffee and tea) in the United States using the first difference version of the Almost Ideal Demand System model. Five expenditure shares and prices demand equations for the non-alcoholic beverages are estimated using the Iterated Seemingly Unrelated Regression (ITSUR) and Full Information Maximum Likelihood (FIML) techniques. These two estimation techniques give similar results. Most of the products exhibit the consistent sign for the own and cross price elasticities as predicted by economic theory. Based on the expenditure elasticity, non-diet beverage is a luxury good (1.632) and the remaining goods have expenditure elasticity less than, which indicates that these products are necessities. These products are not weakly separable based on the regular and adjusted Wald tests. Moreover, seasonality has a positive impact on caloric beverages and water and a negative impact on the remaining productsInt. J. Soc. Sci. Manage. Vol-3, issue-1: 38-46

Residential Mobility in Early Childhood: Household and Neighborhood Characteristics of Movers and Non-Movers.

Understanding residential mobility in early childhood is important for contextualizing influences on child health and well-being. This study describes individual, household, and neighborhood characteristics associated with residential mobility for children aged 0-5. We examined longitudinal data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative sample of children born in 2001. Frequencies describe the prevalence of characteristics for four waves of data and adjusted Wald tests compared means. Moving was common for these families with young children, as nearly three-quarters of children moved at least once. Movers transitioned to neighborhoods with residents of higher socioeconomic status but experienced no improved household socioeconomic position relative to non-movers. Both the high prevalence and unique implications of early childhood residential mobility suggest the need for further research.

Social encounter profiles of greater Melbourne residents, by location--a telephone survey.

BackgroundModels of infectious disease increasingly seek to incorporate heterogeneity of social interactions to more accurately characterise disease spread. We measured attributes of social encounters in two areas of Greater Melbourne, using a telephone survey.MethodsA market research company conducted computer assisted telephone interviews (CATIs) of residents of the Boroondara and Hume local government areas (LGAs), which differ markedly in ethnic composition, age distribution and household socioeconomic status. Survey items included household demographic and socio-economic characteristics, locations visited during the preceding day, and social encounters involving two-way conversation or physical contact. Descriptive summary measures were reported and compared using weight adjusted Wald tests of group means.ResultsThe overall response rate was 37.6 %, higher in Boroondara [n = 650, (46 %)] than Hume [n = 657 (32 %)]. Survey conduct through the CATI format was challenging, with implications for representativeness and data quality. Marked heterogeneity of encounter profiles was observed across age groups and locations. Household settings afforded greatest opportunity for prolonged close contact, particularly between women and children. Young and middle-aged men reported more age-assortative mixing, often with non-household members. Preliminary comparisons between LGAs suggested that mixing occurred in different settings. In addition, gender differences in mixing with household and non-household members, including strangers, were observed by area.ConclusionsSurvey administration by CATI was challenging, but rich data were obtained, revealing marked heterogeneity of social behaviour. Marked dissimilarities in patterns of prolonged close mixing were demonstrated by gender. In addition, preliminary observations of between-area differences in socialisation warrant further evaluation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1237-9) contains supplementary material, which is available to authorized users.

Children With Autism Spectrum Disorder and Screen Time: Results From a Large, Nationally Representative US Study

ObjectiveTo test the hypotheses that children with autism spectrum disorder (ASD) have higher screen time than other children on a US nationally representative sample and that children with ASD are overrepresented among children who exceed the American Academy of Pediatrics (AAP) screen time recommendation (2 hours or less a day). MethodsThe National Survey of Children's Health 2011–2012, a nationally representative survey, asked parents to report their child's (aged 6–17 years) average daily media usage. The ASD subpopulation (n = 1393) was compared to children without ASD (non-ASD, n = 64,163). Differences were compared by design-corrected F tests. Regression models were estimated for both groups separately. Adjusted Wald tests were used to rigorously test the hypotheses. ResultsMore than half of US children exceed the AAP screen time recommendation. Compared to non-ASD, children with ASD had similar amounts of total screen time (3.21 hours per day vs 3.46 hours per day; P > .05), media (TV/video) time, and computer/mobile device leisure time. Children with ASD have a milder age gradient than the general population on computer/mobile device usage. Children with ASD were proportionally represented among high users (more than 2 hours per day). Data did not support hypotheses. ConclusionsIn a large, nationally representative US sample, there was no evidence that children with ASD differ in their screen time habits from other children. Both groups have high screen time use. Caution should be exercised before assuming that children with ASD are at higher risk of exceeding AAP screen time recommendations. Efforts to promote adherence to the recommendation are needed, but they should neither target nor exclude children with ASD.

Evidence to Support Including Lifestyle Light-Intensity Recommendations in Physical Activity Guidelines for Older Adults

The purpose of this study was to examine the association of objectively measured lifestyle light-intensity physical activity (LLPA) and moderate-to-vigorous physical activity (MVPA) with various biological markers and chronic diseases among a nationally representative sample of U.S. older adults (65+ years). A cross-sectional design was used for this study. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Subjects were 1,496 older U.S. adults. Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information. Blood samples were taken to assess biological markers. Adjusted Wald tests and Poisson regression were used to examine the association of LLPA and MVPA with biological markers and chronic disease. Older adults engaging in ≥300 min/wk of LLPA had lower observed values for body mass index, waist circumference, C-reactive protein, and insulin resistance compared to those engaging in <300 min/wk of LLPA. Additionally, those engaging in <300 min/wk of LLPA had a rate 1.18 times greater for having chronic disease compared to those engaging in ≥300 min/wk of LLPA. In this national sample of older U.S. adults, participation in at least 300 min/wk of LLPA was associated with more favorable health outcomes. Future experimental studies are warranted to confirm these findings.

The impact of the Malaysian minimum cigarette price law: findings from the ITC Malaysia Survey

ObjectivesStudy the effects of the 2011 Malaysian minimum price law (MPL) on prices of licit and illicit cigarette brands. Identify barriers to the MPL achieving positive public health effects.MethodsThe International...

Reported Sports Participation, Race, Sex, Ethnicity, and Obesity in US Adolescents From NHANES Physical Activity (PAQ_D).

Objective. To understand the relationships between participation in different types of leisure time sport activity and adolescent obesity, and how those relationships might differ based on race, gender, and household income. Methods. Data consisted of 6667 students that took part in the 1999 to 2006 National Health and Nutrition Examination Survey. The authors used adjusted Wald tests to examine differences in the prevalence of obesity (body mass index >95th percentile for age and sex) by sport for boys and girls separately. Results. Among adolescent youth age 12 to 19 years, 16.6% of male leisure time sport participants and 15.3% of female sport participants were obese, compared with 23.6% for male nonathlete participant-in-other-activities and 17.0% obesity rate for female nonathlete/participant-in-other-activities. For both males and females, reported participation in leisure time sports decreased between middle school and high school, and this reduction was associated with higher body mass index.

U.S. trends in light, moderate, and heavy drinking episodes from 2000 to 2010.

Risks and potential benefits associated with alcohol use vary with the amount of alcohol consumed on a drinking occasion. Over time, changes in the absolute and relative numbers of light or heavy drinking episodes may occur, impacting health and social problems. Analyses of the 2000, 2005, and 2010 National Alcohol Surveys focus on trends in the volumes of alcohol consumed on days where the drinker had 1 to 2, 3 to 4, or 5 or more drinks separately. These volume measures were obtained from graduated frequency questions with adjustments for estimated drink alcohol content for each drinker based on reported beer brand, spirits drink and pour method, contexts of drinking, and demographic characteristics. Respondents with especially high alcohol content drinks were adjusted up 1 category, and those with especially low alcohol content drinks were adjusted down 1 category. Trend significance was tested with adjusted Wald tests and in negative binomial models with 2000 as the reference year, indicators for race/ethnicity group and interactions between these and survey year, and adjustments for age, educational attainment, income, employment status, and wetness region. Analyses were conducted both in the overall sample including abstainers and in the current drinker sample only. Overall trend results indicate an increase in drink alcohol content-adjusted alcohol volume of 25% from 2000 to 2010 with similar changes between 2000 to 2005 and 2005 to 2010. Most of the increase from 2000 to 2005 resulted from increased volume from light drinking (1 to 2 drinks) days for men and women and moderate to heavy drinking (3 to 4 drinks) days for women, while the change from 2005 to 2010 resulted mostly from volume from heavy drinking days (5+ drinks per day) for men. Black and Hispanic women were found not to have participated in the overall trend of increased alcohol volume. Findings highlight shifts in drinking patterns suggesting increased heavy occasion drinking in 2010, particularly among men.

Advanced Degrees of Debt: Analyzing the Patterns and Determinants of Graduate Student Borrowing

Despite record student debt and the growing importance of graduate education, little is known about what drives graduate student borrowing. In response to that research gap, this study draws on several national data sources to analyze the patterns and predictors of education-related debt among graduate students specifically. Adjusted Wald tests show that borrowing among graduate students has increased in recent years, particularly at the master’s and doctoral level, while multilevel tobit analysis suggests that several demographic, disciplinerelated, and institution-level variables exert significant influence on cumulative graduate debt.

Public and Policy Maker Support for Point-of-Sale Tobacco Policies in New York

To compare public and policy maker support for three point-of-sale tobacco policies. Two cross-sectional surveys--one of the public from the New York Adult Tobacco Survey and one of policy makers from the Local Opinion Leader Survey; both collected and analyzed in 2011. Tobacco control programs focus on educating the public and policy makers about tobacco control policy solutions. Six hundred seventy-six county-level legislators in New York's 62 counties and New York City's five boroughs (response rate: 59%); 7439 New York residents aged 18 or older. Landline response rates: 20.2% to 22%. Cell phone response rates: 9.2% to 11.1%. Gender, age, smoking status, presence of a child aged 18 years or younger in the household, county of residence, and policy maker and public support for three potential policy solutions to point-of-sale tobacco marketing. t-tests to compare the demographic makeup for the two samples. Adjusted Wald tests to test for differences in policy support between samples. The public was significantly more supportive of point-of-sale policy solutions than were policy makers: cap on retailers (48.0% vs. 19.2%, respectively); ban on sales at pharmacies (49.1% vs. 38.8%); and ban on retailers near schools (53.3% vs. 42.5%). cross-sectional data, sociodemographic differences, and variations in item wording. Tobacco control programs need to include information about implementation, enforcement, and potential effects on multiple constituencies (including businesses) in their efforts to educate policy makers about point-of-sale policy solutions.

A Descriptive Study of Beverage Consumption among an Ethnically Diverse Sample of Public School Students in Texas

Objective: The purpose of this study was to examine prevalence rates of 5 types of beverage consumption by sociodemographic factors among 4th-, 8th-, and 11th-grade public school students in Texas.Methods: This study is based on secondary analyses of cross-sectional data from the 2004–2005 School Physical Activity and Nutrition study, a comprehensive surveillance study of energy balance–related behaviors and behavioral antecedents in a state-representative sample of 4th-, 8th-, and 11th-grade public school students in Texas (N = 23,190). Previous-day beverage consumption prevalence estimates were calculated for 5 types of beverages (i.e., fruit-flavored drinks, regular sodas, diet sodas, milk, and 100% fruit juice) by grade level, gender, ethnicity, school-level socioeconomic status, and metropolitan status. Logistic regression estimates of consumption prevalence were obtained for important sociodemographic indicators, including sex, grade, and ethnicity. Adjusted Wald tests were used to derive significance tests for sex differences in consumption, as sex emerged as a key determinant of consumption prevalence and varied systematically by type of beverage.Results: The most commonly consumed beverage by all participants was milk. However, more than 50% of students also reported regular soda and fruit-flavored drink consumption during the previous day. Milk and fruit juice consumption showed a steady decline with grade level, while consumption of regular soda increased with grade level. By 11th grade, the prevalence of any beverage consumption, including milk and juice, was significantly greater among boys. Ethnic differences in sugar-sweetened beverage consumption were most prevalent in 8th and 11th grades, with the highest estimated prevalence of sugar-sweetened beverages (i.e., fruit-flavored drink and regular soda) consumption among African Americans. Differences in beverage consumption by school-level socioeconomic status and metropolitan status were small.Conclusions: These findings indicate that a large proportion of public elementary students in Texas are consuming sugar-sweetened beverages and that consumption of sugar-sweetened beverages varies by a range of sociodemographic factors. Given the important link between sugar-sweetened beverages and obesity in children, these findings can be used to tailor obesity prevention efforts to specific subpopulations for the promotion of healthier beverage consumption.

Americans' Attitudes Toward Mental Health Treatment Seeking: 1990-2003

Americans' Attitudes Toward Mental Health Treatment Seeking: 1990-2003

Perceived Effectiveness of Medications Among Mental Health Service Users With and Without Alcohol Dependence

Perceived Effectiveness of Medications Among Mental Health Service Users With and Without Alcohol Dependence