Model Fit Χ2 Research Articles

O.4.2-6 The complexity of physical activity and alcohol consumption in adolescents aged 13-16 years: cross-sectional analysis of Avon Longitudinal Study of Parents and Children data (ALSPAC)

Abstract Purpose A recent review indicated that physical activity (PA), facilitated by organisations/clubs, may reduce alcohol consumption in early to mid-adolescence. Our study aims were to examine these factors, and identify how health determinants may influence association. Methods Cross-sectional secondary data analysis using UK cohort data from ALSPAC. Ages and sample-size: Time-point (TP) 1: 13-14 (n = 1824), TP2: 15-16 (n = 1334). Variables: minutes per day spent in moderate to vigorous PA > =3 days of accelerometer wear. Ancillary PA variables: Club-type (CT); and frequency of attending club (FAC) collected age 15 only. Risk of alcohol-related harm (RARH) categorised as: no current risk, increasing risk, and at risk (AR). Ordinal regression was conducted at each TP, using PA as a covariate. Explanatory variables (EVs): Psychosocial health (PSH) - Cluster membership numbers generated through K-means cluster analysis (uniquely represented at each TP); Socioeconomic status (SES); Educational attainment; BMI; Smoking status, and Gender. EVs entered into regression model if preliminary X2 tests achieved p<.10. Results Regression showed a positive association between PA and RARH at both TPs. Odds of being AR at TP1 were 1.31 greater for each 30 minute increase in PA (95%CI 1.10-1.57; p<0.002). At TP2: OR 1.24 (95%CI 1.01, 1.52; p=.036). TP1: CT (age 15) was not statistically significant at age 13. However, ‘sports club only’ (SCO), had greatest RARH (OR 1.04; 95%CI .806, 1.35; p=.753) vs. no CT. All EVs retained statistical significance at p<.05, excepting IDACI (p = .854) and gender (p = .917). TP2: Although CT was not statistically significant, SCO had the greatest RARH (OR 1.22; 95%CI .798, 1.86; p=.360). RARH was reduced if attending club most evenings vs. no attendance (OR .796; 95%CI .499,1.27; p=.388). Statistically significant EVs were PSH (OR 4.27; 95%CI 3.32, 5.51; p<.001) and smoking (OR 5.39; 95%CI 3.99, 7.29; p<.001). Model fit χ2 331.010, df 11, p<0.001. Pearson .455. Deviance .218. Nagelkerke .251. -2LL test of parallel lines with significance .321. Conclusions The relationship between PA and alcohol consumption is complex. While facilitated PA can provide many benefits for adolescents, potential unwanted consequences may be an increase in risk-behaviours like alcohol consumption. Further research is needed for greater comprehension of this association.

Variations in Health, Illness and Health Care-Seeking Behaviour of Those in the Upper Social Hierarchies in a Caribbean Society

Background: Little research exists in the Caribbean, and in particular Jamaica, on the upper class, and no study emerged from a search of the literature examining health, illness, and health care-seeking behaviour of this group. Aims: To provide pertinent information on the upper class in regards to their general health status, illnesses, typology of illnesses, health care seeking behaviours and factors which determine their (1) moderate-to-very good health status, (2) illness, and (3) health care seeking behaviour in order to make available to policy specialists and public health practitioners information on this group, to be used as a guide in their decision making policies. Methods and materials: A sample of 2,734 respondents from the wealthiest 20% and second wealthy social hierarchies was extracted from a cross-sectional survey of 6,783 respondents. An administered questionnaire was used to collect the data, which were stored and analyzed using SPSS for Windows 16.0 (SPSS Inc; Chicago, IL, USA). The questionnaire was modelled on the World Bank’s Living Standards Measurement Study (LSMS) household survey. Results: The majority of the sample stated at least good health status (83.3%), with 0.5% indicating very poor health status, and 15.3% who indicated an illness in the last 4-week period. Four variables emerged as statistically correlated with moderate-to-very good health status of those in the upper class (i.e. second wealthy and wealthiest 20%) - Model fit χ2 = 57.54, P < 0.0001. The model explained 33.2% of the variance in moderate-to-very good health status, and that the model is a good fit for the data. Three variables emerged as statistically correlated with self-reported illness - Model fit χ2 = 1087.7, P < 0.0001. The significant variables (i.e. health care-seeking behaviour, good health status, and marital status) accounted for 72.4% of the variability in self-reported illness. Three variables emerged as statistically significant correlates of health care-seekers - Model fit χ2 = 995.45, P < 0.0001. The statistically significant correlates (i.e. good health status, self-reported illness, marital status) accounted for 76.4% of the variance in health care-seeking behaviour of the upper class. Conclusion: Rural residents continue to have lower moderate-to-very good health status when compared to the general population, and the second wealthy and the wealthiest 20% in Jamaica. Although only 4 percent of the upper social hierarchy utilize the public health care system, there is still a demand for public health services for this group, and it must be taken into account as a part of the general planning for the health care system of the country.

Classifying subgroups of patients with symptoms of acute coronary syndromes: A cluster analysis

The purpose of the study was to identify subgroups of patients presenting with acute coronary syndromes based on symptom clusters. Two hundred fifty-six patients completed a symptom assessment in their hospital rooms. Latent class cluster analysis and analysis of variance were used to classify subgroups of patients according to selected clinical characteristics. Four subgroups were identified and labeled as Heavy Symptom Burden, Chest Pain Only, Sweating and Weak, and Short of Breath and Weak (model fit χ(2) [130,891, n = 256] = 867.5, p = 1.00). The largest group of patients experienced classic symptoms of chest pain and shortness of breath but not sweating. Younger patients were more likely to cluster in the Heavy Symptom Burden group (F = 5.08, p = .002). Interpretation of the clinical significance of these groupings requires further study.