Multilevel Random Coefficient Modeling Research Articles

Daily state of motivation as the effect of appreciation in a diary study.

Grounded in self-determination theory, the present study aimed to investigate whether daily changes in employee motivation depend on whether employees receive appreciation from various sources at work, using a 7-day diary design. Beyond general knowledge about the effects of appreciation as an important source of motivation, there is still a lack of knowledge about the intrapersonal effect of appreciation on different types of regulation/motivation in terms of self-determination theory over time. The sample consisted of 104 employees in full-time employment. More than half were women (72%) and the mean age was 43.25 years (SD = 10.53). They completed trait-level measures and then daily records, in which they reported their motivation and whether they received appreciation. Sources of appreciation were leaders, followers, and clients. Multilevel random coefficient modeling showed that employees reported higher levels of motivation on days when they received appreciation from different sources, independent of gender, trait-level motivation, and the Big Five. Furthermore, introjected regulation moderated the positive association between daily motivation and daily appreciation by the client, and appreciation did not have a lagged effect for subsequent days. The current study has both practical and theoretical implications. The results show that employee motivation can be supported through simple but effective steps through appreciation regardless of the source, although appreciation may be more important for employees with introjected regulation than for others.

The geography of educational voting: Understanding where individuals with similar qualifications vote differently across Britain

This study offers a novel account of the geographical variation in the association of educational attainment with electoral behaviour. It estimates multilevel random-coefficient models using survey data from the British Election Study Internet Panel and data on constituency characteristics to explore the extent to which, and reasons why, the voting behaviours of individuals with identical qualifications varied across different types of parliamentary constituencies in British general elections from 2015 to 2019. We find the geography of this educational cleavage has not been evenly distributed in recent years. While the individual-level association of educational attainment and vote choice indeed varied geographically at the 2015, 2017 and 2019 general elections, there is only limited evidence to suggest that similarly educated individuals voted differently in constituencies with low and high densities of persons with high levels of education. Rather, our findings suggest that constituency left behind-ness (broadly defined) is the most important factor in explaining the spatial heterogeneity of education-based voting in recent British general elections.

SEX AND RACE/ETHNIC DIFFERENCES IN TERMINAL COGNITIVE DECLINE

Abstract Background Cognitive decline has been documented in older adults, but sex and racial/ethnic differences among decedents have not been studied. Here we investigate the relation of mortality to change in the cognitive function of older individuals by sex and race/ethnicity. Methods The study analyzed data from the Health and Retirement Study (HRS) between 1993 and 2018, which included information on total word recall, mental status, and total cognition of individuals aged 65 and older. The study estimated the loss of cognitive function using a multilevel random coefficient model, considering sex and racial/ethnic differences in the risk of death, age, and death status. The study also approximated terminal cognitive decline using cognitive scores reported within two years before death for decedents. Results On average, older women performed better than older men in word recall and overall cognition, while older White Americans performed better than African Americans and Hispanics/Latinos in overall cognition at all ages. Decedents had a similar cognitive function to survivors at age 65, but their cognition declined quickly with age, especially among older women and White Americans. Evidence of terminal cognitive decline within two years before death was significant regardless of age but less conclusive for African Americans and Hispanics/Latinos due to smaller sample sizes. Conclusions This paper indicated evidence of sex and race/ethnic differences in cognitive decline and terminal cognitive decline among older adults, which may have critical clinical implications directly linked to the onset and duration of dementia risk.

Explaining the urban-rural gradient in later fertility in Europe.

Demographic research shows that, in Europe, fertility takes place later and is lower in cities than in rural areas. One might expect fertility to be delayed in urban areas because of longer periods in education and enhanced career opportunities. We, therefore, examine how prevalent later fertility (35+ and 40+) is along the urban-rural axis, and whether differences can be explained by economic, cultural and compositional factors. We estimate multilevel random coefficient models, employing aggregated Eurostat data of 1328 Nomenclature des unités territoriales statistiques (NUTS) 3 and 270 NUTS 2 regions from 28 European countries. The urban-rural gradient in later fertility considerably diminishes once factors describing the economic environment, family and gender norms as well as population composition are accounted for. The higher prevalence of later fertility in cities is particularly associated with higher female education, greater wealth and a higher share of employment in high-technology sectors.

The role of perceived autonomy support and fear of failure: A weekly diary study on work-related rumination.

Grounded in self-determination theory, the present study examined the weekly fluctuations in different forms of work-related rumination depending on perceived autonomy support and fear of failure at the workplace. Work-related rumination has three dimensions, affective rumination (negative emotions or affect), problem-solving pondering (thinking over the actions to handle the problems), and psychological detachment (mentally distancing oneself from work during nonwork time). In total, 111 employees (Mage = 34.88, SD = 10.43) from various occupations were followed over the course of three weeks via weekly measurements, resulting in 333 matched observations. Multilevel random coefficient modeling showed that on the weeks when employees reported higher levels of perceived autonomy support from the leader, they engaged in affective rumination and problem-solving pondering less. However, weekly fluctuations in psychological detachment from work was not associated with perceived autonomy support. Moreover, on the weeks when employees experienced high fear of failure, they reported less psychological detachment from work during nonwork time. Lastly, within-and and between-person fear of failure moderated the negative link between perceived autonomy support and affective rumination. Findings showed that perceived autonomy support is a protective factor for employees high in both state and trait fear of failure in decreasing affective rumination. Directions for future research and implication for practice were discussed.

Determinants of the food insecurity at household level in Pakistan: A multilevel model approach.

Food insecurity is a major concern for the developing world and around 37% of the population of Pakistan is food insecure. This paper utilizes the Food Insecurity Experience Scale (FIES) to assess the population prevalence of food insecurity and to identify their risk factors and determinants at the household level in Pakistan. This study employs a multi-level random coefficient model, using the Pakistan Panel Household Survey (PPHS-2010) dataset; representative data from 4,130 households. Factors like; income of the household, gender, education, household size, land ownership, and shocks of food insecurity allow the incidence of idiosyncratic shocks (injuries and/or casualties) at the community level, which affects the food insecurity situation of the community, rather differently were included. The study confirms a statistically significant inverse relationship between household income, household size, and household head education with food insecurity and a positive association of shocks and inflation with food insecurity at the household level. Specifically, with increasing per capita income of the household, food insecurity declines (coefficient: -0.083, statistically significant at 1%) and food insecurity increases with shocks (coefficient: 0.058, statistically significant at 1% significance level). The study also reveals a significant heterogeneity at a one percent significance level in the determinants of food insecurity at the district, community, and household levels. The income of the household, household head gender and education level, household size, household assets, shocks, injuries, and inflationary pressure are important determinants of food insecurity in Pakistan.

Predicting academic achievement and student absences in high school: The roles of student and school attributes.

The present study aims at examining predictors of high school students' academic achievement from student-level and school-level predictors in the Kingdom of Saudi Arabia, especially in light of policy mandates on educational reform in accordance with Vision 2030. Participants were 528,854 individuals who took on the Standard Achievement Admission Test (SAAT), along with other demographic variables. The mean age of participants was 19.7 years with an SD = 1.87. There were 234,813 males and 294,041 females. A Multilevel Random Coefficient Modeling (MRCM) model was engaged to identify predictors of academic achievement. Results indicated the positive roles of being a female, having educational parents, being educated in religious schools or large schools, and having small student-to-teacher ratios and the negative roles of student absences, student age, and being educated in new schools. Results are viewed under the lenses of new policy mandates on educational reform in the Kingdom of Saudi Arabia.

The Dynamic Interplay of Objective and Subjective Balance and Subsequent Task Performance: Implications for Fall Risk in Older Adults

Introduction: Falls occur in daily life when an activity results in a loss of balance that is too great to recover from. Our purpose in this study was to examine how fall risk differentiates the dynamic interplay of objective and subjective balance on a given day and subsequent task performance on that day. Methods: For 30 consecutive days, following a baseline fall risk assessment, 41 older adults (56% female, Age M = 75.22, SD = 6.75) self-assessed balance and task performance using a smartphone. The Activity-specific Balance Confidence scale measured subjective balance. Postural sway and chair-stand performance were measured within a smartphone using accelerometry. Data were analyzed using multilevel random coefficient models. Results: Tests of heterogeneity in level one residuals showed day-to-day variability in balance confidence and postural sway to be greater in individuals with higher fall risk at baseline. Baseline fall risk differentiated how the interplay of balance confidence and postural sway on a given day related to chair-stand performance on that day. For those with higher fall risk, on days that balance confidence was higher, greater postural sway was followed by greater chair-stand performance. Conclusion: Findings indicate that older adults, especially those with higher fall risk, may be unaware of subtle fluctuations in balance, which could lead to engaging in activities that exceed the capacity to maintain balance at that moment. Fall prevention efforts should address older adults’ understanding of and responses to fluctuations of physical function in daily life.

SELF-PERCEPTIONS OF AGING, SUPPORT FROM CLOSE SOCIAL TIES, AND HEALTH GOAL PROGRESS IN EVERYDAY LIFE

Abstract Subjective aging is interpersonal, it embodies processes of thinking about the self in relationship to others. We utilize data from the 100-day microlongitudinal Personal Understanding of Life and Social Experiences Project (N = 99; observations = 7,049; Mage = 63, range = 52-88) to explore how self-perceptions of aging differentiate the processes by which older adults shape interactions with close social ties to support progress toward a meaningful health goal in everyday life. Those with more positive self-perceptions of aging identified more friends among their closest social ties and reported a higher levels of goal progress and support toward that goal during the study period. Further, multilevel random coefficient models showed that goal progress on a given day was more sensitive to received support on that day among those with more positive self-perceptions of aging. The implications for adult development and shared experiences of aging within friendship networks is discussed.

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4.

Psychosocial safety climate (PSC) refers to workers' shared perceptions of organizational policies, practices and procedures for the protection of psychological health and safety. PSC offers a multilevel organizational approach that expands traditional models of workplace stress, giving a more comprehensive understanding of occupational health and safety issues. Although considerable research on psychosocial risks in the healthcare sector has been conducted, few studies have explored the role of PSC among healthcare workers at middle management level. Additionally, no validated version of PSC is available in Italian language. The aim of this study is to contribute to the validation of the Italian 4-item version of the PSC and to explore this theory within the Job Demands-Resources model (JD-R) among a sample of Italian healthcare workers by testing PSC at the middle management level. We used cross-sectional data from 276 employees working in 17 different wards in a large Italian hospital. Intra-class coefficient (ICC) coefficient and agreement index were used to test PSC as a climate construct (data nested to hospital ward level). We performed hierarchical linear models to test mediation and moderation effects. The Italian version of PSC-4 proved to have good psychometric properties and confirmed its role as a group-level construct (α = 0.84; ICC = 0.16). Multilevel random coefficient models showed PSC was associated with Job demands (Effort: B = -0.36, SE = 0.07; Emotional demands: B = -0.03, SE = 0.01) and Job resources (Reward: B = 1.16, SE = 0.01; Physical work environment: B = 0.06, SE = 0.01). Results confirmed the indirect effect of PSC on Psychological (Burnout) and Occupational health (Job satisfaction) outcomes supporting the role of Job resources and Job demands as mediators. The multilevel analysis did not find a significant interaction terms between PSC and Job demands on Burnout therefore the moderation hypothesis was not supported. The Italian version of PSC-4 is a valid tool to evaluate PSC. These findings sustain the multilevel framework of PSC and the significant role played by mid-leaders in both the health impairment and motivational path. Further studies should explore the buffering effect of PSC at higher baseline levels as well as the adoption of PSC as a target for occupational health intervention the Italian context.

Individual, Maternal, Household, and Community Level Variability in Determining Inequalities in Childhood Anaemia within Ethiopia: Four-Level Multilevel Analysis Approach

Background: Childhood anaemia is a major public health issue necessitating rapid attention due to its debilitating consequences on the child, family, and society. Previous studies have assessed the prevalence and contributing factors to childhood anaemia in many developing countries. Yet, little is known about the factors that contribute to childhood anaemia in Ethiopia. The study examined the factors associated with inequalities of childhood anaemia in Ethiopia. Methods: Data for the study were extracted from the 2016 Demographic and Health Survey of Ethiopia. A total of 7960 children were considered in the final study. Bivariate and multilevel ordinal logistic regression analyses were used to estimate determinants of inequalities of childhood anaemia status. Results: Overall, the prevalence of mild, moderate, and severe anaemia among the children were 24.5%, 28.4%, and 2.2%, respectively. The child’s age (in months), sex of the child, preceding birth interval (in months), mother’s educational level, antenatal care visit, wealth index of mothers, source of drinking water, type of toilet facility, place of residence, and region were significantly associated with childhood anaemia. The multilevel random coefficient model found that there is a variation of childhood anaemia among women (intra-cluster correlation [ICC] = 15.06%), households (ICC = 15.6%), and communities (ICC = 14.22%) in Ethiopia. Conclusions: This study showed that anaemia is common among Ethiopian children. Factors found to be associated with childhood anaemia were the sociodemographic characteristics of the child and their mothers. We recommend that existing programs and interventions to prevent and reduce childhood anaemia be strengthened. Moreover, a targeted intervention includes deworming, intensified year-round behavior change communication campaigns and testing using digital methods, and point-of-care treatment.

Collective resources for individual recovery: The moderating role of social climate on the relationship between job stressors and work-related rumination – A multilevel approach

In this study, we link cognitive processes of recovery to the social context in which employees experience job stressors. The aim was to examine how the social context in which employees experience work stressors is associated with individuals’ work-related thoughts in nonwork time and thus may prolong work-related mental efforts beyond working hours. We used aggregated individual ratings on social relations with colleagues and supervisors as a primer for social climate within workgroups, calculated the rate of permanent employment contracts per workgroup as a proxy for the stability of social relations within workgroups and used organizational affiliations to specify job settings in terms of routine versus creative tasks. Drawing on cross-sectional data from a psychosocial risk assessment and occupational health promotion survey of N = 1836 employees in 118 workgroups with different occupations at a German university, we tested multilevel random-coefficient models for affective rumination and problem-solving pondering. Results indicated a negative association of collegial climate with affective rumination but no association with problem-solving pondering. Supervisory climate was unrelated to both types of ruminative thinking. The stability of social relations within workgroups was negatively associated with affective rumination as well as with problem-solving pondering, whereas the job setting was only associated with problem-solving pondering. A cross-level interaction indicated a positive moderation effect of collegial climate on the relationship between job stressors and affective rumination. The findings indicate that a positive collegial climate can buffer the negative impact of low to average levels of job stressors on work-related thoughts and lead to the conclusion that the social context in which job stressors are experienced may alter individuals’ ability to mentally unwind from work.

THE IMPLICATIONS OF DIGITAL SOCIAL INTERACTIONS FOR OLDER ADULTS’ EXPERIENCES OF WELL-BEING IN DAILY LIFE

Digital communication technologies expand opportunities for social interactions and as a result have the potential to either amplify or dampen the coupling of social interactions with well-being in daily life. We use data from the 100-day Personal Understanding of Life and Social Experiences project (n = 99, age = 50 – 88) to examine variation in the sensitivity of older adults’ daily reports of well-being to the quality of social interactions with their five closest social partners across digital (email/social media) and analogue (in person/by phone) interactions. Digital interactions were more common among less-close social partners. Multilevel random coefficient models showed days with more digital interactions than normal to be characterized by a) lower well-being and b) less sensitivity in well-being to the quality of social interactions with close social partners on that day. The implications of our findings are discussed within a life-span perspective of social relationships and well-being.

The effect of external inspections on safety in acute hospitals in the National Health Service in England: A controlled interrupted time-series analysis

Objectives To evaluate the effect of Care Quality Commission external inspections of acute trusts on adverse event rates in the English National Health Service. Methods Interrupted time-series analysis including all acute NHS trusts in England ( n = 155) using two control groups (new versus historical inspection regime and trusts not inspected). Multilevel random-coefficient modelling of (1) rates of falls with harm and (2) pressure ulcers, from April 2012 to June 2016, was undertaken using the new, resource-intensive regime of Care Quality Commission inspections as an intervention. Data used in the model included dates and type of inspection, patient safety indicators, demographic characteristics and financial risk of hospitals. Results In one year, Care Quality Commission inspected 66 acute trusts (42% of all English trusts) using their new regime and 46 (30%) using their previous one. Prior to inspections being announced, rates of falls with harm and pressure ulcers were improving in both intervention and control hospitals. The announcement of an inspection did not affect either indicator. After inspections, rates of falls with harm improved more slowly, and pressure ulcer rates no longer improved for trusts inspected using both regimes. Conclusions Neither form of external inspection was associated with positive, clinically significant effects on adverse event rates. Any improvement happening before the announced Care Quality Commission inspections slowed after the inspection.

Validity evidence for programmatic assessment in competency-based education.

IntroductionCompetency-based education (CBE) is now pervasive in health professions education. A foundational principle of CBE is to assess and identify the progression of competency development in students over time. It has been argued that a programmatic approach to assessment in CBE maximizes student learning. The aim of this study is to investigate if programmatic assessment, i. e., a system of assessment, can be used within a CBE framework to track progression of student learning within and across competencies over time.MethodsThree workplace-based assessment methods were used to measure the same seven competency domains. We performed a retrospective quantitative analysis of 327,974 assessment data points from 16,575 completed assessment forms from 962 students over 124 weeks using both descriptive (visualization) and modelling (inferential) analyses. This included multilevel random coefficient modelling and generalizability theory.ResultsRandom coefficient modelling indicated that variance due to differences in inter-student performance was highest (40%). The reliability coefficients of scores from assessment methods ranged from 0.86 to 0.90. Method and competency variance components were in the small-to-moderate range.DiscussionThe current validation evidence provides cause for optimism regarding the explicit development and implementation of a program of assessment within CBE. The majority of the variance in scores appears to be student-related and reliable, supporting the psychometric properties as well as both formative and summative score applications.

Observations on the Medicare Value-Based Ranking of Hospitals During Fiscal Years 2015 and 2016.

Medicare's Value-Based Purchasing Program (VBPP) compensates hospitals based on value of care provided. VBPP's total performance score (TPS) components data were evaluated by hospital groups: physician-owned surgical hospitals (POSH), Kaiser Hospitals, University HealthSystem Consortium Hospitals, Pioneer Accountable Care Organization Hospitals, US News and World Report Honor Roll Hospitals, and other hospitals. Multilevel random coefficient models estimated mean and significance of TPS differences from fiscal year (FY) 2015 and FY 2016, by hospital type. Overall mean TPS for 2985 hospitals decreased from 41.65 to 40.25. POSH and Kaiser Hospitals had significantly higher TPS in FY 2015 and FY 2016. POSH Patient Experience Domain scores exceeded all other Patient Experience Domain scores. The Efficiency Domain scores of Kaiser greatly exceeded the scores of all groups. Results suggest that POSH and Kaiser Hospitals provide significantly greater value of care with consistency from year to year when compared with other groups studied.

Income inequality and privatisation: a multilevel analysis comparing prefectural size of private sectors in Western China

In 2000, the Chinese government initiated a campaign to develop Western China and reduce local and regional inequality. Privatisation has been a central component of the campaign. This article studies the relationship between privatisation and income inequality in Western China, based on survey data from 11 Western provinces collected between 2004 and 2005. This study first explores the link between privatisation and income inequality at the prefecture level, investigating whether a higher degree of privatisation can be linked to increased income inequality. Using multilevel random coefficient modelling, it then studies whether the impact of an individual’s socioeconomic position on their income varies across regions with different degrees of privatisation. The final part presents simulations of economic inequality based on the random slope model. The study shows that income inequality is higher in regions with higher degrees of privatisation, and larger privatisation correlates with lower individual income. Furthermore, the study confirms that individual income is strongly affected by education, occupation, employment sector and household registration status. Income differences based on these factors do not vary with the level of privatisation; however, a finding that contradicts market transition theory in the context of Western China.

A pilot study of patient-centered outcome assessment using PROMIS for patients undergoing colorectal surgery

PurposeFew studies have assessed patient-reported outcomes following colorectal surgery. The absence of this information makes it difficult to inform patients about the near-term effects of surgery, beyond outcomes assessed by traditional clinical measures. This study was designed to provide information about the effects of colorectal surgery on physical, mental, and social well-being outcomes.MethodsThe NIH Patient-Reported Outcomes Measurement Information System (PROMIS®) Assessment Center was used to collect patient responses prior to surgery and at their routine postoperative visit. Four domains were selected based on patient consultation and clinical experience: depression, pain interference, ability to participate in social roles and activities, and interest in sexual activity. Multilevel random coefficient models were used to assess the change in scores during the follow-up period and to assess the statistical significance of differences in trends over time associated with key clinical measures.ResultsIn total, 142 patients were consented, with 107 patients completing pre- and postoperative assessments (75%). Preoperative assessments were typically completed 1 month prior to surgery (mean 29.5 days before, SD = 19.7) and postoperative assessments 1 month after surgery (mean 30.7 days after, SD = 9.2), with a mean of 60.3 days between assessment dates. Patients demonstrated no statistically significant changes in scores for pain interference (−0.18 points, p = 0.80) or the ability to participate in social roles and activities (0.44 points, p = 0.55), but had significant decreases in depression scores between pre- and postoperative assessments (−1.6 points, p = 0.03) and near significant increases in scores for interest in sex (1.5 points, p = 0.06). Pain interference scores for patients with neoadjuvant chemotherapy significantly increased (3.5 points, p = 0.03). Scores for the interest in sex domain decreased (worsened) for patients with oncologic etiology (−3.7 points, p = 0.03). No other differences in score trends by patient characteristics were large enough to be statistically significant at the p < 0.05 threshold.ConclusionThese data suggest that the majority of patients quickly return to baseline physical, mental, and social function following colorectal surgery. This information can be used preoperatively to counsel patients about the typical impact of colorectal surgery on quality of life.

Lending a Helping Hand at Work: A Multilevel Investigation of Prosocial Motivation, Inclusive Climate and Inclusive Behavior

Purpose People with disabilities often encounter difficulties at the workplace such as exclusion or unfair treatment. Researchers have therefore pointed to the need to focus on behavior that fosters inclusion as well as variables that are antecedents of such ‘inclusive behavior’. Therefore the purpose of this study was to research the relationship between prosocial motivation, team inclusive climate and employee inclusive behavior. Method A survey was conducted among a sample of 282 paired employees and colleagues, which were nested in 84 teams. Employees self-rated prosocial motivation and team inclusive climate, their inclusive behavior was assessed by colleagues. Hypotheses were tested using multilevel random coefficient modeling. Results Employees who are prosocially motivated will display more inclusive behavior towards people with disabilities, and this relationship is moderated by team inclusive climate in such a way that the relationship is stronger when the inclusive climate is high. Conclusion This study shows that inclusive organizations, which value a diverse workforce, need to be aware of not only individual employee characteristics, but also team level climate to ensure the smooth integrations of people with disabilities into regular work teams.

Probing Resilience: Daily Environmental Mastery, Self-Esteem, and Stress Appraisal.

The current study explores one way the process of resilience arises by investigating the underlying process of stress appraisal. In particular, the analyses examine how resilience resources function each day to attenuate the extent to which life experiences are perceived as threatening, and how trait-like resilience resources shape the appraisal process. Daily diary and questionnaire data from 96 participants of Successful Aging in Context: The Macroenvironment and Daily Lived Experience (SAIC; MAge = 67 years, SDAge = 4.9 years; range: 58-86 years) were analyzed using multilevel random coefficient modeling to investigate how individuals' daily perceptions of control and self-esteem impacted perceived stress on a given day. Results suggested that both self-esteem and environmental mastery help mitigate the experience of stress; furthermore, dispositional resilience and self-esteem stability predict differences between individuals in the extent to which self-esteem tempers the perception of stress each day. The results inform theoretical and empirical work on the nature of resilience, especially regarding how the process arises in ordinary life. From an application perspective, results imply that augmenting environmental mastery and self-esteem, both of which are malleable, can facilitate resilience by helping elders challenge their perceptions of stress each day.