National-level Survey Research Articles

Wealth-related inequalities of women\u2019s knowledge of cervical cancer screening and service utilisation in 18 resource-constrained countries: evidence from a pooled decomposition analysis

IntroductionResource-constrained countries (RCCs) have the highest burden of cervical cancer (CC) in the world. Nonetheless, although CC can be prevented through screening for precancerous lesions, only a small proportion of women utilise screening services in RCCs. The objective of this study was to examine the magnitude of inequalities of women’s knowledge and utilisation of cervical cancer screening (CCS) services in RCCs.MethodsA total of 1,802,413 sample observations from 18 RCC’s latest national-level Demographic and Health Surveys (2008 to 2017–18) were analysed to assess wealth-related inequalities in terms of women’s knowledge and utilisation of CCS services. Regression-based decomposition analyses were applied in order to compute the contribution to the inequality disparities of the explanatory variables for women’s knowledge and utilisation of CCS services.ResultsOverall, approximately 37% of women had knowledge regarding CCS services, of which, 25% belonged to the poorest quintile and approximately 49% from the richest. Twenty-nine percent of women utilised CCS services, ranging from 11% in Tajikistan, 15% in Cote d’Ivoire, 17% in Tanzania, 19% in Zimbabwe and 20% in Kenya to 96% in Colombia. Decomposition analyses determined that factors that reduced inequalities in women’s knowledge of CCS services were male-headed households (− 2.24%; 95% CI: − 3.10%, − 1.59%; P < 0.01), currently experiencing amenorrhea (− 1.37%; 95% CI: − 2.37%, − 1.05%; P < 0.05), having no problems accessing medical assistance (− 10.00%; 95% CI: − 12.65%, − 4.89%; P < 0.05), being insured (− 6.94%; 95% CI: − 9.58%, − 4.29%; P < 0.01) and having an urban place of residence (− 9.76%; 95% CI: − 12.59%, − 5.69%; P < 0.01). Similarly, factors that diminished inequality in the utilisation of CCS services were being married (− 8.23%;95% CI: − 12.46%, − 5.80%; P < 0.01), being unemployed (− 14.16%; 95% CI: − 19.23%, − 8.47%; P < 0.01) and living in urban communities (− 9.76%; 95% CI: − 15.62%, − 5.80%; P < 0.01).ConclusionsWomen’s knowledge and utilisation of CCS services in RCCs are unequally distributed. Significant inequalities were identified among socioeconomically deprived women in the majority of countries. There is an urgent need for culturally appropriate community-based awareness and access programs to improve the uptake of CCS services in RCCs.

Demographic transition in Sultanate of Oman: emerging demographic dividend and challenges

BackgroundThe sharp fall in fertility and mortality in Oman in recent time is quite stunning and more than expected, which is largely remained unexplored. This paper examined the characteristics of demographic changes and the emerging windows of opportunities and challenges for Oman. It also discussed the policy options. Data come from the national level surveys and censuses as well as the World Population Prospects 2019 Revision of the United Nations.ResultsThe population of Oman grew from less than half a million in 1950 to more than four million in 2015, and expected to reach to seven million by 2055. After 1970, the annual growth rate of population accelerated due to increased immigration of working age population which has increased from less than 1% in 1970 to 44% in 2015. The fertility rate has declined from 8.6 births per woman in 1988 to 3.3 births per woman in 2008, a decline of 5.3 births per woman or 62% decline within a short period of 20 years. Under-five mortality also declined from 359 deaths per 1000 live births in 1950 to nine deaths per 1000 live births in 2015. Demographic transitions leads to many changes in the size and age structure of the population in Oman that open up the opportunities of accruing demographic dividend for economic development of the country. The dependency ratio has decreased from 98% in 1970 to 32% in 2015. Two opening of demographic dividend period has been observed—first from 1958 to 2000 and the second one has opened in 2010 which will reach its peak during the 2020s and will remain open until 2040.ConclusionOman has been experiencing a period of youth bulge over the years and it is expected to continue for at least next 20 years. To reap the benefits of the emerged demographic dividend, necessary steps need to be taken in a timely manner to develop human resources. Understanding the demographic challenges must be a priority for the government of Oman, and formulate policies to harvest the benefits of the demographic windows.

Insights into bacterial diversity in compost: Core microbiome and prevalence of potential pathogenic bacteria

Fertilizer-replacement programs by the ministry of agriculture and rural affairs are extraordinary actions for environment protection and sustainable agriculture in China. A national-level survey was performed to acquire consensuses of bio-physiochemical properties for composts. A total of 116 compost samples collected from 16 provinces in China were analyzed by high throughput sequencing of bacterial 16S rRNA gene amplicons. The germination index and bacterial alpha-diversity were lower in composts from poultry manure than others. This large-scale survey revealed that bacterial communities were distinct among different composts and slightly explained by pH, moisture and total nitrogen, but not by raw material or composting process. Nevertheless, 26 OTUs affiliated with Firmicutes (Cerasibacillus, Atopostipes and Bacillus) and Actinobacteria (Thermobifida, Actinomadura and Nocardiopsis) were present in most (>90%) composts and majority of these bacterial species were possibly associated with the biodegradation of organic materials. Surprisingly, 629 potential human or animal bacterial pathogens accounting an average of 1.21% of total 16S rRNA gene were detected and these bacteria were mainly affiliated with Helicobacter, Staphylococcus, Acinotobacter, Streptococcus, Mycobacterium and Enterococcus. In summary, this study provides baseline data for the diversity and abundance of core microbiome and potential pathogens in composts.

Patients\u2019 satisfaction with clinical Laboratory Services in Public Hospitals in Ethiopia

BackgroundKnowing customers’ level of satisfaction is relevant to improve and provide quality health care services. In the clinical laboratory, monitoring customers’ satisfaction is an important indicator of the quality management system and required by international laboratory standards. However, in Ethiopia, there has not been baseline data about the satisfaction level of patients’ with laboratory services at the national level. The aim of this national level survey was to assess patients’ satisfaction level with laboratory services at public hospitals in Ethiopia.MethodsA national survey was conducted using an institutional based cross-sectional study design was employed from 01 to 30 November 2017. A total of 2399 patients were selected randomly from 60 public hospitals. Data was collected using structured questionnaire, entered in Epi Info and analyzed with SPSS software. Multiple logistic regression model was fitted to identify predictors of patients’ satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant.ResultOverall, 78.6% of the patients were satisfied with the clinical laboratory services. Patients were dissatisfied with cleanness of latrine (47%), long waiting time (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%) and latrine location (20%), availability of requested service (18%), unfair payment of service (17%) and missing of result (12%). The educational status (P = 0.032), and distance (P = 0.000) were significantly associated with client overall satisfaction level.ConclusionMost laboratory patients’ were satisfied with the service provided by public hospital laboratories in public hospitals in Ethiopia. However, patients’ were dissatisfied with the accessibility of sites, adequacy of waiting area, cleanness of latrine, long TAT, communication, missing of results, availability of requested service and cost of service. Therefore, responsible bodies in each level should act on the identified gaps and improve the need of patients in each hospital laboratory. In addition, all hospital laboratories should conduct a satisfaction survey and meet the needs of laboratory patients.

Change in the Prevalence and Determinants of Consanguineous Marriages in India between National Family and Health Surveys of 1992–1993 and 2015–2016

This study aimed to determine the changing prevalence of consanguineous marriage in India between two national-level surveys. The primary hypothesis was whether region of residence and religious affiliation continue to play a significant role in determining consanguineous marriage even after controlling other potentially significant confounding variables. Data from the 81,781 and 85,851 ever-married women during the National Family and Health Surveys (NFHS) survey periods 1992-1993 (NFHS-1) and 2015-2016 (NFHS-4), respectively, were used in the analysis. Multinomial and binary logistic regression analyses examined determinants of consanguineous marriage types and of paternal and maternal first-cousin marriages, respectively. In both analyses a systematic model-building procedure was adopted. Altogether, four models were estimated. In the final model (model 4) of both the analyses, all respondent background characteristics (region of residence, religious affiliation, sociodemographic, household wealth) and years of survey were included. Although the overall prevalence of consanguineous marriage in India declined significantly (16%), it was not uniform across respondent background characteristics. The northern region of India (154%) showed a significant increase in consanguineous marriage, whereas eastern (31%), central (2.3%), northeastern (40%), and southern (8%) regions showed a significant decline. Significant declines in consanguineous marriage were found for Hindus (16%) and Muslims (29%); for Muslims of eastern (48%), central (29%), western (31%), and southern (27%) regions; and for Hindus in the western region (37%). Relative risk ratios estimated using multinomial logistic regression models suggest those living in the southern region show 9.55 (p < 0.001), 5.96 (p < 0.001), and 38.16 (p < 0.001) times more likelihood in the prevalence of first-cousin, second-cousin, and uncle-niece marriages, respectively, compared to the northern region after controlling all other confounding variables. Muslims also showed 3.76 (p < 0.001) and 2.91 (p < 0.001) times more likelihood in first-cousin and second-cousin marriages, respectively, compared to Hindus. Adjusted odds ratios (AORs) estimated using binary logistic regression models suggest those living in southern and northeastern regions were 1.25 (p < 0.001) and 1.36 (p < 0.05) times more likely, respectively, to marry a maternal first cousin compared to the northern region. The AOR estimates also show that Muslims were 1.11 (p < 0.01) times more likely to marry a maternal first cousin compared to Hindus. The authors conclude that, despite significant development in the socioeconomic condition of India during the postglobalization era (beginning in 1992-1993), region of residence and religious affiliation continue to play significant role in determining consanguineous marriage.

Problems of Measurement of the Relationship Between Civil Society and Democracy When Using Survey Data

Over the last three decades, it has become accepted wisdom that membership in civil society organizations enhances civic participation and encourages democratic outcomes. The attraction of the hypothesis grows from the universal power of its predictions. Similar concentrations of membership in civil society should create corresponding pressures for democratization in the United States, Asia or Europe. Utilizing data from 37 national level surveys in eight countries, this article finds that the quality of the data is insufficient to substantiate long-term trends or cross-country comparisons regarding the impact of associational membership on democratization. Methodological flaws in sampling and interviewing preclude validation of theories about the relationship between civil society and democracy.

Essential environmental variables to include in a stratified sampling design for a national-level invasive alien tree survey

There is a direct relationship between the abundance of biological invasions and their impact, which means that it is important to capture spatial patterns in their abundance and use this information to focus management actions. However, protocols to objectively determine invasive alien plant (IAP) distributions and abundance are lacking at a national level, resulting in the inability to determine and monitor changes in spatial extent and density over time. A complete inventory of IAP spatial distribution across an extensive area such as South Africa is not possible and so requires an efficient sampling approach. A simple random sampling design would not be efficient, so monitoring of IAP species at a national level requires an appropriate sampling design such as a stratified sampling. The selection of environmental variables to be included in such a stratification should be based on the relationship between IAP species and their physical environment to successfully summarize variance in their abundance within the different strata. A further objective is to obtain all possible combinations of environmental variables or a full rank design in the stratification to allow for the comparison of different strata based on actual field sampled data. This raises the question of which predictive environmental variables as well as how many to include in the stratification. For this purpose, three invasive tree species, namely Acacia cyclops, Acacia mearnsii and Prosopis glandulosa were selected as they cover the maximum possible area at the highest density with the least amount of geographic overlap. A total of 26 environmental variables that included climatic, soil and topographic type variables were tested with linear regressions against correlations with the abundance of those tree species. The results showed that a combination of average precipitation, soil depth, clay content in the B-horizon and terrain morphological units will serve as a suitable stratification at a national level to explain IAP abundance variation sufficiently well whilst retaining a full rank design. These results will be applied as the first phase in the formation of a regional level IAP monitoring programme for South Africa on a scientific basis.

Maternal empowerment and child malnutrition in Bangladesh

ABSTRACTThe study examines the importance of maternal empowerment in reducing the prevalence of child malnutrition in Bangladesh. Maternal empowerment is measured by a composite index based on four proxy variables that promote maternal empowerment. Factor analysis technique is used in constructing empowerment index. Ordered probit models are specified and estimated using national-level household survey data. Maternal empowerment is found to be the third-most important predictor of child malnutrition in Bangladesh, preceded by maternal endowment and child characteristics. Household characteristics such as partner’s level of education and household income are also associated with child malnutrition. The study has a number of policy implications to address maternal empowerment and child malnutrition. Public policy should focus on factors of maternal empowerment and investment in maternal health in order to improve the health of the next generation.

Application of different fish sampling gear in Korean reservoirs and the analysis of sampling efficiencies

The key objectives of this research were to establish fish monitoring methodologies and sampling efficiency strategies through the analysis of relations between fish species (compositions) and different kinds of sampling gear for lentic ecosystem health assessments. During the study, 81 species of fish and 53,792 individuals were sampled from the thirty reservoirs. When we tested the efficiency of combinations of multiple sampling gears, the combination of the cast net (CN) and kick net (KN) was most cost-effective, based on the sampling time elapsed and total cost of the sampling. This combination (1st choice method) sampled 74 fish species and 21,321 individuals and showed even better results than the combination of four types of gear (2nd choice method), which included the CN, fyke net (FN), trammel net (TN), KN, although 80 species and 52,242 individuals were sampled from the 2nd method. Overall, our preliminary data suggest that the lentic ecosystem health assessment (LEHA) model developed for national-level surveys may be used as an efficient tool for LEHA and the combined use of the CN and KN was more cost-effective than the 2nd choice method of four types of sampling gear (CN, FN, TN, and KN).

Impoverishment Due to Out-of-pocket Health Expenditures: Measurement and Comparison Across Different Surveys in India

Various estimates of impoverishment on account of out-of-pocket expenditure (OOPE) on health are available for India, covering different time periods, but there is a void in terms of comparable estimates. This article uses national level surveys conducted by National Sample Survey Organization for measurement of living standards (Consumption Expenditure Survey [CES]) for 2004–2005 and 2011–2012 and Health and Morbidity Survey (HMS) for 2004 and 2014 to quantify the trends in impoverishment estimates over time and identify the factors explaining these trends. Using consistent methodology, it is estimated that the increase in the number of persons impoverished due to OOPE using HMS is 19.78 million (from 77.9 million to 97.78 million) between 2004 and 2014, while using CES, the increase is 2.90 million (from 51.48 to 54.38 million) between 2004–2005 and 2011–2012. Expenditure on outpatient care including drugs led to 72 million people being pushed below poverty line in 2014. Most of the increase in impoverishment has come in lower income quintiles both in rural and urban areas. Government needs to focus on reducing OOPE for bottom three income quintiles and more specifically the household expenditure on medicines.

A laryngeal disorders prediction model based on cluster analysis and regression analysis.

This study provided the baseline for establishing policies for community health promotion programs to propose the clusters of multiple health risk factors and identify the risks of laryngeal disorders according to the clusters by using the national level survey representing the South Korean population. This study targeted 5941 people who completed the 5th Korean National Health and Nutrition Examination Survey. The independent variables were age, sex, smoking, high-risk drinking, education level, occupation, household income, and self-reported voice problems. The identify cluster relationship with laryngeal disorders by conducting 2-way cluster analysis and multinomial logit analysis. The prevalence of laryngeal disorder was 6.7%. The results of analysis, 3 clusters were automatically extracted. Multinomial logistic regression analysis showed that sociodemographic factors, health risk behaviors, and health status clusters were significantly related to the risk of laryngeal disorders. The males who were smoking, high-risk drinking, college graduate and above, high income, and non-manual workers had a higher risk of laryngeal disorders than females who were non-smokers, non-drinkers, 60 years old and older, economically inactive, and high school graduate. The results of this study suggested that it may be effective to classify population according to sociodemographic and health behaviors and develop health education materials and health promotion program accordingly in order to prevent laryngeal disorders.

Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey

ObjectiveHypertension is the most important risk factor for cardiovascular morbidity and mortality. There is limited data on hypertension prevalence in India. This study was conducted to estimate the prevalence of hypertension among Indian adults. MethodsA national level survey was conducted with fixed one-day blood pressure measurement camps across 24 states and union territories of India. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or a diastolic BP ≥90 mmHg or on treatment for hypertension. The prevalence was age- and gender-standardized according to the 2011 census population of India. ResultsBlood pressure was recorded for 180,335 participants (33.2% women; mean age 40.6 ± 14.9 years). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%), and 2,878 (1.6%) participants were of the age group 18–19, 20–44, 45–54, 55–64, 65–74, and ≥ 75 years, respectively. Overall prevalence of hypertension was 30.7% (95% confidence interval [CI]: 30.5, 30.9) and the prevalence among women was 23.7% (95% CI: 23.3, 24). Prevalence adjusted for 2011 census population and the WHO reference population was 29.7% and 32.8%, respectively. ConclusionThere is a high prevalence of hypertension, with almost one in every three Indian adult affected.

What’s in a word? Language and self-assessed health in the National Health and Nutrition Examination Survey

This study examines the extent to which the Spanish language influences the way in which respondents report health using the ubiquitous self-assessed health (SAH) outcome. We account for citizenship status, ethnicity, and a series of other covariates. The study uses the 2003-2016 national health and nutrition examination survey (NHANES) (n=39,107). Analyses treat SAH as non-ordered categorical and employ multinomial regressions. Results indicate that those answering in Spanish are considerably and significantly more likely to rate health as “fair/regular” ceteris paribus. Non-U.S. citizens and naturalized citizens are significantly more likely to rate their health favorably in comparison to U.S.-born; those identifying as Hispanic, Black, and other/multiracial are likely to rate health less favorably than others regardless of citizenship or interview language. A model that examines only foreign-born and accounts for years lived in the U.S. shows Spanish language still strongly predicted SAH outcomes, but years spent in the U.S. did not, a finding that does not support notions of acculturation. The study concludes that there is a language bias in the standard SAH measure typically used national-level health surveys and national-level surveys such as NHANES should adjust the question translation to better understand the health of immigrants.

Predictors of unmet need for family planning among all women of reproductive age in Ethiopia

IntroductionContraception is a good indicator of the extent to which couples have access to reproductive health services. Survey data on unmet need can provide overall direction by helping to pinpoint the obstacles in society and weaknesses in services that need to be overcome. This study is significant as it provides strong policy recommendations for the design and implementation of economic and non-economic interventions into family planning utilization by all eligible women.ObjectiveTo Identify Predictors of Unmet Need of Family Planning in Ethiopia.MethodsA national level survey by performance monitoring and accountability (PMA 2020), which conducted between March and April 2016 among 7552 all women of 15–49 years were utilized. Stata® version13 were used for survey data for analysis using weighted frequency to give equal chances for enumeration areas represented. Binary and multivariate logistic regression employed. P-value < 0.05 were used to declare independent predictors of unmet need for family planning in Ethiopia.Result7494 women responded to the interview giving response rate of 99.2%. Overall unmet need for family planning was 1, 214 (16.2%) of which 772 (10.3%) was for spacing and 450 (6.0%) for limiting. Overall unmet need was 540 (7.2%) in urban and 1431(19.1%) in rural areas of the Ethiopia. Statistically significant predictors with this were found to be women’s age 0.73 AOR [95% C.I 0.6–0.9], being lower wealth 0.22 AOR [95% C.I 0.07–0.6] as compared to lowest, parity 2.1 AOR [95% C.I 1.4–2.9], number of children at first use of contraceptive 1.1 AOR [95% C.I 1.03–1.19], having final say with provider 0.03 AOR [95% C.I 0.003–0.23] as compared with own decision making.ConclusionUnmet need of family planning in Ethiopia was generally high especially with significant disparity in residence and regional states. Socio-demographic factors (age and wealth status) and obstetric factor (parity) were found to be significant factor. Informed decision making for provision of contraceptives and enhancing women’s awareness starting their childbearing life with family planning were recommended.

Impact of Saudi Arabia’s Sugary Drink Tax on Prices and Purchases (P10-066-19)

ObjectivesConsumption of sugar-sweetened beverages (SSBs) has been associated with weight gain and an increased risk of type 2 diabetes and cardiovascular disease. Use of governmental policies, such as taxation, to reduce SSB consumption, has been successful in a number of global settings. However, the impact of such tax has not been examined in Arab Gulf countries where prevalence of obesity is high, and a unified excise tax was adopted in 2016. This tax increased the price of soda and energy drinks by 50% and 100% respectively, making it the largest beverage tax to date. date. Saudi Arabia was the first of the six Arab Gulf countries to implement these taxes in June 2017, followed by the United Arab Emirates, Bahrain, Oman, and Qatar. Saudi Arabia additionally added a 5% value added tax (VAT) to their beverage tax in 2018. We describe the impact of these excise taxes by examining price changes and purchases of taxed beverages pre-post taxation in Saudi Arabia MethodsThis is an observational study of a natural experiment with a pre-post design. The Saudi General Authority for Statistics’ national-level monthly survey of average prices for soda from 2009–2018 was used to describe the changes in the prices of the taxed beverage before and after the tax’s implementation. The 2004–2018 Euromonitor annual volume sales data for Saudi Arabia was used to describe the changes in soda and energy drink sales. ResultsPost beverage and VAT implementation, annual pruchases (volume per capita) of soda and energy drinks were reduced by 41% and 58%, respectively in 2018 compared to 2016. During the same time period, soda prices prices increased by 67% compared to the announced 55% tax rate (price per can from 1.5 to 2.5 Saudi Riyals). Prior to the implementation of excise taxes, soda prices have been consistent in Saudi Arabia, except for one price increase by manufacturers in 2010 (Figure 1). ConclusionsThese results highlight the substantial impact of excise taxation on the reduction of soda and energy drink sales in Saudi Arabia and contribute to the growing body of global evidence on the effects of SSB taxation on consumption, especially in other Arab Gulf countries that have implemented a similar tax structure. Funding SourcesReem Alsukait is a doctoral student supported by King Saud University, Saudi Arabia. Supporting Tables, Images and/or Graphs▪

Friend Not Foe? Reconsidering Race, the Police, and Community Relations

Given the complicated historical and contemporary relationship between law enforcement and African Americans, academic and popular commentary have focused intently on the existence of conflict between the police and the Black citizenry in the United States. The current project, however, seeks to broaden understanding in this area by exploring the extent to which African Americans know the police in positive, informal ways. Based on a 2017 national-level survey of 1,000 African Americans, this project explores the extent of survey participants’ association with police officers as well as potential predictors of those relationships. Specifically, binary logistic regression is used to analyze the relationship between the survey respondents’ social bonds, demographic characteristics, and their relationships with police officers. The analyses reveal that respondents’ ties to the police were common, with nearly one in four having a police officer as a family member and a majority having some relationship with officers. Those with stakes in conformity were more likely to have bonds to officers, although racial homophily likely also accounts for knowing police officers. Importantly, this project demonstrates the complexity of African Americans’ relationships with the police and identifies further lines of inquiry that might profitably be explored.

Videos Don’t Lie: African Americans’ Support for Body-Worn Cameras

In light of growing concern regarding the policing of inner-city communities—including questionable incidents of use of force—equipping officers with body-worn cameras (BWCs) has emerged as a salient proposal for reform. Based on a national-level survey of African Americans ( n = 1,000), this project shows that wide consensus exists among Black citizens in favor of BWCs. Since ostensibly “videos don’t lie,” implementing camera technology thus may be a means to increase police legitimacy. Importantly, the analysis also reveals that African Americans support a broad range of reforms to improve inner-city policing, of which BWCs are only one. Finally, the survey included a subset of 45 Black police officers. These officers also supported BWCs and most other proposed reforms but at a level that was lower and less intense than African American members of the public.

PCV72 HEALTH BEHAVIORS AMONG MYOCARDIAL INFARCTION SURVIVORS IN THE UNITED STATES: A PROPENSITY SCORE MATCHED STUDY

The American College of Cardiology/American Heart Association (ACC/AHA) recommends health behavior for secondary prevention of myocardial infarction (MI). We compared health behaviors between MI survivors and propensity score matched non-MI controls. This study was a retrospective, cross-sectional, matched case-control study using publicly available Behavioral Risk Factor Surveillance System (BRFSS) 2015 data. The study included adults aged ≥ 50 years responding “yes” to the question, “has a doctor, nurse, or another health professional ever told you that you had a heart attack, also called a myocardial infarction?”. MI survivors were matched on propensity scores to non-MI controls (1:3) based on age, sex, race/ethnicity, and comorbidities using the greedy matching algorithm (8:1-digit match). Dependent variable (health behaviors) of this study consisted of physical activity, alcohol consumption, flu immunization, smoking status, body mass index (BMI), physical checkup, and fruits/vegetable consumption. Univariate (chi-squared test) and multivariable binomial logistic regression analyses were used to compare health behavior between MI survivors and propensity score matched non-MI controls. The final study sample consisted of 17,675 MI survivors and 53,025 non-MI controls after propensity score matching. Multivariable analyses of health behaviors comparing MI survivors and non-MI controls after propensity score matching revealed that MI survivors were more likely to have their cholesterol checked within the past 2 years compared to controls (AOR=1.37, 95% CI: 1.17-1.61). However, they were more likely to be current smokers (AOR=1.30, 95% CI: 1.15-1.47), less likely to have a physical checkup within the past 2 years (AOR=0.82, 95% CI: 0.69-0.96) and engage in physical activity of at least 150 minutes/week (AOR=0.87, 95% CI: 0.80-0.94). Based on this United States national-level survey, MI survivors exhibited poorer health behaviors compared to their propensity score matched non-MI controls. Despite ACC/AHA guidelines, health behaviors have continued to be suboptimal for secondary prevention of MI.

National student survey metrics: where is the room for improvement?

The purpose of this study is to use machine learning and exploratory data analysis to interrogate patterns of metrics from a national-level student survey. Analysis of over 1.8 million returns detected long-term stability of the predictors of student satisfaction, with survey items relating to course management and teaching being consistently most influential. All metric outputs increased over the survey period; however, the rates of increase of several dimensions including Overall Satisfaction decreased markedly in the most recent years to a point of levelling off. There was also a growing similarity in an institution of outcomes at a national level. This study contributes new insights into the influential survey instrument, through rigorous determination of the most influential survey items, descriptions of the changes in variability between institutions, and exploration of the importance of patterns of outliers at the extremes of the metric outputs. We also identify a rapidly growing spike in total satisfaction at a broad course level and highlight how this is inconsistent with a customer satisfaction model. We conclude by considering the challenges of the use of national-level student surveys for the management of student satisfaction in higher education.

A Case Study on Applying Sampling Weight to the National Assessment of Educational Achievement

본 연구에서는 국가수준 학업성취도 평가의 표집 체제 전환에 따른 교육통계&#8228;측정학적 측면에서 표본자료의 대표성 제고를 목적으로 학업성취도 평가의 2단계 층화군집 표집설계에 기반한 가중치 산출 방안을 마련하고 그 실효성을 살펴보았다. 선행연구를 기반으로 학업성취도 평가의 가중치 산정을 위해 학교-학급-학생 자료 구조를 반영한 기본 설계 가중치, 이상 가중치 절삭, 사후층화 보정 방법을 적용하였다. 전반적으로 가중치를 적용한 국가수준 평가 결과는 가중치 미적용 결과에 비해 전수 결과에 좀 더 근접하는 것을 확인할 수 있었으며, 개선점으로 하위집단별(예, 시&#8228;도교육청별×지역규모별) 평가 결과를 산출하고자 할 경우 표집설계를 수정하여 이를 가중치 산정에도 반영할 것을 제안하였다. 본 연구는 복잡한 표집설계를 반영한 국가단위 조사 연구 및 결과 산출을 고려하는 국내 교육연구자들에 실증적인 정보를 제공한다는 점에서 그 의의를 찾을 수 있다.As the National Assessment of Educational Achievement (NAEA) was converted into the sampling test, the purpose of the present study was to improve the representativeness of NAEA sample data by applying the sample weights. Based on the literature review, a method of calculating the weight based on the two-stage stratified cluster sampling design of the NAEA was prepared by applying the weight calculation in the basic design, the outlier weight trimming, and the post-stratification. As a whole, the results based on the weighted sample data appeared a bit closer to the census results in comparison to the corresponding ones from the unweighted sample data. However in order to yield proper NAEA results for sub-populations (e.g., local educational offices × urbanicity), sampling designs should to be revised, along with application of the new sampling design into the weight calculation. The study results provide empirical information for educational researchers who purse national level survey studies with a complicated sampling design.