Secondary Analysis Of Survey Data Research Articles

Secondary Data Analysis of National Surveys in Japan Toward Improving Population Health.

Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population’s health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author’s previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world.

Fifteen years of sector-wide approach (SWAp) in Bangladesh health sector: an assessment of progress.

The Ministry of Health and Family Welfare (MOHFW) of the Government of Bangladesh embarked on a sector-wide approach (SWAp) modality for the health, nutrition and population (HNP) sector in 1998. This programmatic shift initiated a different set of planning disciplines and practices along with institutional changes in the MOHFW. Over the years, the SWAp modality has evolved in Bangladesh as the MOHFW has learnt from its implementation and refined the program design. This article explores the progress made, both in terms of achievement of health outcomes and systems strengthening results, since the implementation of the SWAp for Bangladesh’s health sector. Secondary analyses of survey data from 1993 to 2011 as well as a literature review of published and grey literature on health SWAp in Bangladesh was conducted for this assessment. Results of the assessment indicate that the MOHFW made substantial progress in health outcomes and health systems strengthening. SWAps facilitated the alignment of funding and technical support around national priorities, and improved the government’s role in program design as well as in implementation and development partner coordination. Notable systemic improvements have taken place in the country systems with regards to monitoring and evaluation, procurement and service provision, which have improved functionality of health facilities to provide essential care. Implementation of the SWAp has, therefore, contributed to an accelerated improvement in key health outcomes in Bangladesh over the last 15 years. The health SWAp in Bangladesh offers an example of a successful adaptation of such an approach in a complex administrative structure. Based on the lessons learned from SWAp implementation in Bangladesh, the MOHFW needs to play a stronger stewardship and regulatory role to reap the full benefits of a SWAp in its subsequent programming.

Population experiences of primary care in 11 Organization for Economic Cooperation and Development countries.

To develop a measure of individual user assessments of primary care and test its association with health system performance and quality indicators. Cross-sectional analysis of secondary survey data collected in 2013. Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA. 20 045 respondents. Individual report of financial protection (out of pocket expenses over USD 1000), lack of receipt of appropriate/timely care (use of the emergency room in the past 2 years, having consulted three of more doctors in the past year) and clinical prevention (blood pressure check in past year, cholesterol checked in the past 5 years, receipt of influenza vaccination in past year and report of any medical error). A score of users' primary care experiences was constructed from 14 individual survey questions. Multivariable Poisson and augmented inverse-probability weighted regression assess the relationship between the primary care experience score and outcomes. Countries differed regarding the proportion of the population experiencing problems with primary care. In analyses controlling for age, sex, health status, chronic disease, income level and health insurance, users experiencing poorer primary care were significantly more likely to report significant out of pocket expenses, emergency room use in the past 2 years, having consulted more than three doctors in the past year, lower likelihood of blood pressure or cholesterol screening, an annual flu shot and higher reports of medical error. The measure of individual primary care experience can be used to differentiate among different country's primary care approaches and is strongly associated with overall health system performance and quality indicators.

Trastorno dual en población general de Itagüí, Colombia

ObjectivesTo study the prevalence of dual diagnosis (presence of a substance use disorder and an associated mental disorder) in the general population of a small town in the department of Antioquia in Colombia, through secondary analysis of survey data on Mental Health held in this city in 2011. MethodsWith a sample of 415 subjects, the interview Composite International Diagnostic Interview (CIDI), WHO CAPI version, was used and statistical analysis was performed using SPSS v.21. ResultsThe prevalence of dual diagnosis, considering that the presence of a diagnosis of mental disorder and a disorder snuff use of different substances was 7.2%. Substances with higher prevalence of use in life for individuals with dual diagnosis were alcohol (96.7%), marijuana (80.0%), cocaine and derivatives (33.3%), heroin (23.3%) and finally no prescription tranquilizers (13.3%), finding statistical association between drug use and dual diagnosis. Major depression (40%), oppositional defiant disorder (36.7%), posttraumatic stress (33.3%), specific phobia and attention deficit (26.7%) are the most prevalent disorders in individuals with dual diagnosis of this sample. Alcohol or drugs consumption and fulfilling diagnostic criteria for dual diagnosis have a significant statistical association for consumption of drugs like marijuana, cocaine, heroin and prescription medications (P<0.001), all with disparity ratios of >1.00, very high when the drug is heroin consumed (RD=38.754) or non-prescription medications (RD=29.462). A family history of disease and drug use has a high statistical association with dual diagnosis, with a higher association with a history of mental illness (P<.001; RD=3.677). ConclusionsThe study reports on the prevalence of subjects with dual diagnosis in a Colombian population. Alcohol, marijuana, cocaine and heroin are derivatives and substances mostly consumed by these patients and the most prevalent mental disorders are depression, TOD and posttraumatic stress. These findings motivate clinicians to more actively seek the presence of dual diagnosis, directing a more appropriately treatment plans.

Public Health Information Delivery in the Emergency Department: Analysis of a Kiosk-Based Program

BackgroundBecause more than one-third of the U.S. population visits an emergency department (ED) any given year, public health interventions in the ED can have major population-level impacts. ObjectivesWe determined ED patients’ interest in receiving information via kiosk on common, chronic conditions for which education and preventive screening could offer public health benefit and to assess what topical information patients are interested in receiving. MethodsThis is a secondary analysis of survey data from an ED pilot program December 2011 to April 2012. Main outcome measures were patients’ interests in receiving information on health topics via kiosk module. ResultsMore than half of the 4351 patients indicated interest in receiving information on at least one health topic, including high blood pressure (30%), depression (21%), diabetes (18%), sexually transmitted diseases (11%), drug abuse (6%), and physical abuse (3%). African-American patients were more likely to be interested in receiving information on high blood pressure (odds ratio [OR] 2.7, 95% confidence interval [95% CI] 2.2−3.2]), depression (OR 1.3, 95% CI 1.1−1.6), diabetes/sugar (OR 2.2, 95% CI 1.8−2.8), drug abuse (OR 1.4, 95% CI 1.0−1.9), and sexually transmitted diseases (OR 2.6, 95% CI 1.9−3.7). Participants >55 years of age were more likely to desire information on high blood pressure and diabetes (age 55−64 years: OR 4.0, 95% CI 3.1−5.1; age >64 years: OR 4.4, 95% CI 3.2−6.2). Patients who were interested in receiving public health information were more likely to be older, African American, and male (p < 0.05). ConclusionsInterest in obtaining kiosk-delivered education on hypertension predominated. Kiosks are versatile tools that could be used in ED settings to provide health education services.

Do young women engage in greater sexual risk behaviour with biological fathers of their children?

ObjectivesQualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as ‘baby daddy’ relationships, enable risk for pregnancy and STI/HIV. Our study compared...

Intergenerational Transmission of Marital Violence: Results From a Nationally Representative Sample of Men.

The present study assesses the association between childhood exposure to parental violence and perpetration of marital violence as adults among a representative sample of 3,396 men in Bangladesh. We used secondary analysis of survey data from the nationally representative Bangladesh Demographic and Health Survey 2007 to examine factors associated with perpetration of martial violence among 3,396 ever-married men between the ages of 16 and 50 years. Outcome measure, marital violence perpetration, was measured using a modified Conflict Tactics Scale, and predictor variables included childhood exposure to parental violence, justification of marital violence, marital duration, religion, and demographic variables. Results indicate that marital violence perpetration is significantly associated with childhood exposure to marital violence, suggesting a cycle of violence that is maintained across generations. Implications for policy and practice are discussed.

Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity.

Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. A secondary analysis of survey data from adult participants living with a severe mental illness (N = 401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with 0 partners, 1 partner, or multiple partners over the past 3 months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions on the basis of consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning.

Multi-site Programming Offered to Promote Resilience in Military Veterans

Background and Purpose: Military and veteran suicide rates exceed those found in the general population. Veterans often reject patient identities, creating barriers to care for mental health within the clinical sector and a mandate for prevention programs. The purpose of this study was to offer a postintervention process evaluation of one peer-led resilience program offered to military veterans of Iraq and Afghanistan at three sites in 2013. Methods: Secondary analysis of survey data collected involved mixed-methods analysis of open and closed-ended questions. In total, the research team reviewed 52 electronic survey responses; participant response rate was 48.1%. Results: Descriptive data analysis found that all participants rated Just Roll With It Bootcamp content as “somewhat useful” (17.9%) or “very useful” (82.1%). Qualitative analysis of open-ended questions found that content was perceived as valuable by participants. Emergent themes included: health practices, social support, and participant quality of life or satisfaction. Comments also informed four subthemes which included: meditation/mindfulness, nutrition, physical practice, and the seminars’ physical environment. Conclusion: Culturally-informed prevention programs that emphasize social support, physical movement, and peer-leadership have a vital role to play in working to prevent suicide by promoting quality of life for veterans.

Global warming's five Germanys: A typology of Germans' views on climate change and patterns of media use and information.

People's attitudes toward climate change differ, and these differences may correspond to distinct patterns of media use and information seeking. However, studies extending analyses of attitude types and their specific media diets to countries beyond the United States are lacking. We use a secondary analysis of survey data from Germany to identify attitudes toward climate change among the German public and specify those segments of the population based on their media use and information seeking. Similar to the Global Warming's Six Americas study, we find distinct attitudes (Global Warming's Five Germanys) that differ in climate change-related perceptions as well as in media use and communicative behavior. These findings can help tailor communication campaigns regarding climate change to specific audiences.

Microfinance Participation and Domestic Violence in Bangladesh: Results From a Nationally Representative Survey.

This article examines domestic violence among women who participate in microfinance in Bangladesh. Secondary analysis of survey data from nationally representative Bangladesh Demographic and Health Survey was used to investigate the association between microfinance participation and domestic violence of 4,163 ever-married women between the ages of 18 and 49 years. Outcome measure is experience of domestic violence as measured by a modified Conflict Tactics Scale (CTS) and predictor variables include microfinance, binary indicator of relatively better economic status, autonomy, decision-making power, and demographic variables. The likelihood of experiencing domestic violence was not found to vary with microfinance participation. However, the interaction effect of microfinance and better economic status was found to be significantly associated with domestic violence (9% increased probability). Experience of domestic violence was negatively associated with older age, higher education of the husband, and autonomy. In Bangladesh, microfinance participation may be associated with a higher probability of experiencing domestic violence for women with relatively better economic status, but not for the poorest of the poor.

The relationship between patients’ perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics and patient age

BackgroundThe relationship between nurses’ job satisfaction and their perceptions of quality of care has been examined in previous studies. There is little evidence, however, about relationships between the job satisfaction of nursing staff and quality of care perceived by the patients. The aim of this study was to analyze, how the job satisfaction of nursing staff, organizational characteristics (hospital and unit type), and patients’ age relate to patients’ perceptions of the quality of care.MethodsThe study was cross-sectional and descriptive, based on a secondary analysis of survey data acquired during the At Safe study in Finland. The study included 98 units at four acute care hospitals between autumn 2008 and spring 2009. The participants were 1909 patients and 929 nursing staff. Patients’ perceptions of quality of care were measured using the 42-item RHCS questionnaire. Job satisfaction of nursing staff was measured with the 37-item KUHJSS scale. Statistical analyses included descriptive statistics, principal component analysis, t-tests, analysis of variance, linear regression, and multivariate analysis of variance.ResultsPatients’ perceptions of overall quality of care were positively related to general job satisfaction of nursing staff. Adequate numbers of staff appeared to be the clearest aspect affecting quality of care. Older patients were more satisfied with staff number than younger patients. Patients cared for in outpatient departments felt more respected than patients in wards, whereas patients in wards reported better care of basic needs (e.g., hygiene, food) than outpatients.ConclusionsThe evaluation of resources by nursing staff is related to patients’ perceptions of the adequacy of nursing staff levels in the unit. The results emphasize the importance of considering patients’ perceptions of the quality of care and assessments by nurses of their job satisfaction at the hospital unit level when evaluating quality of care.

Sources, contents, and students' social learning about persons with a disability

A secondary analysis of survey data of Hong Kong school students (N = 2,865) examines social learning about persons with a (physical) disability (PWDs). Path models, connecting recalled information in communication about PWDs of different sources (media, significant others, and contact) and content (assistance, pity, and fear) with perceptions, general attitude, and behavior inclination toward PWDs, showed content as better predictor than either media channels or interpersonal sources. Interpersonal sources were better predictors than media channels were. The effects were also mediated by perception of PWDs' capabilities, perception of PWDs' inner state, and general attitude toward PWDs. The findings are interpreted and discussed.

Patterns and Correlates of Missed Nursing Care in Inpatient Oncology Units

Missed nursing care influences the quality of hospital care, yet this problem has not been explored in the oncology setting, nor are the correlates of missed nursing care in inpatient oncology settings understood. We examined the frequency of missed care in oncology units, differences in missed care between oncology and non-oncology units, and the relationship between unit staffing and missed care. We performed secondary analysis of survey data collected in 2008 to 2009 across 9 hospitals. The MISSCARE Survey was administered to nurses and medical assistants employed in 62 units (n = 2318). Descriptive statistics and linear regression were used to examine the frequency of missed care, differences between oncology (n = 12) and non-oncology units (n=50), and the relationship between unit staffing and missed care. Oncology nursing unit personnel reported ambulation, care conference attendance, and mouth care as most frequently missed. Oncology units had significantly lower missed care than did non-oncology units (P < .05). Higher patient assignments were associated with an increase in reported missed care (P < .05). Missed care is a problem shared by inpatient oncology and non-oncology units. Missed ambulation and mouth care are worrisome, given their importance to oncology patients. Suboptimal staffing increases missed care. These data motivate quality improvement and evidence-based management. Clinicians can strategize to ensure patients receive adequate ambulation and mouth care. Managers can use our findings to support the importance of stable nurse staffing to reduce untoward patient outcomes.

Mode of birth and women’s psychological and physical wellbeing in the postnatal period

BackgroundPhysical and psychological problems after childbirth are common, and may have a significant negative and long-term impact on women’s wellbeing and daily functioning. The method of birth may be a particularly important factor influencing women’s health and wellbeing following birth, however, population-wide evidence is limited. This study uses data from 5,332 women who responded to a national survey of women’s experiences of maternity care in England. We examined women’s postnatal wellbeing in the first three months after birth, and whether these varied by mode of birth.MethodsThis is a secondary analysis of survey data using a random sample of women selected from birth registration. We used multinomial logistic regression models to examine the association between women’s self-reported psychological symptoms, health problems and mode of birth.ResultsWomen who had forceps-assisted vaginal births and unplanned caesarean section births reported the poorest health and wellbeing, while those of women who had unassisted vaginal births and planned caesarean section births were less affected by the birth process. Most women’s physical and emotional health appeared to improve with time, however, those who had a forceps-assisted vaginal birth were more likely to report ongoing posttraumatic-type symptoms several months after the birth.ConclusionsMode of birth was associated with differences in outcomes at three months. By comparison to women who had unassisted vaginal births, the risk of reduced postnatal health and wellbeing was higher amongst the women who had forceps-assisted vaginal births but not amongst women who had ventouse-assisted vaginal births. This would suggest that it is important to differentiate the different types of instrumental birth in outcome studies. Of concern was the higher rate of posttraumatic-type symptoms among women who had forceps-assisted vaginal births relative to the other modes of birth. Women who have forceps-assisted births should be monitored carefully by health professionals in the postnatal period, and in the months after childbirth, when they could be offered the opportunity to discuss their labour and birth.

The Anticipated Emotional Consequences of Adaptive Behaviour—Impacts on the Take-up of Household Flood-Protection Measures

When considering householder responses to flood risk, researchers and policy makers have perhaps focused too much on the influence of risk perceptions and concerns about material costs and benefits. Using secondary analysis of survey data from UK households who had experienced flooding or who were at risk of flooding, this paper presents evidence to suggest that protective behaviour may be influenced less by material and financial considerations than by concerns about feelings of anxiety and insecurity. It also looks at the role of beliefs about protection and flooding in mediating the impacts of flood experience and suggests that experience reduces confidence in the ameliorative capacity of insurance and promotes the belief that protective measures increase anxiety about flooding. The paper concludes that more research should be carried out on the role of anticipated emotions in risk response and that policy makers and the designers of protection products should pay more attention to the emotional barriers and incentives to adaptation.

Organizational structure and continuous improvement and learning: Moderating effects of cultural endorsement of participative leadership

Building upon the culturally endorsed implicit theory of leadership, we investigated the moderating effects of national culture on the relationship between organizational structure and continuous improvement and learning. We propose that the relationship between organic organizations (characterized by flat, decentralized structures with a wide use of multifunctional employees) and continuous improvement and learning will be stronger when national cultural endorsement for participative leadership is high. We further propose that organizational group culture will moderate the relationship between organizational structure and continuous improvement and learning, but that these moderation effects will be stronger in national cultures with low endorsement of participative leadership. Empirical analysis of secondary survey data collected from 266 manufacturing plants operating in three industries and located in nine countries representing a diverse set of geographical regions provided support for the hypotheses. Overall, our findings indicate that, to fully realize the relationship between organic structures and continuous improvement and learning, managers must actively assess the extent to which the national culture endorses participative leadership. In cases where this endorsement is weak, managers should consider the extent to which the organizational culture will provide alternative support for the relationship.

The Relationship Between Prescription Medication Use and Ability to Ambulate Distances After Spinal Cord Injury

Kohout RK, Saunders LL, Krause JS. The relationship between prescription medication use and ability to ambulate distances after spinal cord injury. Objective To investigate the relationship between prescription medication use for pain and spasticity and ambulation distances while controlling for pain severity, injury severity, age, sex, and race in participants with spinal cord injury (SCI). Design Secondary analysis of survey data. Setting Specialty hospital in the Southeast United States. Participants Adults (N=407) with traumatic SCI identified through inpatient and outpatient hospital databases. Intervention Not applicable. Main Outcomes Measures A questionnaire measured prescription medication use, ambulation distance, and other demographic data. A composite score of four 10-point scales from the Brief Pain Inventory was used to measure pain severity. Multinomial logistic regression was used to calculate the odds ratio (OR) of ambulation distance using 1000ft or more as the reference group. Results Persons with SCI who were heavy prescription medication users (defined as weekly or daily use for pain or spasticity) were more likely to be limited to distances less than 150 (OR, 2.82; 95% confidence interval [CI], 1.57–5.04) and 150 to 999ft (OR, 2.52; 95% CI, 1.45–4.39). Conclusion Heavy prescription medication use for pain and spasticity was related inversely to a person's ability to achieve community ambulation distances of 1000ft or more.

Demystifying the demand relationship between online and print products under one newspaper brand: the case of Taiwan and the emergence of a universal pattern

This study uncovers a universal pattern regarding the oft-misunderstood demand relationship between online and print products under one newspaper brand. Growing from the portfolio management perspective and building on previous research conducted in the US and Hong Kong, this study examines the newspaper market in Taiwan. Secondary analysis of survey data collected from 7706 Web users confirmed that: (1) the print edition attains a much higher penetration relative to its online counterpart, suggesting that more people would rather consume the print edition over free Web offerings; and (2) compared with the general public, readers of the online edition were more, not less, likely to read the same newspaper's print edition. Such counter-intuitive findings carry important theoretical and managerial implications regarding the management of multiple product offerings under one newspaper brand.

School Safety, Severe Disciplinary Actions, and School Characteristics: A Secondary Analysis of the School Survey on Crime and Safety

On the basis of a secondary analysis of survey data collected from 1,872 secondary school principals in the 2005–2006 School Survey on Crime and Safety, we examined the frequency of and reasons for severe disciplinary actions and the relationship between school characteristics and severe disciplinary actions. We found that severe disciplinary actions were frequently taken for insubordinations and physical attacks or fights rather than for weapon-related problems. After controlling for the level of students’ problem behaviors, we found that schools serving a larger number of disadvantaged students (underachievers, special education students, ethnic minority students, and students in poverty) tend to use severe disciplinary actions more frequently than do schools with a smaller number of disadvantaged students. Recommendations for ameliorating this inequality in disciplinary practices are offered.