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Advantages and disadvantages of using theory-based versus data-driven models with social and behavioral determinants of health data.
Austin, Robin R; McLane, Tara M; Pieczkiewicz, David S; Adam, Terrence; Monsen, Karen A.
Afiliación
  • Austin RR; School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
  • McLane TM; Dakota County Public Health, Apple Valley, Minnesota, USA.
  • Pieczkiewicz DS; Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
  • Adam T; Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.
  • Monsen KA; College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
J Am Med Inform Assoc ; 30(11): 1818-1825, 2023 10 19.
Article en En | MEDLINE | ID: mdl-37494964
OBJECTIVE: Theory-based research of social and behavioral determinants of health (SBDH) found SBDH-related patterns in interventions and outcomes for pregnant/birthing people. The objectives of this study were to replicate the theory-based SBDH study with a new sample, and to compare these findings to a data-driven SBDH study. MATERIALS AND METHODS: Using deidentified public health nurse-generated Omaha System data, 2 SBDH indices were computed separately to create groups based on SBDH (0-5+ signs/symptoms). The data-driven SBDH index used multiple linear regression with backward elimination to identify SBDH factors. Changes in Knowledge, Behavior, and Status (KBS) outcomes, numbers of interventions, and adjusted R-squared statistics were computed for both models. RESULTS: There were 4109 clients ages 13-40 years. Outcome patterns aligned with the original research: KBS increased from admission to discharge with Knowledge improving the most; discharge KBS decreased as SBDH increased; and interventions increased as SBDH increased. Slopes of the data-driven model were steeper, showing clearer KBS trends for data-driven SBDH groups. The theory-based model adjusted R-squared was 0.54 (SE = 0.38) versus 0.61 (SE = 0.35) for the data-driven model with an entirely different set of SBDH factors. CONCLUSIONS: The theory-based approach provided a framework to identity patterns and relationships and may be applied consistently across studies and populations. In contrast, the data-driven approach can provide insights based on novel patterns for a given dataset and reveal insights and relationships not predicted by existing theories. Data-driven methods may be an advantage if there is sufficiently comprehensive SBDH data upon which to create the data-driven models.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vocabulario Controlado / Enfermeros de Salud Comunitaria Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Female / Humans / Pregnancy Idioma: En Revista: J Am Med Inform Assoc Asunto de la revista: INFORMATICA MEDICA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vocabulario Controlado / Enfermeros de Salud Comunitaria Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Female / Humans / Pregnancy Idioma: En Revista: J Am Med Inform Assoc Asunto de la revista: INFORMATICA MEDICA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido