142nd APHA Annual Meeting and Exposition

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Relationships between wave non-response and substance use in a 11-year follow-up study– results from marginal event-specific Cox model

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Dih-Ling Luh , School of Public Health, Chung Shan Medical University, Taichung, Taiwan
Wen-Chi Wu, PhD , School of Healthcare Management, Kainan University, Tao-Yuan, Taiwan
Hsing-Yi Chang, PhD , Center for Health Policy Research and Development, National Health Research Institutes, Miaoli County, Taiwan
Chi-Chen Wu , Institute of Population Health Sciences, National Health Research Insitutes, Maoli, Taiwan
Lee-Lan Yen, ScD , Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan, Taipei, Taiwan
Background and Purpose Wave non-response could bias the prevalence estimation of risk behaviors. Furthermore, wave non-response could be recurrent at long-term follow-up study. Instead of using logistic regression, marginal event-specific modeling is a method that estimates parameters by considering the occurrence order of the repeated events. Thus, the purpose of this study was to use marginal event-specific Cox model to investigate the relationships between substance use behaviors (smoking, alcohol drinking, and betel-nut chewing) and wave non-response by using marginal event-specific Cox model.

Methods The data came from Child and Adolescent Behaviors in Long-term Evolution project, which followed 2853 children since their 2nd grade (2002) until 12thgrade (2012). In each year, the research team endeavored to contact the participants who did not respond during the previous year, and then produced a dataset with recurrent non-response events. We conducted the marginal event-specific Cox models, while the order of the occurrences was considered.

Results After adjusting for sex, living area, parental education, family income and parental marital status at baseline, marginal event-specific Cox model showed that: those who had been a current smoker less likely to be a non-responder (HR = 0.79, p=0.0110), and those who had been a current alcohol drinker also less likely to be a non-responder (HR = 0.52, p<.0001). However, chewing betel-nut was not significantly associated with non-response.

Conclusions  The participants who used substance had a lower probability of not-responding. Therefore, the users of this dataset should notice the possibility of overestimating the rates of smoking and alcohol drinking.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Social and behavioral sciences

Learning Objectives:
Demonstrate that the marginal event-specific Cox model can be applied to analyze the data with recurrent wave non-response events in a long-term follow-up study.

Keyword(s): Methodology, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.