Statistical Interactions in Studies of Physician Utilization Promise and Pitfalls

Ronis, David L.; Harrison, Kimberley

doi:10.1097/00005650-198804000-00005

Cited by 10 publications

(3 citation statements)

References 16 publications

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“…Significant R 2 of less than 30% have been reported by other studies (Ronis & Harrison, 1988;Slaughter & Ronis, 2003).…”

Section: Limitations Of the Studymentioning

confidence: 61%

“…It should be noted that although the multiple regression model only explained 28% of the variance of women's use of mammography screening, the variance accounted for was statistically significant, suggesting that application of the findings to clinical practice could make a difference in mammogram use among Chinese women living in the target community or other communities like it. Significant R 2 of less than 30% have been reported by other studies (Ronis & Harrison, 1988;Slaughter & Ronis, 2003).…”

Section: Limitations Of the Studymentioning

confidence: 61%

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Cultural Affiliation and Mammography Screening of Chinese Women in an Urban County of Michigan

Mood

2005

J Transcult Nurs

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The aim of this study is to explore the relationship of culturally based attitudes on breast cancer screening behavior of Chinese women currently residing in the United States. This cross-sectional study used a survey instrument that was administered to a consecutive nonprobability sample of 202 Chinese women residing in an urban Michigan county. Mood's strength of cultural affiliation scale (SCAS) was modified for cultural appropriateness prior to being translated into Chinese, back-translated, and pretested prior to use for this study. Data were analyzed using descriptive, correlational, and multivariate analysis techniques. Statistical analyses revealed that cultural diversity within the Chinese sample was associated with differing health behaviors and that the SCAS had indirect effects, through access to health care, on women's mammography screening use (R2 = 28.3%). These study's findings reveal that cultural affiliation and beliefs are related to the breast cancer screening behavior of immigrant Chinese women.

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“…Significant R 2 of less than 30% have been reported by other studies (Ronis & Harrison, 1988;Slaughter & Ronis, 2003).…”

Section: Limitations Of the Studymentioning

confidence: 61%

Section: Limitations Of the Studymentioning

confidence: 61%

Cultural Affiliation and Mammography Screening of Chinese Women in an Urban County of Michigan

Mood

2005

J Transcult Nurs

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“…In the experimental study, the repeated-measures design and the scanty description of the health threat may have led subjects to simplify their usual decision-making process. In the flossing study, the low reliability of the severity measure reduced the ability of the analyses to detect any effects of severity—especially the multiplicative (interaction) effect because interaction effects in multiple regression tend to be obscured by the unreliability of the predictors (Ronis & Harrison, 1988).…”

Section: Discussionmentioning

confidence: 99%

Conditional health threats: Health beliefs, decisions, and behaviors among adults.

Ronis¹

1992

Health Psychology

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176

141

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We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed.

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Equitable access to health care: Methodological extensions to the analysis of physician utilization in Canada

1993

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In this paper we analyse the distribution of family physician use in Canada to explore whether the stated goal of reasonable access to care has been achieved. We test hypotheses to see whether (a) variations in incidence and quantity of use are independent of need for care as proxied by self-assessed health status and (b) any observed relationship between variations in use and need is independent of other population characteristics. Previous research has conceptual, statistical and data limitations which bring into question the validity of the findings. These limitations are addressed by using more appropriate data, a conditional model for service utilization and correction for self-selectivity of users in the statistical analysis. Variations in need are identified as important and significant in explaining variations in both incidence and quantity of use with the estimated relationship between use and need being positive. Other population characteristics were found to be important and significant in explaining variations in use although household income is not among them. The relationship between use and need is associated with other variables including education, social support and region of residence. These findings suggest that analyses of utilization based on simple multivariate techniques and aggregate data can produce a picture of utilization that conceals important, policy relevant relationships while revealing other relationships that are essentially artifacts of inappropriate aggregation in ways which provide a false sense of achievement.

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Statistical Interactions in Studies of Physician Utilization Promise and Pitfalls

Cited by 10 publications

References 16 publications

Cultural Affiliation and Mammography Screening of Chinese Women in an Urban County of Michigan

Cultural Affiliation and Mammography Screening of Chinese Women in an Urban County of Michigan

Conditional health threats: Health beliefs, decisions, and behaviors among adults.

Equitable access to health care: Methodological extensions to the analysis of physician utilization in Canada

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