Project Title

Analysis of Birth Rate and Predictors Using Linear Regression Model and Propensity Score Matching Method

Authors' Affiliations

Aleigha Spaulding, College of Public Health, East Tennessee State University, Johnson City, TN Jessica Barbee, College of Public Health, East Tennessee State University, Johnson City, TN Dr. Nathan Hale, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN Dr. Shimin Zheng, Department of Epidemiology and Biostatistics, College of Public Health, East Tennessee State University, Johnson City, TN Dr. Michael Smith, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN Edward Francis Leinaar, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN Dr. Amal Jamil Khoury, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN

Location

AUDITORIUM ROOM 137A

Start Date

4-12-2019 11:20 AM

End Date

4-12-2019 11:35 AM

Faculty Sponsor’s Department

Health Services Management & Policy

Name of Project's Faculty Sponsor

Dr. Nathan Hale

Type

Oral Presentation

Classification of First Author

Graduate Student-Master’s

Project's Category

Public Health, Biostatistics

Abstract Text

Evaluating the effectiveness of an intervention can pose challenges if there is not an adequate control group. The effects of the intervention can be distorted by observable differences in the characteristics of the control and treatment groups. Propensity score matching can be used to confirm the outcomes of an intervention are due to the treatment and not other characteristics that may also explain the intervention effects. Propensity score matching is an advanced statistical technique that uses background information on the characteristics of the study population to establish matched pairs of treated participants and controls. This technique improves the quality of control groups and allowing for a better evaluation of the true effects of an intervention. The purpose of this study was to implement this technique to derive county-level matches across the southeastern United States for existing counties within a single state where future statewide initiatives are planned. Statistical analysis was performed using SAS 9.4 (Cary, NC, USA). A select set of key county-level socio-demographic measures theoretically relevant for deriving appropriate matches was examined. These include the proportion of African Americans in population, population density, and proportion of the female population below poverty level. To derive the propensity-matched counties, a logistic regression model with the state of primary interest as the outcome was conducted. The baseline covariates of interest were included in the model and used to predict the probability of a county being in the state of primary interest; this acts as the propensity score used to derive matched controls. A caliper of 0.2 was used to ensure the ratio of the variance of the linear propensity score in the control group to the variance of the linear propensity score in the treatment group is close to 1. The balance of covariates before and after the propensity score matching were assessed to determine if significant differences in each respective covariate persisted after the propensity score matching. Before matching, a significant difference was found in the proportion of African Americans in control group (21.08%, n=3,450) and treatment group (36.95%, n=230) using the t-test (P<0.0001). The percent of females below poverty level showed significant difference between control and treatment group (P=0.0264). The t-test of population density also showed significant differences between the groups (P=0.0424). After matching, the mean differences for the treated-control groups were all zero for these three covariates and the characteristics were no longer showing any significant differences between the two groups. This study found that the use of propensity score matching methods improved the accuracy of matched controls. Ensuring that the control and treatment counties have statistically similar characteristics is important for improving the rigor of future studies examining county-level outcomes. Propensity score matching does not account for unobserved differences between the treatment and control groups that may affect the observed outcomes; however, it does ensure that the observable characteristics between the groups are statistically similar.This method reduces the threat to internal validity that observable characteristics pose on interventions by matching for these potentially confounding characteristics.

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Apr 12th, 11:20 AM Apr 12th, 11:35 AM

Analysis of Birth Rate and Predictors Using Linear Regression Model and Propensity Score Matching Method

AUDITORIUM ROOM 137A

Evaluating the effectiveness of an intervention can pose challenges if there is not an adequate control group. The effects of the intervention can be distorted by observable differences in the characteristics of the control and treatment groups. Propensity score matching can be used to confirm the outcomes of an intervention are due to the treatment and not other characteristics that may also explain the intervention effects. Propensity score matching is an advanced statistical technique that uses background information on the characteristics of the study population to establish matched pairs of treated participants and controls. This technique improves the quality of control groups and allowing for a better evaluation of the true effects of an intervention. The purpose of this study was to implement this technique to derive county-level matches across the southeastern United States for existing counties within a single state where future statewide initiatives are planned. Statistical analysis was performed using SAS 9.4 (Cary, NC, USA). A select set of key county-level socio-demographic measures theoretically relevant for deriving appropriate matches was examined. These include the proportion of African Americans in population, population density, and proportion of the female population below poverty level. To derive the propensity-matched counties, a logistic regression model with the state of primary interest as the outcome was conducted. The baseline covariates of interest were included in the model and used to predict the probability of a county being in the state of primary interest; this acts as the propensity score used to derive matched controls. A caliper of 0.2 was used to ensure the ratio of the variance of the linear propensity score in the control group to the variance of the linear propensity score in the treatment group is close to 1. The balance of covariates before and after the propensity score matching were assessed to determine if significant differences in each respective covariate persisted after the propensity score matching. Before matching, a significant difference was found in the proportion of African Americans in control group (21.08%, n=3,450) and treatment group (36.95%, n=230) using the t-test (P<0.0001). The percent of females below poverty level showed significant difference between control and treatment group (P=0.0264). The t-test of population density also showed significant differences between the groups (P=0.0424). After matching, the mean differences for the treated-control groups were all zero for these three covariates and the characteristics were no longer showing any significant differences between the two groups. This study found that the use of propensity score matching methods improved the accuracy of matched controls. Ensuring that the control and treatment counties have statistically similar characteristics is important for improving the rigor of future studies examining county-level outcomes. Propensity score matching does not account for unobserved differences between the treatment and control groups that may affect the observed outcomes; however, it does ensure that the observable characteristics between the groups are statistically similar.This method reduces the threat to internal validity that observable characteristics pose on interventions by matching for these potentially confounding characteristics.