Repeated Measures, Essay Example from Our Database

Repeated measures are important statistical methods in which data are collected to assess change over time in a longitudinal study. One area in which repeated measures find application is in measuring health literacy change among parents. As a matter of fact, parental health literacy determines the health of a child (Abram, Klass, and Dreyer, 2009). Literacy involves reading ability of parents in medical-related matters. According to Yin et al. (2009), most US parents and adults have low health literacy, a situation that makes them unable to perform healthcare-record related tasks such as filling out medical forms. This paper examines the use of repeated measures to measure the change in parental health literacy (PHL) among parents in the US.

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Comprehension and reading tests of medical documents and terms are important determinants of health literacy. Pleasant (2008) suggests that better measures should be adopted that reflect parents' health literacy. However, research studies reveal that there are rare studies on health literacy interventions, particularly community-based, customized to cater for the population that has low health literacy levels and various interventions meant to improve parent skills (Dewalt and Hink, 2009; Abram et al., 2009; Rudd, 2010). To effectively use repeated measures in determining a change in health literacy, health literacy should be considered as a paramount life skill necessitated in the contemporary society as well as everyday choices and healthcare systems (Kickbush, 2006). This implies considering health literacy to be evolving over time, and early parenting is a prerequisite for the development of good health literacy skills that are instrumental to the entire family. Wollesen and Peifer (2006) assert that to measure health literacy change using repeated measures; it is prudent to re-purpose Life Skills Progression (LSP), the most common instrument for evaluating home visitation services effects on child/parent outcomes.

LSP parental depression indicators, as well as conditions of surrounding families, enable the federal government to assess or evaluate the effectiveness of healthcare literary scales. Analysis of depression levels involves two fundamental steps. According to Smith and Moore (2012), the first step is to use ANOVA (Analysis of Variance) with repeated measures in determining the change in PHL and depression scores. This is determined from a baseline period to a year or one and half years. A within-cohort group called "comparison parents" is created to avert the limitation associated with this approach of maturation over time. Other than age, parents are matched on the reading level, race, and sex. It is prudent to note that "comparison parents" represent what to expect of "experimental parents" scores at similar age devoid of operational home visitation services. It is expected that after a period of 1-1.5 years, experimental parents are expected to have higher scores compared to new parents. The results obtained are then presented in figure 1 below.

Figure 1 showing LSP health literacy scales

The second phase involves determining the connection between depression and PHL by establishing a correlation between concurrent depression and PHL scores as well as using mixed design ANOVA to assess change pattern associated with health literacy for depressed parents against non-depressed parents (Smith & Moore, 2012). Notably, the baseline scores for depression are not considerably different from "experimental" and "comparison" parents [4.6 vs. 4.6; F (1, 1,370) =.2; ns]. 25% of parents were found to be depressed as compared to 75% of the parents who were not depressed. A normal distribution function revealed that 21 % were depressed at intake while 28% were presumed dropouts (kh2 (1) = 7.2; P < .01). Repeated measures ANOVA exposed that parents that remain in home visitation services for a year had improved depression outcomes (F (1, 703) = 4; P < .05). Additionally, Smith and Moore (2012) go further to explain that both ScL and HcL had improved rating of (F (1, 688) = 57; P < .001) and (F (1, 668) = 48; P < .001) respectively. The study further revealed that parents who suffered from depression had lower HcL (Healthcare Literacy) and ScL (Selfcare Literacy) than non-depressed parents {(4.3 vs. 4.0: F (1, 1310) = 33; P < .001) compared to (4.3 vs. 4.1: F (1, 1324) = 81; P < .001).}. Smith and Moore (2012) summarize the correlation as shown below.

Figure showing a correlation between depression and HcL/ScL over a period of 12 months of home visitations.

Conclusion

Repeated measures are important statistical methods used to analyze both related and dependent data. They are therefore used to determine the correlation between two data or activities. Repeated measures find extensive use in healthcare systems to measure parental literacy levels in health-related matters through re-purposing life skill process. Parental health literacy helps to improve the health and well-being of children as well as the entire family. Therefore, a good knowledge of repeated measures is necessary to establish a correlation between two variables.

References

Abrams, M. A., Klass, P., & Dreyer, B. P. (2009). Health literacy and children: recommendations for action. Pediatrics, 124(Supplement 3), S327-S331.

DeWalt, D. A., & Hink, A. (2009). Health literacy and child health outcomes: a systematic review of the literature. Pediatrics, 124(Supplement 3), S265-S274.

Kickbush, I. (2006). Health literacy: Skilling students for better health. Virtually Healthy, 3(41), 2.

Pleasant, A. (2008). A second look at the health literacy of American adults and the national assessment of adult literacy (pp. 46-52). World Ed

Rudd, R. E. (2010). Mismatch between skills of patients and tools in use: might literacy affect diagnoses and research?. The Journal of Rheumatology, 37(5), 885-886.

Smith, S. A., & Moore, E. J. (2012). Health Literacy and Depression in the Context of Home Visitation. Maternal and Child Health Journal, 16(7), 1500-1508.

Wollesen, L., & Peifer, K. (2006). Life skills progression. An outcome and intervention planning instrument for use with families at risk. Baltimore: Paul H.

Yin, H. S., Johnson, M., Mendelsohn, A. L., Abrams, M. A., Sanders, L. M., & Dreyer, B. P. (2009). The health literacy of parents in the United States: a nationally representative study. Pediatrics, 124(Supplement 3), S289-S298.