Multidisciplinary design and analytic approaches to advance prospective research on the multilevel determinants of child health

Sara B. Johnson, Todd D. Little, Katherine Masyn, Paras D. Mehta, Sharon R. Ghazarian

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose Characterizing the determinants of child health and development over time, and identifying the mechanisms by which these determinants operate, is a research priority. The growth of precision medicine has increased awareness and refinement of conceptual frameworks, data management systems, and analytic methods for multilevel data. This article reviews key methodological challenges in cohort studies designed to investigate multilevel influences on child health and strategies to address them. Methods We review and summarize methodological challenges that could undermine prospective studies of the multilevel determinants of child health and ways to address them, borrowing approaches from the social and behavioral sciences. Results Nested data, variation in intervals of data collection and assessment, missing data, construct measurement across development and reporters, and unobserved population heterogeneity pose challenges in prospective multilevel cohort studies with children. We discuss innovations in missing data, innovations in person-oriented analyses, and innovations in multilevel modeling to address these challenges. Conclusions Study design and analytic approaches that facilitate the integration across multiple levels, and that account for changes in people and the multiple, dynamic, nested systems in which they participate over time, are crucial to fully realize the promise of precision medicine for children and adolescents.

Original languageEnglish
Pages (from-to)361-370
Number of pages10
JournalAnnals of Epidemiology
Volume27
Issue number6
DOIs
StatePublished - Jun 2017

Keywords

  • Child health
  • Cohort studies
  • Longitudinal
  • Missing data
  • Mixture model
  • Multilevel
  • Precision medicine
  • Study design

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