Browsing by Subject "latent class analysis"

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    Classes of Intimate Partner Violence From Late Adolescence to Young Adulthood.
    (J Interpers Violence, 2017-06-01) Saint-Eloi Cadely, Hans; Pittman, Joe F; Pettit, Gregory S; Lansford, Jennifer E; Bates, John E; Dodge, Kenneth A; Holtzworth-Munroe, Amy
    Researchers do not agree on how intimate partner violence (IPV) emerges and changes from adolescence to young adulthood. This may be because change in these behaviors varies across individuals. The present study uses a longitudinal, person-centered approach to examine whether there are multiple classes or patterns of change in the perpetration of IPV during the transitional period from adolescence (age 18) to young adulthood (age 25) using data collected annually from a community sample of 484 participants. Latent class analysis was the analytic approach used. Results revealed three patterns for psychological IPV (Little-to-None, Minor/Increasing, and Extensive/Increasing) and two patterns for physical IPV (Little-to-None and Extensive). Patterns varied greatly in number of representatives, although they were more balanced in size for psychological than physical IPV. Variations in IPV behaviors were also revealed across classes, although as expected in a community sample, minor forms of IPV were more common than severe forms. In addition, classes differed in demographic and relationship status variables. These findings suggest that IPV may occur in multiple distinct patterns as opposed to one average pattern across a population. This suggests that interventions for IPV may need to be geared to differences in patterns to enhance their efficacy.
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    Health Care Utilization Behaviors Predict Disengagement From HIV Care: A Latent Class Analysis.
    (Open forum infectious diseases, 2018-05) Okeke, Nwora Lance; Clement, Meredith E; McKellar, Mehri S; Stout, Jason E

    Background

    The traditional definition of engagement in HIV care in terms of only clinic attendance and viral suppression provides a limited understanding of how persons living with HIV (PLWH) interact with the health care system.

    Methods

    We conducted a retrospective analysis of patients with ≥1 HIV clinic visits at the Duke Adult Infectious Diseases Clinic between 2008 and 2013. Health care utilization was characterized by 4 indicators: clinic attendance in each half of the year (yes/no), number of emergency department (ED) visits/year (0, 1, or 2+), inpatient admissions/year (0, 1, 2+), and viral suppression (never, intermittent, always). Health care engagement patterns were modeled using latent class/latent transition analysis.

    Results

    A total of 2288 patients (median age, 46.4 years; 59% black, 71% male) were included in the analysis. Three care engagement classes were derived from the latent class model: "adherent" "nonadherent," and "sick." Patients age ≤40 years were more likely to be in the nonadherent class (odds ratio, 2.64; 95% confidence interval, 1.38-5.04) than other cohort members. Whites and males were more likely to transition from nonadherent to adherent the following year. Nonadherent patients were significantly more likely to disengage from care the subsequent year than adherent patients (23.6 vs 0.2%, P < .001).

    Conclusions

    A broader definition of health care engagement revealed distinct and dynamic patterns among PLWH that would have been hidden had only previous HIV clinic attendance had been considered. These patterns may be useful for designing engagement-targeted interventions.
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    Is there a nonadherent subtype of hypertensive patient? A latent class analysis approach.
    (Patient preference and adherence, 2010-07) Trivedi, Ranak B; Ayotte, Brian J; Thorpe, Carolyn T; Edelman, David; Bosworth, Hayden B
    To determine subtypes of adherence, 636 hypertensive patients (48% White, 34% male) reported adherence to medications, diet, exercise, smoking, and home blood pressure monitoring. A latent class analysis approach was used to identify subgroups that adhere to these five self-management behaviors. Fit statistics suggested two latent classes. The first class (labeled "more adherent") included patients with greater probability of adhering to recommendations compared with the second class (labeled "less adherent") with regard to nonsmoking (97.7% versus 76.3%), medications (75.5% versus 49.5%), diet (70.7% versus 46.9%), exercise (63.4% versus 27.2%), and blood pressure monitoring (32% versus 3.4%). Logistic regression analyses used to characterize the two classes showed that "more adherent" participants were more likely to report full-time employment, adequate income, and better emotional and physical well-being. Results suggest the presence of a less adherent subtype of hypertensive patients. Behavioral interventions designed to improve adherence might best target these at-risk patients for greater treatment efficiency.