School variation in asthma: compositional or contextual?

<h4>Background</h4>Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different...

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Autores principales:	Tracy K Richmond, S V Subramanian
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3f40e65173014970b165effc7f87e02c
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spelling	oai:doaj.org-article:3f40e65173014970b165effc7f87e02c2021-11-25T06:27:05ZSchool variation in asthma: compositional or contextual?1932-620310.1371/journal.pone.0008512https://doaj.org/article/3f40e65173014970b165effc7f87e02c2009-12-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20041121/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different schools. Our objective was to determine whether between-school variation in asthma prevalence exists and if so, if it is related to the differential distribution of individual risk factors for and correlates of asthma or to contextual influences of schools.<h4>Methods</h4>Cross-sectional analysis of 16,640 teens in grades 7-12 in Wave 1 (data collected in 1994-5) of the National Longitudinal Study of Adolescent Health. Outcome was current diagnosis of asthma as reported by respondents' parents. Two-level random effects models were used to assess the contribution of schools to the variance in asthma prevalence before and after controlling for individual attributes.<h4>Results</h4>The highest quartile schools had mean asthma prevalence of 21.9% compared to the lowest quartile schools with mean asthma prevalence of 7.1%. In our null model, the school contributed significantly to the variance in asthma (sigma(u0)(2) = 0.27, CI: 0.20, 0.35). Controlling for individual, school and neighborhood attributes reduced the between-school variance modestly (sigma(u0)(2) = 0.19 CI: 0.13-0.29).<h4>Conclusion</h4>Significant between-school variation in current asthma prevalence exists even after controlling for the individual, school and neighborhood factors. This provides evidence for school level contextual influences on asthma. Further research is needed to determine potential mechanisms through which schools may influence asthma outcomes.Tracy K RichmondS V SubramanianPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 12, p e8512 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tracy K Richmond S V Subramanian School variation in asthma: compositional or contextual?
description	<h4>Background</h4>Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different schools. Our objective was to determine whether between-school variation in asthma prevalence exists and if so, if it is related to the differential distribution of individual risk factors for and correlates of asthma or to contextual influences of schools.<h4>Methods</h4>Cross-sectional analysis of 16,640 teens in grades 7-12 in Wave 1 (data collected in 1994-5) of the National Longitudinal Study of Adolescent Health. Outcome was current diagnosis of asthma as reported by respondents' parents. Two-level random effects models were used to assess the contribution of schools to the variance in asthma prevalence before and after controlling for individual attributes.<h4>Results</h4>The highest quartile schools had mean asthma prevalence of 21.9% compared to the lowest quartile schools with mean asthma prevalence of 7.1%. In our null model, the school contributed significantly to the variance in asthma (sigma(u0)(2) = 0.27, CI: 0.20, 0.35). Controlling for individual, school and neighborhood attributes reduced the between-school variance modestly (sigma(u0)(2) = 0.19 CI: 0.13-0.29).<h4>Conclusion</h4>Significant between-school variation in current asthma prevalence exists even after controlling for the individual, school and neighborhood factors. This provides evidence for school level contextual influences on asthma. Further research is needed to determine potential mechanisms through which schools may influence asthma outcomes.
format	article
author	Tracy K Richmond S V Subramanian
author_facet	Tracy K Richmond S V Subramanian
author_sort	Tracy K Richmond
title	School variation in asthma: compositional or contextual?
title_short	School variation in asthma: compositional or contextual?
title_full	School variation in asthma: compositional or contextual?
title_fullStr	School variation in asthma: compositional or contextual?
title_full_unstemmed	School variation in asthma: compositional or contextual?
title_sort	school variation in asthma: compositional or contextual?
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/3f40e65173014970b165effc7f87e02c
work_keys_str_mv	AT tracykrichmond schoolvariationinasthmacompositionalorcontextual AT svsubramanian schoolvariationinasthmacompositionalorcontextual
_version_	1718413675627282432

School variation in asthma: compositional or contextual?

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