In your response post, comment on at least one of your group member’s materials and methods (section B). Please give positive and constructive feedback. As much as possible, provide your colleague with concrete recommendations for improvement. Compare and contrast your methods section, paying special attention to the analysis plan.
Post::
Hi Everyone. I included Section A below for reference, and Section B is labeled if you scroll down.
The proposed research topic is the influence of socioeconomic factors on chronic illness perception, specifically men and women living with HIV in Wakiso District, Uganda. My research question is, is socioeconomic status (SES) associated with illness perception for men and women aged 35-50 living with HIV in Wakiso District, Uganda and how does diagnosis and treatment change attitude/motivation towards work?
The quantitative and qualitative components of this analysis use data from the larger quasi-experimental research study, the Life on antiretroviral therapy: People’s adaptive coping and adjustment to living with HIV as a chronic condition in Wakiso District, Uganda.1 The data were collected between January 2011 and March 2012 in Wakiso District, central Uganda. Participants for both components were recruited from three types of ART delivery sites in Wakiso District; the HIV clinic at the government hospital in Entebbe, three government health centres (level 3) that have referral links to Entebbe, and the Entebbe branch of The AIDS Support Organisation (TASO). Those who had been on ART for at least one year were eligible to participate in the study, and those with less than one year of treatment were excluded. Surveys were administered to gather quantitative data on illness perception and socioeconomic status. Unstructured and semi-structured interviews were utilized to collect qualitative data regarding motivation and attitude towards work for those on ART.
For the quantitative component, eligible participants from the three ART sites were put into three lists based on their location. A systematic random sample was used to recruit 263 people living with HIV (PLWH) taking ART. The random sample, using set intervals, was taken after excluding all participants from the qualitative component.
The surveys were enumerated by intensely-trained staff, and two different types of surveys were used. One survey was used for people living with HIV (PLWH), and the other was used for the control group. For this data analysis, which involves comparing the illness perceptions of PLWH across different socioeconomic status,’ only the survey from PLWH was used, as the control group did not answer questions about illness perception. Participants who completed the survey also disclosed information regarding age, gender, household size, years in education, religion, and marital status. Socioeconomic characteristics were measured in Section I of the questionnaire by assessing participants’ food security and coping index, and livelihood activities. Question 12 (a-k) is based on Maxwell’s food security and coping index.2 Questions regarding how often participants had to rely on less expensive food, other relatives for financial stability, and other resources were measured from a-d (never, 1x-2x per week, 3x-6x per week, and everyday).1 There were also several other questions regarding the socioeconomic status of participants in this section.
Illness perception data was gathered from Section D of the survey, using a set of nine questions pertaining to outlook of treatment, level of emotional impact, control over symptoms, symptom frequency, perceived prognosis, and life impact. Illness perception was measured using the Illness Perception instrument (IPQ Brief).3 Participants were asked to rate the perceived impact of their illness as 1: No effect at all (tewali kukosebwa kwonna) 2: Little effect (nkosebwa kitono) 3: Some effect (nkosebwamu) 4: Great effect (nkosebwa kinene) and 5: Severely affects my life (nkosebwa ddala nnyo).1
The data for the qualitative component were interviewer-administered and conducted through both unstructured and structured interviews. Both interviews inquired about the life-impacts associated with HIV diagnosis and starting ART, including its impact on daily activities, relationships, mobilization of support, feelings regarding achievements and failures, and potential effects of diagnosis and treatment on outlook, hope, and motivation. Recruitment for the qualitative interview component occurred in a two-step sampling technique. All eligible participants (on ART for at least one year) from the same three facilities were compiled into three lists, and the lists were stratified by gender and age. A systematic random sample of 94 participants was then taken from each facility. The sampling interval was larger than required to minimize the potential for attrition due to loss to follow-up, failure to complete assessments, and refusals to participate. In order to fairly represent different age groups, both sexes, and different patient experiences, another purposeful sample was taken. After four drop-outs, 38 participants (18 male, 20 female) remained for qualitative interviews.
The first interviews conducted were unstructured, and occurred over days and weeks due to time constraints. Some of the interviews occurred across up to 4 different time periods, and none of the interviews took longer than two months to complete. These interviews focused on both life and illness history, experiences with illness and treatment, and recovery. Detailed notes were also taken on observations of participants’ attitudes and behaviors, both in general and towards the interview process, as well as their responsiveness and cooperation. This was followed by a brief narrative where participants give a brief life and illness history. Unstructured interviews were not tape-recorded, but detailed notes were taken on participant responses. The second interviews were semi-structured, and focused on issues surrounding self-management of HIV. These interviews were taped, and later transcribed to English. The data regarding whether or not motivation for/attitude towards work has changed since HIV diagnosis, was collected during the second, semi-structured interview.
Ethical approval was granted by the Uganda Virus research Institute and the University of East Anglia, UK. The Uganda National Council for Science and Technology granted overall approval. In order to maintain confidentiality of participants in this report, pseudonyms are used.
Materials and Methods Section B
To analyze the data, a concurrent triangulation design was used where the quantitative and qualitative components are collected almost simultaneously.4 It is a concurrent-dependent analysis, where if SES and chronic illness perception are associated, how does this affect attitudes and motivation towards work? Primary variables of study are illness perception and socioeconomic status, and the supplemental variable is attitude and motivation towards work.
First, descriptive statistics will be generated for the quantitative component which includes the mean, median, standard deviation, range, and frequency of illness perception and SES. The statistical method used to assess the categorical variables is the bivariate analysis method, Chi-square test of independence, because the outcome is categorical.5 The test statistic is X2, and assumes in the null hypothesis that illness perception and SES are independent. The alpha level is set to 0.05, and the null hypothesis of no association was rejected if the p-value was less than 0.05.
The qualitative data in this study were transcribed verbatim and annotations were included to provide additional data regarding behaviors, social expressions, and other observations. A coding system was developed and tested, and the intercoder reliability reached 95%.6
Potential confounding variables to account for in this study are sociodemographic factors that were collected such as age, religion, and work and daily activities. Stratification was used to control for confounding and effect modification.7
REFERENCES:
Russell S. Life on antiretroviral therapy: People’s adaptive coping and adjustment to living with HIV as a chronic condition in Wakiso District, Uganda. 2013. doi: 10.5255/ukda-sn-851094.
Maxwell DG. Measuring food insecurity: The frequency and severity of “coping strategies”. Food policy. 1996;21(3):291-303. doi: 10.1016/0306-9192(96)00005-X.
The illness perception questionnaire. https://ipq.h.uib.no/. Accessed July 11, 2021.
Schoonenboom J, Johnson RB. How to Construct a Mixed Methods Research Design. Kolner Z Soz Sozpsychol. 2017;69(Suppl 2):107-131. doi:10.1007/s11577-017-0454-1
Jason LA, Reed J. The use of mixed methods in studying a chronic illness. Health Psychol Behav Med. 2015;3(1):40-51. doi:10.1080/21642850.2014.1000908
McHugh ML. The chi-square test of independence. Biochem Med (Zagreb). 2013;23(2):143-149. doi:10.11613/bm.2013.018
Centers for Disease Control and Prevention. The CDC field of epidemiology manual. https://www.cdc.gov/eis/field-epi-manual/chapters/analyze-Interpret-Data.html. Updated 2018. Accessed July 18, 2021.
The original assignment:
Describe in sufficient detail the statistical methods used for the study data analysis, including descriptive statistics and methods for statistical inference. This section should have a close link to the aims of the study and should precisely establish what will be presented in the results section.
