Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-10 (of 10 Records) |
Query Trace: Paulose-Ram R[original query] |
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Assessing consent for and response to health survey components in an era of falling response rates: National Health and Nutrition Examination Survey, 2011-2018
McQuillan G , Kruszon-Moran D , Di H , Schaar D , Lukacs S , Fakhouri T , Paulose-Ram R . Surv Res Methods 12/28/2021 15 (3) 257-268 Response rates for national population-based surveys have declined, including the National Health and Nutrition Examination Survey (NHANES). Declining response to the initial NHANES interview may impact consent and participation in downstream survey components such as record linkage, physical exams, storage of biological samples and phlebotomy. Interview response rates dropped from 68% in 2011-2012 to 53% in 2017-2018 for adults age 18 and older. Response was higher for children (1-17 years) but with a similar downward trend (2011-2012, 81%; 2017-2018, 65%). Despite declining interview response rates, changes in consent and response rates for downstream components over time have been mixed. Among those interviewed, the examination response rate was over 93%, consent for record linkage was over 90%, and consent for storage of specimens for future research was over 99%. The availability of a blood sample for storage ranged between 60%-65% for children and 78%-85% for adults. |
Data related to social determinants of health captured in the National Health and Nutrition Examination Survey
Lau DT , Ahluwalia N , Fryar CD , Kaufman M , Arispe IE , Paulose-Ram R . Am J Public Health 2023 113 (12) 1290-1295 Health equity is defined as “attainment of the highest level of health for all people” and encompasses fair and just opportunities for everyone to be as healthy as possible.1 Health equity research examines the existence of health disparities and their underlying factors, which can be categorized into broad determinants of health, including genetics, behavior, environmental influences, medical care, and social factors.2 The last category, also known as social determinants of health (SDOH), includes social and structural factors, such as racism and discriminatory practices and policies.3 Healthy People 2030 categorizes SDOH into five domains4: education access and quality, economic stability, health care access and quality, social and community context, and neighborhood and built environment. Evidence shows that SDOH influence a wide range of health outcomes5,6 and nutritional status.7 Exposures to adverse SDOH, such as food deserts and unsafe neighborhoods, are inequitably experienced by subgroups that vary by race and ethnicity, socioeconomic status, and other characteristics historically associated with discrimination or exclusion. Variation among groups in access to resources and their differential vulnerability to adverse exposures result in health disparities.8 |
The National Health and Nutrition Examination Survey (NHANES), 2021-2022: Adapting Data Collection in a COVID-19 Environment.
Paulose-Ram R , Graber JE , Woodwell D , Ahluwalia N . Am J Public Health 2021 111 (12) 2149-2156 The National Health and Nutrition Examination Survey (NHANES) is a unique source of national data on the health and nutritional status of the US population, collecting data through interviews, standard exams, and biospecimen collection. Because of the COVID-19 pandemic, NHANES data collection was suspended, with more than a year gap in data collection. NHANES resumed operations in 2021 with the NHANES 2021-2022 survey, which will monitor the health and nutritional status of the nation while adding to the knowledge of COVID-19 in the US population. This article describes the reshaping of the NHANES program and, specifically, the planning of NHANES 2021-2022 for data collection during the COVID-19 pandemic. Details are provided on how NHANES transformed its participant recruitment and data collection plans at home and at the mobile examination center to safely collect data in a COVID-19 environment. The potential implications for data users are also discussed. (Am J Public Health. 2021;111(12):2149-2156. https://doi.org/10.2105/AJPH.2021.306517). |
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012
Tilert T , Paulose-Ram R , Howard D , Butler J , Lee S , Wang MQ . EC Pulmonol Respir Med 2018 7 (9) 650-662 Introduction: Chronic obstructive pulmonary disease (COPD) is a respiratory disease that often goes undiagnosed, particularly in its early stages. Objective: To examine sociodemographic, general health, and COPD specific factors, including severity of lung obstruction, that are associated with healthcare provider-diagnosed COPD among U.S. adults. Methods: NHANES cross-sectional data collected from 2007-2012 on adults aged 40-79 years (n=10,219) were analyzed. The primary outcome was self-reported COPD diagnosis with predictive factors analyzed via chi-square and logistic regression analyses. Results: During 2007-2012, 5.2% of US adults aged 40-79 reported being diagnosed with COPD. Among those diagnosed, 50.8% reported fair or poor health, 47.1% were currently smoking cigarettes, 49.1% were taking prescription respiratory medication, 36.4% had moderate or worse lung obstruction, and nearly 90% had one or more respiratory symptoms. Logistic regression revealed positive associations between receiving a COPD diagnosis and the following: being white (AOR: 3.08, 95% CI: 1.82-5.20); being aged 60-79 years (AOR: 1.65, 95% CI: 1.07-2.53); reporting fair/poor health (AOR: 2.91, CI: 1.55-5.46); having 4-9 (AOR: 3.5, CI: 1.3-9.4) or 10 or more healthcare visits in prior year (AOR: 5.06, CI: 1.62-15.77); being a former (AOR: 1.75, CI: 1.2-2.5) or current smoker (AOR: 1.70, CI: 1.17-2.48); having more severe lung obstruction (AOR: 4.90, CI: 3.28-7.32); having 3 or more respiratory symptoms (AOR: 22.07, CI: 12.03-40.49). Conclusions: Multiple factors are associated with self-reported COPD diagnosis with number of reported respiratory symptoms having the strongest association. After controlling for other factors, having mild lung obstruction was not associated with being diagnosed. |
Overview of Asian American data collection, release, and analysis: National Health and Nutrition Examination Survey 2011-2018
Paulose-Ram R , Burt V , Broitman L , Ahluwalia N . Am J Public Health 2017 107 (6) e1-e6 The National Health and Nutrition Examination Survey (NHANES), conducted by the National Center for Health Statistics, is a cross-sectional survey on the health and nutritional status of US adults and children. Data Collection/Processing. A complex, multistage probability design is used to select a sample representative of the US civilian, noninstitutionalized population. NHANES includes in-home interviews, physical examinations, and biospecimen collection. About 5000 persons are examined annually. Since 2011, NHANES has been oversampling Asian Americans in addition to traditionally oversampled groups, including Hispanics and non-Hispanic Blacks. Data Analysis/Dissemination. Data are publicly released online in 2-year cycles. Some data, because of disclosure risk, are only available through the Research Data Center. Data users should read documentation, examine sample sizes and response rates, and account for the complex survey design. With publicly released data, analyses of Asians as a single group is only possible; some Asian subgroup analyses may be conducted through the Research Data Center. Public Health Implications. Oversampling Asians in NHANES 2011-2018 allows national estimates to be computed on health conditions, nutrition, and risk factors of public health importance on this growing subpopulation of Asian Americans. |
Prevalence and trends in psychotropic medication use among US male veterans, 1999-2010
Frenk SM , Sautter JM , Paulose-Ram R . Pharmacoepidemiol Drug Saf 2015 24 (11) 1215-9 PURPOSE: Prior studies of psychotropic medication use among US veterans are limited in their ability to generalize estimates to the full veteran population and make comparisons with non-veterans. This study estimated the prevalence of psychotropic medication use and trends over time among male US veterans, compared their use of psychotropic medications with non-veteran males, and examined differences among veteran subpopulations. METHODS: The data for our analysis came from the National Health and Nutrition Examination Survey (1999-2010), a cross-sectional, nationally representative study of the civilian, non-institutionalized US population. RESULTS: The percentage of male veterans who used any psychotropic medication increased from 10.4% in 1999-2002 to 14.3% in 2003-2006, then remained stable in 2007-2010 (14.0%). During the same time period, the percentage of non-veteran males who used psychotropic medications remained relatively stable (7.0%, 8.3%, and 9.2%, respectively). Veterans were more likely to use psychotropic medication, specifically antidepressants, than non-veterans. The percentage of non-Hispanic white veterans and veterans aged 60 years and over who used psychotropic medications increased between 1999-2002 and 2003-2006, but the percentages remained stable between 2003-2006 and 2007-2010. In 2003-2006 and 2007-2010, a higher percentage of non-Hispanic white veterans used psychotropic medications than non-Hispanic black veterans. CONCLUSIONS: This study found that the use of psychotropic medications and antidepressants was higher among male veterans than male non-veterans, and that prevalence of use increased between 1999-2002 and 2007-2010 for male veterans but remained relatively stable for non-veterans. There were significant variations in the use of psychotropic medications among veteran subpopulations. |
Prevalence of airflow obstruction in U.S. adults aged 40-79 years: NHANES data 1988-1994 and 2007-2010
Doney B , Hnizdo E , Dillon CF , Paulose-Ram R , Tilert T , Wolz M , Beeckman-Wagner LA . COPD 2014 12 (4) 355-65 BACKGROUND: The study evaluated the change in the prevalence of airflow obstruction in the U.S. population 40-79 years of age from years 1988-1994 to 2007-2010. METHODS: Spirometry data from two representative samples of the U.S. population, the National Health and Nutrition Examination Surveys (NHANES) conducted in 1988-1994 and 2007-2010, were used. The American Thoracic Society/European Respiratory Society (ATS/ERS) criteria were used to define airflow obstruction. RESULTS: Based on ATS/ERS criteria, the overall age-adjusted prevalence of airflow obstruction among adults aged 40-79 years decreased from 16.6% to 14.5% (p < 0.05). Significant decreases were observed for the older age category 60-69 years (20.2% vs. 15.4%; p < 0.01), for males (19.0% vs. 15.4%; p < 0.01), and for Mexican American adults (12.7% vs. 8.4%; p < 0.001). The prevalence of moderate and more severe airflow obstruction decreased also (6.4% vs. 4.4%; p < 0.01). Based on ATS/ERS criteria, during 2007-2010, an estimated 18.3 million U.S. adults 40-79 years had airflow obstruction, 5.6 million had moderate or severe airflow obstruction and 1.4 million had severe airflow obstruction. CONCLUSIONS: The overall age-adjusted prevalence of airflow obstruction among U.S. adults aged 40-79 years decreased from 1988-1994 to 2007-2010, especially among older adults, Mexican Americans, and males. |
Data needs for B-24 and beyond: NHANES data relevant for nutrition surveillance of infants and young children
Ahluwalia N , Herrick K , Paulose-Ram R , Johnson C . Am J Clin Nutr 2014 99 (3) 747S-54S The period from birth to 24 mo (B-24) is a critical phase in which nutrient requirements for growth and development are high and several transitions in food consumption practices occur. A few large-scale national studies (eg, the Feeding Infants and Toddlers Study and Infant Feeding Practices Study) offer important insights into infant feeding practices and food consumption patterns in young children in the United States. The NHANES collects comprehensive cross-sectional data on the nutrition and health of Americans including infants and toddlers. This article describes the NHANES program and data from NHANES 1999-2010 on young children that are relevant for the B-24 Project. NHANES is a nationally representative survey of the noninstitutionalized US population that combines personal interviews with standardized physical examination and measurements via mobile examination centers. Data on infant feeding practices (breastfeeding and timing of introduction and nature of complementary foods), dietary intake (two 24-h recalls), and nutrient supplements are collected. Data on demographic characteristics, anthropometric measurements, biomarkers of nutrient status, food security, and participation in federal nutrition programs are also available. Data can be accessed online, downloaded, and pooled over several survey cycles, allowing examination of infant feeding practices, food and nutrient intakes, and nutritional status of Americans <2 y old. Subgroup analyses by race-ethnicity and income status are also possible. NHANES responds to evolving data needs, as feasible, in the context of the survey design, research priorities, and funding. It offers a vehicle for potentially gathering additional data on children <2 y to address the objectives of the B-24 Project in the future. |
Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007-2010
Tilert T , Dillon C , Paulose-Ram R , Hnizdo E , Doney B . Respir Res 2013 14 (1) 103 BACKGROUND: During 2007-2010, the National Health and Nutrition Examination Survey (NHANES) conducted a spirometry component which obtained pre-bronchodilator pulmonary lung function data on a nationally representative sample of US adults aged 6-79 years and post-bronchodilator pulmonary lung function data for the subset of adults with airflow limitation. The goals of this study were to 1) compute prevalence estimates of chronic obstructive pulmonary disease (COPD) using pre-bronchodilator and post-bronchodilator spirometry measurements and fixed ratio and lower limit of normal (LLN) diagnostic criteria and 2) examine the potential impact of nonresponse on the estimates. METHODS: This analysis was limited to those aged 40-79 years who were eligible for NHANES pre-bronchodilator spirometry (n=7,104). Examinees with likely airflow limitation were further eligible for post-bronchodilator testing (n=1,110). Persons were classified as having COPD based on FEV1/FVC < 70% (fixed ratio) or FEV1/FVC < lower limit of normal (LLN) based on person's age, sex, height, and race/ethnicity. Those without spirometry but self-reporting both daytime supplemental oxygen therapy plus emphysema and/or current chronic bronchitis were also classified as having COPD. The final analytic samples for pre-bronchodilator and post-bronchodilator analyses were 77.1% (n=5,477) and 50.8% (n=564) of those eligible, respectively. To account for non-response, NHANES examination weights were adjusted to the eligible pre-bronchodilator and post-bronchodilator subpopulations. RESULTS: In 2007-2010, using the fixed ratio criterion and pre-bronchodilator test results, COPD prevalence was 20.9% (SE 1.1) among US adults aged 40-79 years. Applying the same criterion to post-bronchodilator test results, prevalence was 14.0% (SE 1.0). Using the LLN criterion and pre-bronchodilator test results, the COPD prevalence was 15.4% (SE 0.8), while applying the same criterion to post-bronchodilator test results, prevalence was 10.2% (SE 0.8). CONCLUSIONS: The overall COPD prevalence among US adults aged 40-79 years varied from 10.2% to 20.9% based on whether pre- or post-bronchodilator values were used and which diagnostic criterion (fixed ratio or LLN) was applied. The overall prevalence decreased by approximately 33% when airflow limitation was based on post-bronchodilator as compared to pre-bronchodilator spirometry, regardless of which diagnostic criterion was used. |
The methodology of visual field testing with frequency doubling technology in the National Health and Nutrition Examination Survey, 2005-2006
Terry AL , Paulose-Ram R , Tilert TJ , Johnson CA , Zhang X , Lee PP , Saaddine JB . Ophthalmic Epidemiol 2010 17 (6) 411-21 PURPOSE: To describe the frequency doubling technology (FDT) methodology to measure visual field loss in the National Health and Nutrition Examination Survey and to evaluate data reliability. METHODS: Participants aged 40 years and older were eligible (n = 2,529) for 2 visual field tests per eye performed with the Humphrey Matrix N-30-5 screening test. Visual field loss was determined using a 2-2-1 algorithm requiring 2 complete tests per eye, with at least 2 abnormal field results in each test, and 1 common abnormal field. RESULTS: Response rate was 86.2%. Time constraints were the main reason for no exam (55.6%). Median times were: single test, 37 seconds; entire exam, 9.1 minutes. When defining reliability based on ≤ 1/3 blind spots, ≤ 1/3 false positive tests, and technician noted proper fixation, 80.1% of examined adults had 2 reliable tests for both eyes; an additional 13.4% had 2 reliable tests for 1 eye. Increasing age, decreasing visual acuity, and the presence of self-reported glaucoma resulted in decreased examination rates, increased test times, and decreased data reliability. Sensitivity and specificity to detect persons with glaucoma was 54.8% and 91.9%, respectively. CONCLUSIONS: FDT is a feasible, fast, and reliable method for visual field loss screening in a population-based U.S. study, with an 86.2% response rate, median exam time ~9 minutes, and nearly 95% of examined participants having complete, reliable results in 1 or both eyes. |
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