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Open Access Multilevel Health Promotion Research: Conceptual and Analytical Considerations

Considérations d'ordre conceptuel et analytique relatives à la recherche multiniveaux en promotion de la santé

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Abstract:

Health promotion research is often conceptualized through the use of socioecological frameworks.This results in data or variables associated with multiple levels such as individual, community, and provincial.These data are nested, or clustered. In other words, multilevel health promotion research is based on the idea that community influences health, above and beyond one's individual characteristics or behaviours.These contextual effects can be analyzed rigorously using multilevel modelling (MLM), thus determining whether contextual effects are truly derived from context or are the result of residents' social profile. MLM also facilitates examination of cross-level interaction effects.The authors discuss conceptual and methodological issues related to multilevel research.While multilevel pathways to health outcomes have been suggested at the conceptual level, analytical techniques that produce only average overall effects fail to reveal the various other influences on health behaviour.

French
La recherche en promotion de la santé fait souvent appel à un modèle socioécologique pour élaborer ses concepts. Celui-ci produit des données ou des variables associées à plusieurs niveaux, tels que le niveau individuel, le niveau correspondant au milieu de vie et le niveau provincial. Ces données sont ensuite regroupées par niches ou par grappes. En d'autres termes, la recherche multiniveaux en promotion de la santé se fonde sur l'idée que le milieu influe sur la santé, transcendant les caractéristiques et comportements individuels. On peut faire une analyse rigoureuse de ces effets de contexte à l'aide de la modélisation multiniveaux, dans le but de déterminer s'ils découlent véritablement du milieu ou sont le produit du profil social des résidants. Cette méthode facilite également l'analyse des effets de l'interaction transversale. Les auteurs abordent les questions conceptuelles et méthodologiques soulevées par la recherche multiniveaux. Bien que les modèles conceptuels permettent de proposer des trajectoires multiniveaux vers des résultats de santé, les analyses techniques ne révélant que des effets globaux moyens ne permettent pas de mettre en évidence les autres facteurs influençant les comportements de santé.

Keywords: CONTEXT; CONTEXTUAL; EFFECTS; HIERARCHICAL MULTILEVEL MODELLING; MULTILEVEL MODELLING; PUBLIC HEALTH RESEARCH

Document Type: Research Article

Publication date: 2004-03-01

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