Spatiotemporal meta-analysis: reviewing health psychology phenomena over space and time

A research agenda for understanding how social inequality is linked to brain structure and function

Consistent evidence documents powerful effects of social inequality on health, well-being and academic achievement. Yet research on whether social inequality may also be linked to brain structure and function has, until recently, been rare. Here we describe three methodological approaches that can be used to study this question-single site, single study; multi-site, single study; and spatial meta-analysis. We review empirical work that, using these approaches, has observed associations between neural outcomes and structural measures of social inequality-including structural stigma, community-level prejudice, gender inequality, neighbourhood disadvantage and the generosity of the social safety net for low-income families. We evaluate the relative strengths and limitations of these approaches, discuss ethical considerations and outline directions for future research. In doing so, we advocate for a paradigm shift in cognitive neuroscience that explicitly incorporates upstream structural and contextual factors, which we argue holds promise for uncovering the neural correlates of social inequality.

EpiVECS: exploring spatiotemporal epidemiological data using cluster embedding and interactive visualization

The analysis of data over space and time is a core part of descriptive epidemiology, but the complexity of spatiotemporal data makes this challenging. There is a need for methods that simplify the exploration of such data for tasks such as surveillance and hypothesis generation. In this paper, we use combined clustering and dimensionality reduction methods (hereafter referred to as 'cluster embedding' methods) to spatially visualize patterns in epidemiological time-series data. We compare several cluster embedding techniques to see which performs best along a variety of internal cluster validation metrics. We find that methods based on k-means clustering generally perform better than self-organizing maps on real world epidemiological data, with some minor exceptions. We also introduce EpiVECS, a tool which allows the user to perform cluster embedding and explore the results using interactive visualization. EpiVECS is available as a privacy preserving, in-browser open source web application at https://episphere.github.io/epivecs .

Relationship between foot pressure and spinal parameters in healthy adults - A systematic review

BACKGROUND

Foot pressure has an essential impact on the entire musculoskeletal chain. So far, the direct influence of foot pressure onto the spinal posture and vice versa is still unclear.

RESEARCH QUESTION

The aim of this study was to determine the relationship between foot pressure and spinal posture in healthy adults under static and dynamic conditions.

METHODS

Systematic research was conducted using PubMed to demonstrate the relationship between foot pressure and spinal posture. The search strategy was based on the PICOS selection criteria. The risk of bias within the studies was assessed using SIGN rankings.

RESULTS

Based on the search strategy, 719 articles were identified by screening title and abstract. 11 studies with moderate methodological quality partially showed a relationship between foot pressure and spinal posture (SIGN:2-1- and B-D). Apart from the foot pressure, the included studies analyzed parameters of muscle thickness (sonography), trunk displacement, head position, posterior tilt angle, trunk tilt, pelvic rotation, spinal range of motion, or spinal motion. Strength training and increased muscle thickness in the lumbar spine ensure decreased foot pressure. The head position partly induces a change of foot pressure under static conditions. No correlation was identified between spinal posture and foot pressure during forward and backward walking without manipulation. The static and dynamic measurements only show statistical correlations between foot and back muscles.

SIGNIFICANCE

Foot pressure and spinal posture seem to be interrelated under static and dynamic conditions. Static and dynamic measurements are necessary for body posture analysis, as the conditions do not always show consistent results. Due to the small number of studies and low sample sizes, further investigations are necessary to gain more precise perception of the interplay of the spine and foot pressure. For better comparison, more homogeneous studies investigating similar spine parameters are needed.

Editors' Best of 2022

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2022 articles that we think deserve your attention or at least a second read.

Loneliness across time and space

People feel lonely when their social needs are not met by the quantity and quality of their social relationships. Most research has focused on individual-level predictors of loneliness. However, macro-level factors related to historical time and geographic space might influence loneliness through their effects on individual-level predictors. In this Review, we summarize empirical findings on differences in the prevalence of loneliness across historical time and geographical space and discuss four groups of macro-level factors that might account for these differences: values and norms, family and social lives, technology and digitalization, and living conditions and availability of individual resources. Regarding historical time, media reports convey that loneliness is on the rise, but the empirical evidence is mixed, at least before the COVID-19 pandemic. Regarding geographical space, national differences in loneliness are linked to differences in cultural values (such as individualism) but might also be due to differences in the sociodemographic composition of the population. Research on within-country differences in loneliness is scarce but suggests an influence of neighbourhood characteristics. We conclude that a more nuanced understanding of the effects of macro-level factors on loneliness is necessary because of their relevance for public policy and propose specific directions for future research.

Community-level explicit racial prejudice potentiates whites' neural responses to black faces: A spatial meta-analysis

We evaluated the hypothesis that neural responses to racial out-group members vary systematically based on the level of racial prejudice in the surrounding community. To do so, we conducted a spatial meta-analysis, which included a comprehensive set of studies (k = 22; N = 481). Specifically, we tested whether community-level racial prejudice moderated neural activation to Black (vs. White) faces in primarily White participants. Racial attitudes, obtained from Project Implicit, were aggregated to the county (k = 17; N = 10,743) in which each study was conducted. Multi-level kernel density analysis demonstrated that significant differences in neural activation to Black (vs. White) faces in right amygdala, dorsal anterior cingulate cortex, and dorsolateral prefrontal cortex were detected more often in communities with higher (vs. lower) levels of explicit (but not implicit) racial prejudice. These findings advance social-cognitive neuroscience by identifying aspects of macro-social contexts that may alter neural responses to out-group members.

Meta-analysis: Are Psychotherapies Less Effective for Black Youth in Communities With Higher Levels of Anti-Black Racism?

OBJECTIVE

To examine whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth.

METHOD

A subset of studies from a previous meta-analysis of 5 decades of youth psychotherapy randomized controlled trials was analyzed. Studies were published in English between 1963 and 2017 and identified through a systematic search. The 194 studies (N = 14,081 participants; age range, 2-19) across 34 states comprised 2,678 effect sizes (ESs) measuring mental health problems (eg, depression) targeted by interventions. Anti-Black cultural racism was operationalized using a composite index of 31 items measuring explicit racial attitudes (obtained from publicly available sources, eg, General Social Survey) aggregated to the state level and linked to the meta-analytic database. Analyses were conducted with samples of majority-Black (ie, ≥50% Black) (n = 36 studies) and majority-White (n = 158 studies) youth.

RESULTS

Two-level random-effects meta-regression analyses indicated that higher anti-Black cultural racism was associated with lower ESs for studies with majority-Black youth (β = -0.2, 95% CI [-0.35, -0.04], p = .02) but was unrelated to ESs for studies with majority-White youth (β = 0.0004, 95% CI [-0.03, 0.03], p = .98), controlling for relevant area-level covariates. In studies with majority-Black youth, mean ESs were significantly lower in states with the highest anti-Black cultural racism (>1 SD above the mean; Hedges' g = 0.19) compared with states with the lowest racism (<1 SD below the mean; Hedges' g = 0.60).

CONCLUSION

Psychotherapies tested with samples of majority-Black youth were significantly less effective in states with higher (vs lower) levels of anti-Black cultural racism, suggesting that anti-Black cultural racism may be one contextual moderator of treatment effect heterogeneity.

Does Stigma Moderate the Efficacy of Mental- and Behavioral-Health Interventions? Examining Individual and Contextual Sources of Treatment-Effect Heterogeneity

In this article, we argue that stigma may be an important, but heretofore underrecognized, source of heterogeneity in treatment effects of mental- and behavioral-health interventions. To support this hypothesis, we review recent evidence from randomized controlled trials and spatial meta-analyses suggesting that stigma may predict not only who responds more favorably to these health interventions (i.e., individuals with more stigma experiences), but also the social contexts that are more likely to undermine intervention effects (i.e., communities with greater structural stigma). By highlighting the potential role of personal and contextual stigma in shaping response to interventions, our review paves the way for additional research.

Ensuring Prevention Science Research is Synthesis-Ready for Immediate and Lasting Scientific Impact

When seeking to inform and improve prevention efforts and policy, it is important to be able to robustly synthesize all available evidence. But evidence sources are often large and heterogeneous, so understanding what works, for whom, and in what contexts can only be achieved through a systematic and comprehensive synthesis of evidence. Many barriers impede comprehensive evidence synthesis, which leads to uncertainty about the generalizability of intervention effectiveness, including inaccurate titles/abstracts/keywords terminology (hampering literature search efforts), ambiguous reporting of study methods (resulting in inaccurate assessments of study rigor), and poorly reported participant characteristics, outcomes, and key variables (obstructing the calculation of an overall effect or the examination of effect modifiers). To address these issues and improve the reach of primary studies through their inclusion in evidence syntheses, we provide a set of practical guidelines to help prevention scientists prepare synthesis-ready research. We use a recent mindfulness trial as an empirical example to ground the discussion and demonstrate ways to ensure the following: (1) primary studies are discoverable; (2) the types of data needed for synthesis are present; and (3) these data are readily synthesizable. We highlight several tools and practices that can aid authors in these efforts, such as using a data-driven approach for crafting titles, abstracts, and keywords or by creating a repository for each project to host all study-related data files. We also provide step-by-step guidance and software suggestions for standardizing data design and public archiving to facilitate synthesis-ready research.

Geopersonality of Preventable Death in the United States: Anger-Prone States and Opioid Deaths

BACKGROUND

Opioid overdoses have reached epidemic levels in the United States and have clustered in Northeastern and "Rust Belt" states. Five Factor Model (FFM) personality traits also vary at the state level, with anger-prone traits clustered in the Northeast region. This study tested the hypothesis that state-level anger proneness would be associated with a greater increase in rates of opioid overdose death.

METHODS

This was a secondary analysis of state-level data on FFM traits, opioid overdose deaths, and other classes of preventable death. Robust mixed models tested whether change in rates of opioid overdose death from 2008 to 2016 was moderated by state-level anger proneness.

RESULTS

State-level anger proneness was significantly associated with greater increases in rates of opioid overdose deaths (B = 1.01, standard error = 0.19, P < .001, 95% confidence interval: 0.63-1.39). The slope of increase in opioid overdose death rates was 380% greater in anger-prone states and held after adjustment for potential confounders such as state-level prevalence of major depressive disorder, number of mental health facilities, and historical patterns of manufacturing decline. A similar pattern was observed between state-level anger proneness and benzodiazepine overdose deaths but was not significant for the latter after adjustment for potential confounders.

CONCLUSION

These findings suggest that states characterized as more anger prone have experienced greater increases in opioid overdose deaths.

Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) statement

Spatial lifecourse epidemiology is an interdisciplinary field that utilizes advanced spatial, location-based, and artificial intelligence technologies to investigate the long-term effects of environmental, behavioural, psychosocial, and biological factors on health-related states and events and the underlying mechanisms. With the growing number of studies reporting findings from this field and the critical need for public health and policy decisions to be based on the strongest science possible, transparency and clarity in reporting in spatial lifecourse epidemiologic studies is essential. A task force supported by the International Initiative on Spatial Lifecourse Epidemiology (ISLE) identified a need for guidance in this area and developed a Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) Statement. The aim is to provide a checklist of recommendations to improve and make more consistent reporting of spatial lifecourse epidemiologic studies. The STrengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement for cohort studies was identified as an appropriate starting point to provide initial items to consider for inclusion. Reporting standards for spatial data and methods were then integrated to form a single comprehensive checklist of reporting recommendations. The strength of our approach has been our international and multidisciplinary team of content experts and contributors who represent a wide range of relevant scientific conventions, and our adherence to international norms for the development of reporting guidelines. As spatial, location-based, and artificial intelligence technologies used in spatial lifecourse epidemiology continue to evolve at a rapid pace, it will be necessary to revisit and adapt the ISLE-ReSt at least every 2-3 years from its release.

Best Practice Guidelines and Essential Methodological Steps to Conduct Rigorous and Systematic Meta-Reviews

BACKGROUND

A growing body of primary study and systematic review literature evaluates interventions and phenomena in applied and health psychology. Reviews of reviews (i.e., meta-reviews) systematically synthesise and utilise this vast and often overwhelming literature; yet, currently there are few practical guidelines for meta-review authors to follow.

OBJECTIVE

The aim of this article is to provide an overview of the best practice guidelines for all research synthesis and to detail additional specific considerations and methodological details for the best practice of conducting a rigorous meta-review.

METHODS

This article provides readers with six systematic and practical steps along with accompanying examples to address with rigor the unique challenges that arise when authors familiar with systematic review methods begin a meta-review: (a) detailing a clear scope, (b) identifying synthesis literature through strategic searches, (c) considering datedness of the literature, (d) addressing overlap among included reviews, (e) choosing and applying review quality tools, and (f) appropriate options for handling the synthesis and reporting of the vast amount of data collected in a meta-review.

CONCLUSIONS

We have curated best practice recommendations and practical tips for conducting a meta-review. We anticipate that assessments of meta-review quality will ultimately formalise best-method guidelines.

Twitter-based measures of neighborhood sentiment as predictors of residential population health

Several studies have recently applied sentiment-based lexicons to Twitter to gauge local sentiment to understand health behaviors and outcomes for local areas. While this research has demonstrated the vast potential of this approach, lingering questions remain regarding the validity of Twitter mining and surveillance in local health research. First, how well does this approach predict health outcomes at very local scales, such as neighborhoods? Second, how robust are the findings garnered from sentiment signals when accounting for spatial effects? To evaluate these questions, we link 2,076,025 tweets from 66,219 distinct users in the city of San Diego over the period of 2014-12-06 to 2017-05-24 to the 500 Cities Project data and 2010-2014 American Community Survey data. We determine how well sentiment predicts self-rated mental health, sleep quality, and heart disease at a census tract level, controlling for neighborhood characteristics and spatial autocorrelation. We find that sentiment is related to some outcomes on its own, but these relationships are not present when controlling for other neighborhood factors. Evaluating our encoding strategy more closely, we discuss the limitations of existing measures of neighborhood sentiment, calling for more attention to how race/ethnicity and socio-economic status play into inferences drawn from such measures.

Systematic reviews and meta-analyses in the health sciences: Best practice methods for research syntheses

RATIONALE

The journal Social Science & Medicine recently adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Moher et al., 2009) as guidelines for authors to use when disseminating their systematic reviews (SRs).

APPROACH

After providing a brief history of evidence synthesis, this article describes why reporting standards are important, summarizes the sequential steps involved in conducting SRs and meta-analyses, and outlines additional methodological issues that researchers should address when conducting and reporting results from their SRs.

RESULTS AND CONCLUSIONS

Successful SRs result when teams of reviewers with appropriate expertise use the highest scientific rigor in all steps of the SR process. Thus, SRs that lack foresight are unlikely to prove successful. We advocate that SR teams consider potential moderators (M) when defining their research problem, along with Time, Outcomes, Population, Intervention, Context, and Study design (i.e., TOPICS + M). We also show that, because the PRISMA reporting standards only partially overlap dimensions of methodological quality, it is possible for SRs to satisfy PRISMA standards yet still have poor methodological quality. As well, we discuss limitations of such standards and instruments in the face of the assumptions of the SR process, including meta-analysis spanning the other SR steps, which are highly synergistic: Study search and selection, coding of study characteristics and effects, analysis, interpretation, reporting, and finally, re-analysis and criticism. When a SR targets an important question with the best possible SR methods, its results can become a definitive statement that guides future research and policy decisions for years to come.

An Examination of State-Level Personality Variation and Physician Aid in Dying Legislation

CONTEXT

Physician aid in dying is a controversial topic in the U.S., and legislation exists in some states. Personality traits are associated with preferences for end-of-life care and also tend to cluster systematically across states and other geographic regions. Such clustering of personality traits could relate to legislation including physician aid in dying.

OBJECTIVE

To determine whether average levels of personality traits in each U.S. state differ between states with and without physician aid in dying legislation.

METHODS

This secondary analysis of national surveys included data on state demographics, political leanings, and state-level averages of Five-Factor Model personality traits. Wilcoxon tests and logistic regression tests were used to assess whether state-level averages in personality traits differed across states with and without physician aid in dying legislation.

RESULTS

States with physician aid in dying legislation had significantly higher average levels of the trait of openness and significantly lower average levels of the trait of neuroticism. The association with openness was no longer significant after accounting for state conservative advantage.

CONCLUSION

The social dialogue and potential controversy surrounding physician aid in dying may be linked to aggregate differences in state personality profiles. States with physician aid in dying legislation tend to be areas where constituents are on average more open minded and experience greater emotional stability. More work is needed to ascertain whether the experiences of receiving and providing end-of-life care may differ across these regions, particularly in relation to conversations around physician aid in dying.

What are the keys to a longer, happier life? Answers from five decades of health psychology research

RATIONALE

It has long been known that factors of the mind and of interpersonal relationships influence health, but it is only in the last 50 years that an independent scientific field of health psychology appeared, dedicated to understanding psychological and behavioral processes in health, illness, and healthcare.

OBJECTIVE AND METHOD

This article (a) reviews important research that answers the question of how human beings can have longer, happier lives; and (b) highlights trends in health psychology featuring articles in Social Science & Medicine as well as other related literature.

RESULTS

Since the 1970s, health psychology has embraced a biopsychosocial model such that biological factors interact and are affected by psychological and social elements. This model has illuminated all subjects of health, ranging from interventions to lower stress and/or to improve people's ability to cope with stressors, to mental and physical health. Importantly, a health psychology perspective is behavioral: The majority of chronic diseases of today can be avoided or reduced through healthy lifestyles (e.g., sufficient exercise, proper diet, sufficient sleep). Thus, behavior change is the key target to help reduce the immense public health burden of chronic lifestyle illnesses. Health psychology also focuses on how social patterns influence health behavior and outcomes, in the form of patient-provider interactions or as social forces in communities where people live, work, and play. Health psychology is congenial to other health sciences, especially when allied with ecological perspectives that incorporate factors upstream from individual behavior, such as networks linked to individuals (e.g., peer groups, communities). Over its history, health psychology research has been responsive to societal and medical needs and has routinely focused on understanding health disparities.

CONCLUSION

By relying on a strong interdisciplinary approach, research in health psychology provides a remarkably comprehensive perspective on how people can live healthier lives.