1. Give an example of a research question for investigating racial/ethnic health disparities where: [1] SES is a confounder; [2] SES is an effect modifier; [3] SES is a mediator. Briefly discuss the interpretations/implications of each approach as it relates to understanding health disparities by race/ethnicity.
Answer:
RQ for investigating racial/ethnic health disparities where...
A - SES is a confounder: Is there an association between race/ethnicity and the number of magazine subscriptions one has, and does this association change when controlling for SES?
B - SES is an effect modifier: Is there an association between race/ethnicity and having a library card, and does the association differ by SES level?
C - SES as a mediator: Is there an association between race/ethnicity and owning a KitchenAid mixer, and are there associations between race/ethnicity and SES and/or SES and owning a KitchenAid mixer? Further, is there an association for race/ethnicity and owning a KitchenAid mixer after controlling for SES?
2. Describe a potential effect modifier, mediator, or contextual variable (for definition of contextual variable, see Diez-Roux reading) for an association of interest to you and relevant to health disparities. For example, for investigating the association between education and hypertension, I might be interested in evaluating whether the association between years of education and hypertension is different for Black men than for White men. Describe how you would study whether this relationship exists.
Answer:
Among other topics, I am interested in investigating the relationship between race/ethnicity and how NCAA Division I student-athletes access health and wellness resources on their institution's campus. I would be interested to see if gender is an effect modifier in this relationship. In order to study whether or not this relationship exists, I could run a study where I tested an intervention to improve the rate at which all NCAA DI athletes access health and wellness resources, and then compare the changes in access rates for White women versus men of various races and ethnicities, Black women versus men of various races and ethnicities, etc. The relationship likely exists if the intervention works better for women of all races and ethnicities compared with men of the same group of races and ethnicities.