EPI265_SPR17: Week 5 response

I am interested in how improved leadership skill leads to better managed programs and ultimately superior health outcomes. It is possible to apply the lifecourse model, taking into account the critical period, accumulation and effect modification assumptions.

In this case, the critical period is in childhood and whether an individual was taught critical-thinking and problem solving skills through their primary education.

The application of the accumulation hypothesis in this case is the frequency and duration of exposure to good problem solvers/managers, both in school and in early jobs.

It is unlikely that an effect modifier like having a very good boss/mentor later in life would be effective in reversing the habits and transmitting leadership skills, but nonetheless possible.

I am not sure how I might develop a regression model for this analysis.

I am not aware of any data sets that could be used for this analysis. I have been in early conversations with colleagues at the University of Global Health Equity in Rwanda about doing the very first part of this analysis around the skills that their students have before entering a Master’s program, their performance in school and their placement and progress in jobs after graduation. I would be worried about how to balance the relative weighting of each experience on the outcome. It’s not clear to me whether or how much more influential the early formative experiences of how to analyze information and solve problems is compared to recent experiences with on the job training and a strong model and mentor. Certainly, the likelihood of getting a good job with a strong mentor is diminished without the initial foundational skills, so we need to model the interactive effect, but I don’t know enough through empirical examples to be sure how to consider the relative importance.

After wading through the Mishtra article again, I can see how each of the models might be constructed, based on what is most important.

If it's about the accumulation of experiences with critical thinking/problem solving in education and career experiences, assuming n experiences that either were or were not positive, then the causal parameter of interest or lifetime score, is the difference between an individual with all positive experiences and the individual with no positive experiences divided by the number of experiences. Therefore, the expected value of the outcome would be alpha + beta * the sum of the lifetime scores, where beta = the difference as noted.

If there is a critical period, say the two most recent jobs, then the causal parameter of interest is the difference between those with positive experiences in the last two jobs and those with negative experiences in the last two jobs, regardless of their prior experiences. Therefore the expected value of the outcome would be alpha + beta * whether the experience was positive or negative, where beta = the difference noted.

I'm still confused about how to apply the mobility model.

Re: Week 5 response

by Maria Glymour - Monday, May 1, 2017, 9:28 AM

Amy

Your examples are always interesting and challenging! I think your conceptualization makes sense. It may also be useful to conceptualize the development of leadership skills within the course of a job, e.g., instead of using years of chronological age as the core time scale, use time in the role - perhaps the most important things are very early training and mentorship experiences at job initiation, and subsequent remediation is very difficult. On the other hand, maybe constant ongoing support and training is critical.

The ideas from lifecourse epi have usually been applied in a particular setting where the emphasis is on human physiologic development, but I think many of the ideas could be usefully reframed around other developmental processes, such as accrual of job leadership or technical skills.

For the mobility model, perhaps consider job satisfaction instead of leadership skills. I bet job satisfaction is very closely tied to how your current position contrasts with your last position, not just how good your current position is compared to the rest of the world of possible positions- the salient comparison is probably what you just came from (but that's my hypothesis- quite testable).

Maria