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1.
Health Serv Outcomes Res Methodol ; 23(2): 149-165, 2023.
Article in English | MEDLINE | ID: covidwho-2315013

ABSTRACT

Understanding how best to estimate state-level policy effects is important, and several unanswered questions remain, particularly about the ability of statistical models to disentangle the effects of concurrently enacted policies. In practice, many policy evaluation studies do not attempt to control for effects of co-occurring policies, and this issue has not received extensive attention in the methodological literature to date. In this study, we utilized Monte Carlo simulations to assess the impact of co-occurring policies on the performance of commonly-used statistical models in state policy evaluations. Simulation conditions varied effect sizes of the co-occurring policies and length of time between policy enactment dates, among other factors. Outcome data (annual state-specific opioid mortality rate per 100,000) were obtained from 1999 to 2016 National Vital Statistics System (NVSS) Multiple Cause of Death mortality files, thus yielding longitudinal annual state-level data over 18 years from 50 states. When co-occurring policies are ignored (i.e., omitted from the analytic model), our results demonstrated that high relative bias (> 82%) arises, particularly when policies are enacted in rapid succession. Moreover, as expected, controlling for all co-occurring policies will effectively mitigate the threat of confounding bias; however, effect estimates may be relatively imprecise (i.e., larger variance) when policies are enacted in near succession. Our findings highlight several key methodological issues regarding co-occurring policies in the context of opioid-policy research yet also generalize more broadly to evaluation of other state-level policies, such as policies related to firearms or COVID-19, showcasing the need to think critically about co-occurring policies that are likely to influence the outcome when specifying analytic models.

2.
Health services & outcomes research methodology ; : 1-17, 2022.
Article in English | EuropePMC | ID: covidwho-2295827

ABSTRACT

Understanding how best to estimate state-level policy effects is important, and several unanswered questions remain, particularly about the ability of statistical models to disentangle the effects of concurrently enacted policies. In practice, many policy evaluation studies do not attempt to control for effects of co-occurring policies, and this issue has not received extensive attention in the methodological literature to date. In this study, we utilized Monte Carlo simulations to assess the impact of co-occurring policies on the performance of commonly-used statistical models in state policy evaluations. Simulation conditions varied effect sizes of the co-occurring policies and length of time between policy enactment dates, among other factors. Outcome data (annual state-specific opioid mortality rate per 100,000) were obtained from 1999 to 2016 National Vital Statistics System (NVSS) Multiple Cause of Death mortality files, thus yielding longitudinal annual state-level data over 18 years from 50 states. When co-occurring policies are ignored (i.e., omitted from the analytic model), our results demonstrated that high relative bias (> 82%) arises, particularly when policies are enacted in rapid succession. Moreover, as expected, controlling for all co-occurring policies will effectively mitigate the threat of confounding bias;however, effect estimates may be relatively imprecise (i.e., larger variance) when policies are enacted in near succession. Our findings highlight several key methodological issues regarding co-occurring policies in the context of opioid-policy research yet also generalize more broadly to evaluation of other state-level policies, such as policies related to firearms or COVID-19, showcasing the need to think critically about co-occurring policies that are likely to influence the outcome when specifying analytic models.

3.
RAND Corporation ; 2021.
Article in English | ProQuest Central | ID: covidwho-1566792

ABSTRACT

In fall 2017, Propel Schools initiated the expansion of one of its schools, Propel Montour. Originally a single K-8 school with two classrooms per grade, Montour added a new high school and expanded into separate elementary and middle schools over four years, adding a classroom to each grade. In this report, the authors used difference-in-difference and doubly robust regression models to examine the academic and behavioral experiences of both continuing and expansion Montour students from fall 2017 through the onset of the coronavirus disease 2019 (COVID-19) pandemic in spring 2020. The analyses did not find evidence that the academic and behavioral experiences of either the continuing or expansion students fell below what would have been expected absent expansion. Although the expansion experiences of a single charter management organization (CMO) network might be idiosyncratic to that entity and the locale and population it serves, this report should be of interest to similarly structured CMOs, the organizations from which they might seek expansion funding, those involved in school choice policy, and state and local education leaders and policymakers. [This report was supported through a subcontract with Propel Schools Foundation.]

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