420 – Contributed Poster Presentations: Health Policy Statistics Section
Comparison Between Individual and Ecological-Level Models: An HIV PrEP Prescription Example Using a National Pharmacy Database
Neal Carnes
U.S. Centers for Disease Control and Prevention
Deborah Gelaude
U.S. Centers for Disease Control and Prevention
Karen Hoover
U.S. Centers for Disease Control and Prevention
Ya-Lin A. Huang
U.S. Centers for Disease Control and Prevention
Yuko Mizuno
U.S. Centers for Disease Control and Prevention
Jun Zhang
U.S. Centers for Disease Control and Prevention
Aggregate data may offer valuable clues about variable relationships, but the relationships do not necessarily hold at the individual-level. In this analysis, we include a policy level variable as a contextual predictor in both an individual and an ecological model of HIV pre-exposure prophylaxis (PrEP) prescription. Using a national pharmacy database, we assess the comparability of predictors of PrEP prescription by nurse practitioners at the individual- and ecological-level using two statistical approaches: a state (ecological) level Poisson regression with robust error variance and an individual-level hierarchical logistic regression model. The predictors are state licensure laws (both models: full practice, reduced practice and restricted practice), patient age (individual model: 5 age categories; ecological model: % 25 years of age or younger) and patient gender (individual model: male/female; ecological model % male). Licensure laws was significant in both models. Patient age and gender were significant in the individual model but only age was significant in the state model. The influence of policy level variable on individual and ecological outcomes will be discussed.