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Briana JK Stephenson

Publications and source records attributed to Briana JK Stephenson.

2 recordsLinked to original sources

Salient Bayesian Clustering for Proportional Data via a Multivariate Beta Mixture Model

Neighborhoods are multifaceted entities whose attributes span sociocultural, economic, and environmental dimensions. Clustering neighborhoods based on social determinants of health (SDoH) can inform the allocation of public health resources and interventions tailored to community needs. Continuous and bounded data, as seen in aggregated neighborhood-level SDoH data, can pose challenges for widely used clustering methods (e.g., k-means or Gaussian mixture models) that rely on Euclidean distances or normality assumptions. Moreover, not all SDoH variables contribute equally to meaningfully characterize neighborhood clusters, and the inclusion of irrelevant or weakly informative determinants can obscure the underlying structure. To address this issue, we propose a Bayesian Salient Multivariate Beta mixture (SAMBA-Mix) model that flexibly models proportional data with embedded feature saliency to identify relevant variables for clustering. Our model showed improved accuracy in cluster identification and structure, compared to existing models. Using data from the U.S. Agency for Healthcare Research and Quality(AHRQ) SDoH database, we demonstrate the utility of our model to derive neighborhood-level SDoH profiles in Massachusetts and identify key determinants that best characterize differences amongst the different profiles.

stat.ME↗

A Bayesian Mixture Model Approach to Examining Neighborhood Social Determinants of Health Disparities in Endometrial Cancer Care in Massachusetts

Many studies have examined social determinants of health (SDoH) independently, overlooking their interconnected nature. Our study uses a multidimensional approach to construct a neighborhood-level measure that explores how multiple SDoH jointly impact care received for endometrial cancer (EC) patients in Massachusetts (MA). Using 2015-2019 American Community Survey data, we implemented a Bayesian multivariate Bernoulli mixture model to identify neighborhoods with similar SDoH features in MA. Five neighborhood SDoH (NSDoH) profiles were derived and characterized: (1) advantaged non-Hispanic White; (2) disadvantaged racially/ethnically diverse, more renter-occupied housing with limited English proficiency; (3) working class, lower educational attainment; (4) racially/ethnically diverse and greater economic security and educational attainment; and (5) racially/ethnically diverse, more renter-occupied housing with limited English proficiency. Based on residential information, we assigned these profiles to EC patients in the Massachusetts Cancer Registry. We used these profile assignments as the primary exposure in a Bayesian logistic regression to estimate the odds of receiving optimal EC care, adjusting for patient-level sociodemographic and clinical characteristics. NSDoH profiles were not significantly associated with receiving optimal EC care. However, compared to patients assigned to Profile 1, patients in all other profiles had lower odds of receiving optimal care. Our findings demonstrate how a flexible model-based clustering approach can account for the interconnected and multidimensional nature of NSDoH in a practical and interpretable way. Deriving and geospatially mapping NSDoH profiles may allow for identifying areas of need and inform targeted public health interventions tailored to each neighborhood's specific social determinants to improve healthcare delivery.

stat.AP↗