Time: ~30 minutes
Goal: Practice one-way ANOVA analysis from start to finish using real public health data
Learning Objectives:
Structure:
Submission: Upload your completed .Rmd file and published to Brightspace by the end of class.
Why ANOVA? We have one continuous outcome (SBP) and one categorical predictor with THREE groups (BMI category). Using multiple t-tests would inflate our Type I error rate.
# Load necessary libraries
library(tidyverse) # For data manipulation and visualization
library(knitr) # For nice tables
library(car) # For Levene's test
library(NHANES) # NHANES dataset
# Load the NHANES data
data(NHANES)Create analysis dataset:
# Set seed for reproducibility
set.seed(553)
# Create BMI categories and prepare data
bp_bmi_data <- NHANES %>%
filter(Age >= 18 & Age <= 65) %>% # Adults 18-65
filter(!is.na(BPSysAve) & !is.na(BMI)) %>%
mutate(
bmi_category = case_when(
BMI < 25 ~ "Normal",
BMI >= 25 & BMI < 30 ~ "Overweight",
BMI >= 30 ~ "Obese",
TRUE ~ NA_character_
),
bmi_category = factor(bmi_category,
levels = c("Normal", "Overweight", "Obese"))
) %>%
filter(!is.na(bmi_category)) %>%
select(ID, Age, Gender, BPSysAve, BMI, bmi_category)
# Display first few rows
head(bp_bmi_data) %>%
kable(caption = "Blood Pressure and BMI Dataset (first 6 rows)")| ID | Age | Gender | BPSysAve | BMI | bmi_category |
|---|---|---|---|---|---|
| 51624 | 34 | male | 113 | 32.22 | Obese |
| 51624 | 34 | male | 113 | 32.22 | Obese |
| 51624 | 34 | male | 113 | 32.22 | Obese |
| 51630 | 49 | female | 112 | 30.57 | Obese |
| 51647 | 45 | female | 118 | 27.24 | Overweight |
| 51647 | 45 | female | 118 | 27.24 | Overweight |
##
## Normal Overweight Obese
## 1939 1937 2150
Interpretation: We have 6026 adults with complete BP and BMI data across three BMI categories.
# Calculate summary statistics by BMI category
summary_stats <- bp_bmi_data %>%
group_by(bmi_category) %>%
summarise(
n = n(),
Mean = mean(BPSysAve),
SD = sd(BPSysAve),
Median = median(BPSysAve),
Min = min(BPSysAve),
Max = max(BPSysAve)
)
summary_stats %>%
kable(digits = 2,
caption = "Descriptive Statistics: Systolic BP by BMI Category")| bmi_category | n | Mean | SD | Median | Min | Max |
|---|---|---|---|---|---|---|
| Normal | 1939 | 114.23 | 15.01 | 113 | 78 | 221 |
| Overweight | 1937 | 118.74 | 13.86 | 117 | 83 | 186 |
| Obese | 2150 | 121.62 | 15.27 | 120 | 82 | 226 |
Observation: The mean SBP appears to increase from Normal (114.2) to Overweight (118.7) to Obese (121.6).
# Create boxplots with individual points
ggplot(bp_bmi_data,
aes(x = bmi_category, y = BPSysAve, fill = bmi_category)) +
geom_boxplot(alpha = 0.7, outlier.shape = NA) +
geom_jitter(width = 0.2, alpha = 0.1, size = 0.5) +
scale_fill_brewer(palette = "Set2") +
labs(
title = "Systolic Blood Pressure by BMI Category",
subtitle = "NHANES Data, Adults aged 18-65",
x = "BMI Category",
y = "Systolic Blood Pressure (mmHg)",
fill = "BMI Category"
) +
theme_minimal(base_size = 12) +
theme(legend.position = "none")What the plot tells us:
Null Hypothesis (H₀): μ_Normal = μ_Overweight =
μ_Obese
(All three population means are equal)
Alternative Hypothesis (H₁): At least one population mean differs from the others
Significance level: α = 0.05
# Fit the one-way ANOVA model
anova_model <- aov(BPSysAve ~ bmi_category, data = bp_bmi_data)
# Display the ANOVA table
summary(anova_model)## Df Sum Sq Mean Sq F value Pr(>F)
## bmi_category 2 56212 28106 129.2 <2e-16 ***
## Residuals 6023 1309859 217
## ---
## Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
Interpretation:
Why do we need this? The F-test tells us that groups differ, but not which groups differ. Tukey’s Honest Significant Difference controls the family-wise error rate for multiple pairwise comparisons.
## Tukey multiple comparisons of means
## 95% family-wise confidence level
##
## Fit: aov(formula = BPSysAve ~ bmi_category, data = bp_bmi_data)
##
## $bmi_category
## diff lwr upr p adj
## Overweight-Normal 4.507724 3.397134 5.618314 0
## Obese-Normal 7.391744 6.309024 8.474464 0
## Obese-Overweight 2.884019 1.801006 3.967033 0
Interpretation:
| Comparison | Mean Diff | 95% CI | p-value | Significant? |
|---|---|---|---|---|
| Overweight - Normal | 4.51 | [3.4, 5.62] | 1.98e-13 | Yes |
| Obese - Normal | 7.39 | [6.31, 8.47] | < 0.001 | Yes |
| Obese - Overweight | 2.88 | [1.8, 3.97] | 1.38e-09 | Yes |
Conclusion: All three pairwise comparisons are statistically significant. Obese adults have higher SBP than overweight adults, who in turn have higher SBP than normal-weight adults.
# Extract sum of squares from ANOVA table
anova_summary <- summary(anova_model)[[1]]
ss_treatment <- anova_summary$`Sum Sq`[1]
ss_total <- sum(anova_summary$`Sum Sq`)
# Calculate eta-squared
eta_squared <- ss_treatment / ss_total
cat("Eta-squared (η²):", round(eta_squared, 4), "\n")## Eta-squared (η²): 0.0411
## Percentage of variance explained: 4.11 %
Interpretation: BMI category explains 4.11% of the variance in systolic BP.
While statistically significant, the practical effect is modest—BMI category alone doesn’t explain most of the variation in blood pressure.
ANOVA Assumptions:
Diagnostic Plot Interpretation:
# Levene's test for homogeneity of variance
levene_test <- leveneTest(BPSysAve ~ bmi_category, data = bp_bmi_data)
print(levene_test)## Levene's Test for Homogeneity of Variance (center = median)
## Df F value Pr(>F)
## group 2 2.7615 0.06328 .
## 6023
## ---
## Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
Levene’s Test Interpretation:
Overall Assessment: With n > 2000, ANOVA is robust to minor violations. Our assumptions are reasonably satisfied.
Example Results Section:
We conducted a one-way ANOVA to examine whether mean systolic blood pressure (SBP) differs across BMI categories (Normal, Overweight, Obese) among 6,026 adults aged 18-65 from NHANES. Descriptive statistics showed mean SBP of 114.2 mmHg (SD = 15) for normal weight, 118.7 mmHg (SD = 13.9) for overweight, and 121.6 mmHg (SD = 15.3) for obese individuals.
The ANOVA revealed a statistically significant difference in mean SBP across BMI categories, F(2, 6023) = 129.24, p < 0.001. Tukey’s HSD post-hoc tests indicated that all pairwise comparisons were significant (p < 0.05): obese adults had on average 7.4 mmHg higher SBP than normal-weight adults, and 2.9 mmHg higher than overweight adults.
The effect size (η² = 0.041) indicates that BMI category explains 4.1% of the variance in systolic blood pressure, representing a small practical effect. These findings support the well-established relationship between higher BMI and elevated blood pressure, though other factors account for most of the variation in SBP.
Your Task: Complete the same 9-step analysis workflow you just practiced, but now on a different outcome and predictor.
# Prepare the dataset
set.seed(553)
mental_health_data <- NHANES %>%
filter(Age >= 18) %>%
filter(!is.na(DaysMentHlthBad) & !is.na(PhysActive)) %>%
mutate(
activity_level = case_when(
PhysActive == "No" ~ "None",
PhysActive == "Yes" & !is.na(PhysActiveDays) & PhysActiveDays < 3 ~ "Moderate",
PhysActive == "Yes" & !is.na(PhysActiveDays) & PhysActiveDays >= 3 ~ "Vigorous",
TRUE ~ NA_character_
),
activity_level = factor(activity_level,
levels = c("None", "Moderate", "Vigorous"))
) %>%
filter(!is.na(activity_level)) %>%
select(ID, Age, Gender, DaysMentHlthBad, PhysActive, activity_level)
# YOUR TURN: Display the first 6 rows and check sample sizes
# First 6 rows:
head(mental_health_data)## # A tibble: 6 × 6
## ID Age Gender DaysMentHlthBad PhysActive activity_level
## <int> <int> <fct> <int> <fct> <fct>
## 1 51624 34 male 15 No None
## 2 51624 34 male 15 No None
## 3 51624 34 male 15 No None
## 4 51630 49 female 10 No None
## 5 51647 45 female 3 Yes Vigorous
## 6 51647 45 female 3 Yes Vigorous
## None Moderate Vigorous
## 3139 768 1850
YOUR TURN - Answer these questions:
# YOUR TURN: Calculate summary statistics by activity level
# Hint: Follow the same structure as the guided example
# Variables to summarize: n, Mean, SD, Median, Min, Max
activity_summary_total <- mental_health_data %>%
group_by(activity_level) %>%
summarize(
N = n(),
Mean = mean(DaysMentHlthBad),
SD = sd(DaysMentHlthBad),
Median = median(DaysMentHlthBad),
Min = min(DaysMentHlthBad),
Max = max(DaysMentHlthBad)
)
print(activity_summary_total)## # A tibble: 3 × 7
## activity_level N Mean SD Median Min Max
## <fct> <int> <dbl> <dbl> <dbl> <int> <int>
## 1 None 3139 5.08 9.01 0 0 30
## 2 Moderate 768 3.81 6.87 0 0 30
## 3 Vigorous 1850 3.54 7.17 0 0 30
YOUR TURN - Interpret:
# YOUR TURN: Create boxplots comparing DaysMentHlthBad across activity levels
# Hint: Use the same ggplot code structure as the example
# Change variable names and labels appropriately
ggplot(mental_health_data,
aes(x = activity_level, y = DaysMentHlthBad, fill = activity_level)) +
geom_boxplot(alpha = 0.5, outlier.shape = NA,) +
geom_jitter(width = 0.2, alpha = 0.1, size = 0.5) +
# scale_fill_brewer(palette = "Set2") +
labs(
title = "Days of Reported Poor Mental Health by Activity Level",
subtitle = "NHANES Data, Adults aged 18-65",
x = "Activity Level",
y = "Days Reporting Bad Mental Health",
fill = "Activity Level"
) +
theme_classic(base_size = 12) +
theme(legend.position = "none")YOUR TURN - Describe what you see:
Do the groups appear to differ?
The groups do appear to differ, somewhat. The
medians of each group by activity level remains around 0, though the
variances differ somewhat between the three groups.
Are the variances similar across
groups?
The variance of Days Reporting Bad Mental
Health Days for people reporting vigorous activity are smaller than the
cariances seen in “None” and “Moderate” activity levels, though those
groups are similar.
YOUR TURN - Write the hypotheses:
Null Hypothesis (H₀): μ_None = μ_Moderate = μ_Vigorous (All three population means of # of bad mental health days are equal)
Alternative Hypothesis (H₁): At least one population mean differs from the others.
Significance Level: α = 0.05
# YOUR TURN: Fit the ANOVA model
# Outcome: DaysMentHlthBad
# Predictor: activity_level
# Fit the one-way ANOVA model
activity_anova <- aov(DaysMentHlthBad ~ activity_level, data = mental_health_data)
# Display the ANOVA table
summary(activity_anova)## Df Sum Sq Mean Sq F value Pr(>F)
## activity_level 2 3109 1554.6 23.17 9.52e-11 ***
## Residuals 5754 386089 67.1
## ---
## Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
YOUR TURN - Extract and interpret the results:
- F-statistic:
23.17
- Degrees of
freedom: 2
- p-value: <0.001
-
Decision (reject or fail to
reject H₀): Reject
- Statistical conclusion in words:
There is statistically significant evidence that mean
number of poor health days differs across at least activity level
categories.
—
# YOUR TURN: Conduct Tukey HSD test
# Only if your ANOVA p-value < 0.05
# Conduct Tukey HSD test
activity_tukey <- TukeyHSD(activity_anova)
print(activity_tukey)## Tukey multiple comparisons of means
## 95% family-wise confidence level
##
## Fit: aov(formula = DaysMentHlthBad ~ activity_level, data = mental_health_data)
##
## $activity_level
## diff lwr upr p adj
## Moderate-None -1.2725867 -2.045657 -0.4995169 0.0003386
## Vigorous-None -1.5464873 -2.109345 -0.9836298 0.0000000
## Vigorous-Moderate -0.2739006 -1.098213 0.5504114 0.7159887
YOUR TURN - Complete the table:
| Comparison | Mean Difference | 95% CI Lower | 95% CI Upper | p-value | Significant? |
|---|---|---|---|---|---|
| Moderate - None | -1.2725867 | -2.045657 | -0.4995169 | 0.0003386 | Yes |
| Vigorous - None | -1.5464873 | -2.109345 | -0.9836298 | 0.0000000 | Yes |
| Vigorous - Moderate | -0.2739006 | -1.098213 | 0.5504114 | 0.7159887 | No |
Interpretation:
Which specific groups differ significantly?
None differs significantly from vigorous and
moderate, but vigorous and moderate do not differ from each other.
# YOUR TURN: Calculate eta-squared
# Hint: Extract Sum Sq from the ANOVA summary
# Extract sum of squares from ANOVA table
activity_summary <- summary(activity_anova)[[1]]
ss_treatment <- activity_summary$`Sum Sq`[1]
ss_total <- sum(activity_summary$`Sum Sq`)
# Calculate eta-squared
eta_squared <- ss_treatment / ss_total
cat("Eta-squared (η²):", round(eta_squared, 4), "\n")## Eta-squared (η²): 0.008
## Percentage of variance explained: 0.8 %
cat("Effect Size:",
ifelse(eta_squared < 0.06,
"Small", ifelse(eta_squared < 0.14,
"Medium",
"Large")
)
)## Effect Size: Small
YOUR TURN - Interpret:
- η² = 0.008
-
Percentage of variance
explained: = 0.8%
- Effect size classification =
Small
- What does this
mean practically? While statistically significant, the
practical effect is minimal— activity level alone doesn’t explain most
of the variation in the number of poor mental health days.
YOUR TURN - Evaluate each plot:
# YOUR TURN: Conduct Levene's test
activity_levene <- leveneTest(DaysMentHlthBad ~ activity_level, data = mental_health_data)
print(levene_test)## Levene's Test for Homogeneity of Variance (center = median)
## Df F value Pr(>F)
## group 2 2.7615 0.06328 .
## 6023
## ---
## Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
YOUR TURN - Overall assessment:
- Are assumptions reasonably met?
We fail to reject the null,indicating that we can
assume homogeneiity of variance.
- Do any violations threaten your
conclusions? No, regular ANOVA should be fine.
YOUR TURN - Write a complete 2-3 paragraph results section:
Include: 1. Sample description and descriptive statistics 2. F-test results 3. Post-hoc comparisons (if applicable) 4. Effect size interpretation 5. Public health significance
Your Results Section:
We conducted a one-way ANOVA to examine whether mean number of days reporting poor mental health differs across levels of activity (None, Moderate, Vigorous) among 5,757 adults aged 18-65 from NHANES. Descriptive statistics showed a mean number of days reporting poor mental health of 5.1 days (SD = 9) for those with no activity, a mean number of days of 3.8 days (SD = 6.9)) for those with moderate activity, and a mean of 3.5 days (SD = 7.2) for those with vigorous activity,
The ANOVA revealed a statistically significant difference in mean days reporting poor mental health across activity categories, F(2, 5754) = 23.17, p < 0.001.
Tukey’s HSD post-hoc tests indicated that only the comparisons between those with no activity and moderate and vigorous respectively differed, while moderate and vigorous did not differ between each other.
The effect size (η² = 0.008) indicates that activity level explains 0.8% of the variance days reporting poor mental health representing a small practical effect. These findings indicate that most variance is not accounted for by activity level.
1. How does the effect size help you understand the practical vs. statistical significance?
Effect size describes how much of the variance is accounted for by this measure.
2. Why is it important to check ANOVA assumptions? What might happen if they’re violated?
If these are violated we should be instead using modifications of the ANOVA that account for the specific violations.
3. In public health practice, when might you choose to use ANOVA?
Use anova if comparing means across more than two groups. Any categories that aren’t binary.
4. What was the most challenging part of this lab activity?
I think learning to interpret the diagnostic plots was the most challenging because a lot of the examples online were more dramatic and intentionally different deviations, whereas actual data felt more subject to interpretation in the way that you learn over time.
Before submitting, verify you have:
To submit: Upload both your .Rmd file and the HTML output to Brightspace.
Lab completed on: February 05, 2026
Total Points: 15
| Category | Criteria | Points | Notes |
|---|---|---|---|
| Code Execution | All code chunks run without errors | 4 | - Deduct 1 pt per major error - Deduct 0.5 pt per minor warning |
| Completion | All “YOUR TURN” sections attempted | 4 | - Part B Steps 1-9 completed - All fill-in-the-blank answered - Tukey table filled in |
| Interpretation | Correct statistical interpretation | 4 | - Hypotheses correctly stated (1 pt) - ANOVA results interpreted (1 pt) - Post-hoc results interpreted (1 pt) - Assumptions evaluated (1 pt) |
| Results Section | Professional, complete write-up | 3 | - Includes descriptive stats (1 pt) - Reports F-test & post-hoc (1 pt) - Effect size & significance (1 pt) |
Code Execution (4 points):
Completion (4 points):
Interpretation (4 points):
Results Section (3 points):