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)
##
## $bmi_category
## diff lwr upr p adj
## Overweight-Normal 4.507724 3.397134 5.618314 0
## Obese-Normal 7.391744 6.309024 8.474464 0
## Obese-Overweight 2.884019 1.801006 3.967033 0
Interpretation:
| Comparison | Mean Diff | 95% CI | p-value | Significant? |
|---|---|---|---|---|
| Overweight - Normal | 4.51 | [3.4, 5.62] | 3.82e-12 | Yes |
| Obese - Normal | 7.39 | [6.31, 8.47] | < 0.001 | Yes |
| Obese - Overweight | 2.88 | [1.8, 3.97] | 1.38e-09 | Yes |
Conclusion: All three pairwise comparisons are statistically significant. Obese adults have higher SBP than overweight adults, who in turn have higher SBP than normal-weight adults.
# Extract sum of squares from ANOVA table
anova_summary <- summary(anova_model)[[1]]
ss_treatment <- anova_summary$`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.
# 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)
# 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
head (mental_health_data) %>%
kable(caption = "Activity Level and Mental Health (first 6 rows)")| ID | Age | Gender | DaysMentHlthBad | PhysActive | activity_level |
|---|---|---|---|---|---|
| 51624 | 34 | male | 15 | No | None |
| 51624 | 34 | male | 15 | No | None |
| 51624 | 34 | male | 15 | No | None |
| 51630 | 49 | female | 10 | No | None |
| 51647 | 45 | female | 3 | Yes | Vigorous |
| 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
# Calculate summary statistics by mental health category
summary_stats <- mental_health_data %>%
group_by(activity_level) %>%
summarise(
n = n(),
Mean = mean(DaysMentHlthBad),
SD = sd(DaysMentHlthBad),
Median = median(DaysMentHlthBad),
Min = min(DaysMentHlthBad),
Max = max(DaysMentHlthBad)
)
summary_stats %>%
kable(digits = 2,
caption = "Descriptive Statistics: Mental Health Levels by Physical Activity")| activity_level | n | Mean | SD | Median | Min | Max |
|---|---|---|---|---|---|---|
| None | 3139 | 5.08 | 9.01 | 0 | 0 | 30 |
| Moderate | 768 | 3.81 | 6.87 | 0 | 0 | 30 |
| 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
# Create boxplots with individual points
ggplot(mental_health_data,
aes(x = activity_level, y = DaysMentHlthBad, fill = activity_level)) +
geom_boxplot(alpha = 0.7, outlier.shape = NA) +
geom_jitter(width = 0.2, height = 0.2, alpha = 0.08, size = 0.5) +
scale_fill_brewer(palette = "Set2") +
labs(
title = "Mental Health Levels by Physical Activity",
subtitle = "NHANES Data, Adults aged 18-65",
x = "Physical Activity Levels",
y = "Number of Days with Poor Mental Health",
fill = "Activity Level"
) +
theme_minimal(base_size = 12) +
theme(legend.position = "none")YOUR TURN - Describe what you see:
Do the groups appear to differ? The none groups seems to have the highest number of poor mental health days, while the vigorous group has the least. The moderate group is in the middle compared to the other two groups for the number of poor mental health days.The boxes also seem to overlap.
Are the variances similar across groups? The standard deviations between the groups are similar, which can suggest comparable variability when comparing poor mental health days across the activity levels.
YOUR TURN - Write the hypotheses:
Null Hypothesis (H₀): μ_None = μ_Moderate = μ_Vigorous
Alternative Hypothesis (H₁): At least one group mean is different from the other
Significance level: α = 0.05
# YOUR TURN: Fit the ANOVA model
# Outcome: DaysMentHlthBad
# Predictor: activity_level
# Fit the one-way ANOVA model
anova_model <- aov(DaysMentHlthBad ~ activity_level, data = mental_health_data)
# Display the ANOVA table
summary(anova_model)## 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:
# YOUR TURN: Conduct Tukey HSD test
# Only if your ANOVA p-value < 0.05
# Conduct Tukey HSD test
tukey_results <- TukeyHSD(anova_model)
print(tukey_results)## Tukey multiple comparisons of means
## 95% family-wise confidence level
##
## Fit: aov(formula = DaysMentHlthBad ~ activity_level, data = mental_health_data)
##
## $activity_level
## diff lwr upr p adj
## Moderate-None -1.2725867 -2.045657 -0.4995169 0.0003386
## Vigorous-None -1.5464873 -2.109345 -0.9836298 0.0000000
## Vigorous-Moderate -0.2739006 -1.098213 0.5504114 0.7159887
YOUR TURN - Complete the table:
| Comparison | Mean Difference | 95% CI Lower | 95% CI Upper | p-value | Significant? |
|---|---|---|---|---|---|
| Moderate - None | -1.27 | -2.05 | -0.50 | .0003 | Yes |
| Vigorous - None | -1.55 | -2.11 | -0.98 | <.0001 | Yes |
| Vigorous - Moderate | -0.27 | -1.10 | 0.55 | 0.716 | No |
Interpretation:
Which specific groups differ significantly? The groups that differ significantly are moderate-none and vigorous-none from vigorous-moderate because their p-values are both <0.05, showing that those groups significantly significant, compared to the group that have levels vigorous-moderate. —
# YOUR TURN: Calculate eta-squared
# Hint: Extract Sum Sq from the ANOVA summary
# Extract sum of squares from ANOVA table
anova_summary <- summary(anova_model)[[1]]
ss_treatment <- anova_summary$`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): 0.008
## Percentage of variance explained: 0.8 %
YOUR TURN - Interpret:
# YOUR TURN: Create diagnostic plots
# Create diagnostic plots
par(mfrow = c(2, 2))
plot(anova_model)YOUR TURN - Evaluate each plot:
# YOUR TURN: Conduct Levene's test
# Levene's test for homogeneity of variance
levene_test <- 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 23.168 9.517e-11 ***
## 5754
## ---
## Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
YOUR TURN - Overall assessment:
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 determine whether the mean number of poor mental health days differs across physical activity levels (None, Moderate, Vigorous). We utilized NHANES data collected from from 5,757 adults aged 18–65 to form conclusions. The descriptive statistics demonstrated a mean of 5.08 days (SD = 9.01) for individuals reporting no physical activity, 3.81 days (SD = 6.87) for those reporting moderate activity, and 3.54 days (SD = 7.17) for those reporting vigorous activity. Overall, individuals who engaged in more physical activity reported fewer poor mental health days on average.
The ANOVA revealed a statistically significant difference in mean poor mental health days across different activity levels, F(2, 5754) = 23.17, p < 0.001. Tukey’s HSD post-hoc tests proved that both the moderate and vigorous activity groups reported significantly fewer poor mental health days than the no-activity group, in which the p-values were less than 0.001 for both comparisons. However, there was no significant difference between the moderate and vigorous activity groups since the p value was marked at p = 0.716.
1. How does the effect size help you understand the practical vs. statistical significance?
Effect size helps me to understand practical vs. statistical significance because a result can be statistically significant, such as having a low p-value, but the conclusion wouldn’t be practical if the effect size is small. Effect sizes are made to show how practical and the real world significance of that effect.
2. Why is it important to check ANOVA assumptions? What might happen if they’re violated?
It is important to check ANOVA assumptions to make sure they are actually valid, because if they are violated, it could lead to Type 1 errors, and inaccurate misinterpretations for the conclusion.
3. In public health practice, when might you choose to use ANOVA?
In public health practice, it would be ideal to use ANOVA when researchers would want to compare different variances across the means of different groups. For example, in this lab, we wanted to compare how different activity levels would affect mental health, in which we would use three means for the levels to help draw conclusions. It would also help prevent Type 1 error rate by abstaining from using multiple t-tests.
4. What was the most challenging part of this lab activity?
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):