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.
# 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) %>%
kable(caption = "Physical Activity and Mental Health Dataset (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 |
## sample size: 5757 adults aged 18+
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
summary_stats <- mental_health_data %>%
group_by(activity_level) %>%
summarise(
n=n(),
mean= mean(DaysMentHlthBad, na.rm= TRUE),
SD= sd(DaysMentHlthBad, na.rm= TRUE),
Median= median(DaysMentHlthBad, na.rm=TRUE),
min= min(DaysMentHlthBad, na.rm= TRUE),
max= max(DaysMentHlthBad, na.rm= TRUE),
)
summary_stats %>%
kable( digits= 3,
caption= "Descriptive statistics for Bad Mental Health Days by physical activity level")| activity_level | n | mean | SD | Median | min | max |
|---|---|---|---|---|---|---|
| None | 3139 | 5.084 | 9.010 | 0 | 0 | 30 |
| Moderate | 768 | 3.811 | 6.873 | 0 | 0 | 30 |
| Vigorous | 1850 | 3.537 | 7.171 | 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 = 0.7) +
geom_jitter(width = 0.2, alpha = 0.3, size = 0.5) +
scale_fill_brewer(palette = "Set2") +
labs(
title = "Bad Mental Health Days by Physical Activity Level",
subtitle = "NHANES 2017-2018, Adults aged 18+",
x = "Physical Activity Level",
y = "Bad Mental Health Days",
fill = "Activity Level"
) +
theme_minimal(base_size = 12) +
theme(legend.position = "none")YOUR TURN - Describe what you see:
Yes the groups appear to differ from each other. The graph shows that the vigorous physical activity group had, on average, a lower amount of bad mental health days. There is a lot of overlap between all three groups but the IQR for vigorous is smaller indicating that more individuals in this group reported very few/zero bad mental health days. The none group had more concentrated data points at the higher numbers of bad mental health days (20-30 days) while the vigourous group had some scattered at this area but most data is concentrated at zero.
YOUR TURN - Write the hypotheses:
Null Hypothesis (H₀): μ_None = μ_Moderate =
μ_Vigorous
(All three population means 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
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
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)
##
## $activity_level
## diff lwr upr p adj
## Moderate-None -1.2725867 -2.045657 -0.4995169 0.0003386
## Vigorous-None -1.5464873 -2.109345 -0.9836298 0.0000000
## Vigorous-Moderate -0.2739006 -1.098213 0.5504114 0.7159887
YOUR TURN - Complete the table:
| Comparison | Mean Difference | 95% CI Lower | 95% CI Upper | p-value | Significant? |
|---|---|---|---|---|---|
| Moderate - None | -1.27 | -2.05 | -0.50 | 0.0003 | Yes |
| Vigorous - None | -1.55 | -2.11 | -0.098 | 0.000 | Yes |
| Vigorous - Moderate | -0.27 | -1.10 | 0.55 | 0.716 | No |
Interpretation:
Which specific groups differ significantly?
# YOUR TURN: Calculate eta-squared
# Hint: Extract Sum Sq from the ANOVA summary
anova_summary <- summary(anova_model)[[1]]
ss_treatment <- anova_summary$`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 - Evaluate each plot:**
1. **Residuals vs Fitted:** The red line is slightly diagonal and slanted away from zero which is not a good sign
2. **Q-Q Plot:** The points do not follow the dotted line well, they curve upward far away from the line. Normality assumption is not reasonable
3. **Scale-Location:** The line is not flat and slightly diagonal. Equal variance assumption is not reasonable
4. **Residuals vs Leverage:** No points cross Cook's distance lines indicating no highly influential outliers
``` r
# YOUR TURN: Conduct Levene's test
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:
I conducted a one-way ANOVA to test whether bad mental health days differed across three physical activity levels: none, moderate, and vigorous. There were differences in mean bad mental health days across the activity groups. The no physical activity group (none) was 5.1 while the moderate groups mean was 3.8 and vigorous was 3.1.
The F-statistic was F(2, 5754)= 23.17, this means that the between-group variation is 23 times larger than the within-group variation. The p-value is less than .0001 which indicates that the difference between groups is unlikely to have happened by chance if all groups had the same mean.
The post-hoc tukey HSD tests revealed that there was no statistically significant difference between the moderate and vigorous groups because p=0.716 which suggests that the benefits of vigorous activity is similar to that of moderate physical activity. There was a difference between moderate and none and vigorous and none.
1. How does the effect size help you understand the practical vs. statistical significance?
Effect size tells us how much the factor we are looking at effects the variance in the problem we are examining, in this case how much physical activity effects the amount of bad mental health days. This helps us understand the practical significance because even though statistical significance can occur, the effect size helps determine if the differences we see across different activity levels is meaningful in real world contexts.
2. Why is it important to check ANOVA assumptions? What might happen if they’re violated?
Checking ANOVA assumptions is imprtant because it helps ensure that the conclusions being drawn are reliable. If they are violated then it can be assumed that p-values are wrong and error may be occuring.
3. In public health practice, when might you choose to use ANOVA?
Anova may be chosen when looking at mental health outcomes across dietary patterns or sleep patterns. These patterns would have three or more groups to be evaluated for ANOVA to be chosen, such as varying amounts of calorie intake per day.
4. What was the most challenging part of this lab activity?
During this lab the most challenging part was checking assumptions and levenes test, while it was easy to run the code I struggled a bit to understand the meaning of the output/graphs to properly relate them to the research question.
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):