Accepted for Publication: July 29, 2022.
Published: October 13, 2022. doi:10.1001/jamanetworkopen.2022.31633
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 McCall SJ et al. JAMA Network Open.
Corresponding Author: Stephen J. McCall, DPhil, Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon (sm227@aub.edu.lb).
Author Contributions: Dr McCall and Miss Abi Zeid had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Mrs El Khoury and Mrs Salibi contributed equally. Drs Abdulrahim, Chaaya, Ghattas, and Sibai contributed equally as co–senior authors.
Concept and design: McCall, Abdulrahim, Chaaya, Ghattas, Sibai.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: McCall, El Khoury.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: McCall, Salibi, Abi Zeid, El Haddad, Chaaya, Sibai.
Obtained funding: McCall, Abdulrahim, Ghattas, Sibai.
Administrative, technical, or material support: McCall, El Khoury, Alawieh, Abdulrahim, Ghattas.
Supervision: McCall, Abdulrahim, Ghattas.
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was supported by Elrha’s Research for Health in Humanitarian Crisis (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth and Development Office, Wellcome, and the UK National Institute for Health Research.
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Disclaimer: The views expressed herein should not be taken, in any way, to reflect the official opinion of the Norwegian Refugee Council or Elrha.
12.Mohamad
M , Moussally
K , Lakis
C ,
et al. Self-reported medication adherence among patients with diabetes or hypertension, Médecins Sans Frontières Shatila refugee camp, Beirut, Lebanon: a mixed-methods study.
PLoS One. 2021;16(5):e0251316. doi:
10.1371/journal.pone.0251316
PubMedGoogle ScholarCrossref 15.DeJong
J , Ghattas
H , Bashour
H , Mourtada
R , Akik
C , Reese-Masterson
A . Reproductive, maternal, neonatal and child health in conflict: a case study on Syria using Countdown indicators.
BMJ Glob Health. 2017;2(3):e000302. doi:
10.1136/bmjgh-2017-000302
PubMedGoogle ScholarCrossref 23.Abdulrahim
S , Ghattas
H , McCall
S ,
et al. Tracking adherence of older refugees to COVID-19 preventive measures in response to changing vulnerabilities: a multi-level, panel study to inform humanitarian response in Lebanon, 2021 [survey documentation]. Accessed August 15, 2022.
https://scholarworks.aub.edu.lb/handle/10938/22852 25.Young
SL , Miller
JD , Frongillo
EA , Boateng
GO , Jamaluddine
Z , Neilands
TB ; HWISE Research Coordination Network. Validity of a four-item household water insecurity experiences scale for assessing water issues related to health and well-being.
Am J Trop Med Hyg. 2021;104(1):391-394. doi:
10.4269/ajtmh.20-0417
PubMedGoogle ScholarCrossref 28.Van Calster
B , McLernon
DJ , van Smeden
M , Wynants
L , Steyerberg
EW ; Topic Group ‘Evaluating diagnostic tests and prediction models’ of the STRATOS initiative. Calibration: the Achilles heel of predictive analytics.
BMC Med. 2019;17(1):230. doi:
10.1186/s12916-019-1466-7
PubMedGoogle ScholarCrossref 29.Steyerberg
EW . Overfitting and optimism in prediction models. In:
Clinical Prediction Models. Springer; 2019:95-112. doi:
10.1007/978-3-030-16399-0_5
30.Leijdekkers
JA , Eijkemans
MJC , van Tilborg
TC ,
et al; OPTIMIST group. Predicting the cumulative chance of live birth over multiple complete cycles of in vitro fertilization: an external validation study.
Hum Reprod. 2018;33(9):1684-1695. doi:
10.1093/humrep/dey263
PubMedGoogle Scholar 32.Fernandez-Felix
B , García-Esquinas
E , Muriel
A , Royuela
A , Zamora
J . Bootstrap internal validation command for predictive logistic regression models.
Stata J. 2021;21(2):498-509. doi:
10.1177/1536867X211025836
Google Scholar 33.Moons
KG , Donders
ART , Steyerberg
EW , Harrell
FE . Penalized maximum likelihood estimation to directly adjust diagnostic and prognostic prediction models for overoptimism: a clinical example.
J Clin Epidemiol. 2004;57(12):1262-1270. doi:
10.1016/j.jclinepi.2004.01.020
PubMedGoogle Scholar 36.Lyles
E , Burnham
G , Chlela
L , Spiegel
P , Morlock
L , Doocy
S ; Lebanon Health Access Survey (LHAS) Study Team. Health service utilization and adherence to medication for hypertension and diabetes among Syrian refugees and affected host communities in Lebanon.
J Diabetes Metab Disord. 2020;19(2):1245-1259. doi:
10.1007/s40200-020-00638-6
PubMedGoogle Scholar 37.Workman
CL , Brewis
A , Wutich
A , Young
S , Stoler
J , Kearns
J . Understanding biopsychosocial health outcomes of syndemic water and food insecurity: applications for global health.
Am J Trop Med Hyg. 2021;104(1):8-11. doi:
10.4269/ajtmh.20-0513
PubMedGoogle Scholar 38.Jamaluddine
Z , Sahyoun
NR , Choufani
J , Sassine
AJ , Ghattas
H . Child-reported food insecurity is negatively associated with household food security, socioeconomic status, diet diversity, and school performance among children attending UN Relief and Works Agency for Palestine Refugees schools in Lebanon.
J Nutr. 2019;149(12):2228-2235. doi:
10.1093/jn/nxz189
PubMedGoogle Scholar 39.Omidvar
N , Ghazi-Tabatabie
M , Sadeghi
R , Mohammadi
F , Abbasi-Shavazi
MJ . Food insecurity and its sociodemographic correlates among Afghan immigrants in Iran.
J Health Popul Nutr. 2013;31(3):356-366. doi:
10.3329/jhpn.v31i3.16828
PubMedGoogle Scholar 40.Leung
CW , Epel
ES , Ritchie
LD , Crawford
PB , Laraia
BA . Food insecurity is inversely associated with diet quality of lower-income adults.
J Acad Nutr Diet. 2014;114(12):1943-53.e2. doi:
10.1016/j.jand.2014.06.353PubMedGoogle Scholar 41.Ghattas
H , Sassine
AJ , Seyfert
K , Nord
M , Sahyoun
NR . Food insecurity among Iraqi refugees living in Lebanon, 10 years after the invasion of Iraq: data from a household survey.
Br J Nutr. 2014;112(1):70-79. doi:
10.1017/S0007114514000282
PubMedGoogle Scholar 43.Barnett
K , Mercer
SW , Norbury
M , Watt
G , Wyke
S , Guthrie
B . Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.
Lancet. 2012;380(9836):37-43. doi:
10.1016/S0140-6736(12)60240-2
PubMedGoogle Scholar 47.Bambauer
KZ , Soumerai
SB , Adams
AS , Zhang
F , Ross-Degnan
D . Provider and patient characteristics associated with antidepressant nonadherence: the impact of provider specialty.
J Clin Psychiatry. 2007;68(6):867-873. doi:
10.4088/JCP.v68n0607
PubMedGoogle Scholar 49.Krueger
K , Botermann
L , Schorr
SG , Griese-Mammen
N , Laufs
U , Schulz
M . Age-related medication adherence in patients with chronic heart failure: a systematic literature review.
Int J Cardiol. 2015;184:728-735. doi:
10.1016/j.ijcard.2015.03.042
PubMedGoogle Scholar 51.Chew
SM , Lee
JH , Lim
SF , Liew
MJ , Xu
Y , Towle
RM . Prevalence and predictors of medication nonadherence among older community-dwelling people with chronic disease in Singapore.
J Adv Nurs. 2021;77(10):4069-4080. doi:
10.1111/jan.14913
PubMedGoogle Scholar 52.Nair
KV , Belletti
DA , Doyle
JJ ,
et al. Understanding barriers to medication adherence in the hypertensive population by evaluating responses to a telephone survey.
Patient Prefer Adherence. 2011;5:195-206. doi:
10.2147/PPA.S18481
PubMedGoogle Scholar