Multilevel models for continuous outcomes

Abstract

Multilevel models (mixed-effect models or hierarchical linear models) are now a standard approach to analysing clustered and longitudinal data in the social, behavioural and medical sciences. This review article focuses on multilevel linear regression models for continuous responses (outcomes or dependent variables). These models can be viewed as an extension of conventional linear regression models to account for and learn from the clustering in the data. Common clustered applications include studies of school effects on student achievement, hospital effects on patient health, and neighbourhood effects on respondent attitudes. In all these examples, multilevel models allow one to study how the regression relationships vary across clusters, to identify those cluster characteristics which predict such variation, to disentangle social processes operating at different levels of analysis, and to make cluster-specific predictions. Common longitudinal applications include studies of growth curves of individual height and weight and developmental trajectories of individual behaviours. In these examples, multilevel models allow one to describe and explain variation in growth rates and to simultaneously explore predictors of both of intra- and inter-individual variation. This article introduces and illustrates this powerful class of model. We start by focusing on the most commonly applied two-level random-intercept and -slope models. We illustrate through two detailed examples how these models can be applied to both clustered and longitudinal data and in both observational and experimental settings. We then review more flexible three-level, cross-classified, multiple membership and multivariate response models. We end by recommending a range of further reading on all these topics.