Methods to Compare Mechanisms of Action in Substance Use Programs

比较药物使用计划中作用机制的方法

• 批准号: 8044943
• 负责人: Jason Williams
• 金额: $ 8.33万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8044943
• 关键词: Accounting; Address; Adoption; Age; Alcohol or Other Drugs use; Alcohols; Applied Research; Area; Behavior; Behavioral; Complex; Confidence Intervals; Cost Savings; Data; Data Collection; Data Set; Development; Elements; Evaluation; Eye; Gender; Grant; Human; Intervention; Intervention Studies; Investigation; Journals; Lead; Learning; Literature; Mediating; Mediation; Mediator of activation protein; Methodology; Methods; Metric; Military Personnel; Modeling; Nature; Online Systems; Outcome; Paper; Pathway interactions; Patient Self-Report; Performance; Population; Prevention; Prevention program; Principal Investigator; Process; Program Development; Program Evaluation; Property; Public Health; Publishing; Reliance; Reporting; Research; Research Personnel; Research Training; Resources; Role; Steroids; Structure; Target Populations; Techniques; Testing; Training; United States National Institutes of Health; Work; base; behavior change; comparative effectiveness; comparison group; cost effective; design; direct application; drug abuse prevention; effective intervention; evaluation/testing; falls; intervention program; performance tests; programs; real world application; simulation; statistics; substance use prevention; symposium; theories; tool; treatment program

DESCRIPTION (provided by applicant): This R03 small grant mechanism, submitted by a new NIH Principal Investigator, will address important gaps in mediation analysis of substance use intervention data. Behavioral theories guiding program development have become increasingly complex, resulting in interventions targeting multiple mechanisms, or mediators that are believed to be causally related to use. Mediation analysis has been instrumental in exploring these pathways to substance use and the role of interventions in altering these developmental trajectories. Hypotheses about mediation have also increased in complexity and now often include questions about how mediated effects compare to one another. These contrasts of mediated effects are an increasingly important aspect of program evaluation, as they allow researchers to understand the comparative effectiveness of several treatments or treatment components. Comparisons of mediated effects can help researchers more efficiently tailor intervention programs to the most salient mechanisms of behavior change. Such information is critical for developing cost-effective interventions in the face of decreasing availability of resources. Unfortunately, in practice these comparisons have been based on invalid metrics such as the absolute size of the effects in question or their t scores. Such reliance on improper methods can obscure the processes that truly account for the majority of behavior change. Similarly, crude comparisons of group-specific mediated effects may suggest that one group would not benefit from a component, a conclusion that could be supported or refuted by more stringent statistical examination. This study will provide applied substance use researchers with the tools needed to properly conduct comparisons of mediated effects by addressing two specific aims. First is an extensive simulation study that will examine the statistical properties of all five known contrast tests (Wald, percentile and bias-corrected bootstrap, likelihood-based confidence intervals, and a dummy latent variable test). The statistical properties (e.g., power, Type I error rate) of these tests are either unknown or unclear, so this information will provide guidance about the situations (e.g., types of hypotheses, data structures) in which these various tests should be employed. The simulation results will then inform the second component of this study: a thorough application of contrast methods to existing prevention data from two multicomponent substance use prevention programs. Both programs are representative of many prevention designs, with features such as multiple mediators and outcomes and longitudinal self-reported data collection. These features, together with previous findings of significant mediation in both data sets, make them well suited to a pedagogical demonstration of how to formulate and test mediated effect contrasts. PUBLIC HEALTH RELEVANCE: This study will increase the tools available to public health researchers as they attempt to uncover and change the mechanisms by which substance use occurs. Comparisons of these mechanisms, also called mediated effects, are important for determining how treatment and prevention programs achieve their effects and how program efficacy differs across groups based on factors such as gender and age. The results of this study will identify the best methods for making these comparisons and provide concrete pedagogical examples that applied substance use researchers can use to benefit their own evaluations.

描述（由申请人提供）：新的NIH首席研究员提交的R03小型赠款机制将解决对物质使用干预数据的调解分析中的重要差距。指导计划发展的行为理论变得越来越复杂，导致针对多种机制的干预措施，或者被认为与使用有因果关系有关的介体。调解分析对探索这些物质使用的途径以及干预措施在改变这些发育轨迹中的作用发挥了作用。关于调解的假设的复杂性也有所增加，现在通常包括有关介导效应相比如何相比的问题。这些介导作用的对比是程序评估的越来越重要的方面，因为它们使研究人员能够了解几种治疗或治疗成分的比较有效性。介导效应的比较可以帮助研究人员更有效地将干预计划定制为行为改变的最显着机制。这种信息对于面对减少资源的可用性而制定具有成本效益的干预措施至关重要。不幸的是，实际上，这些比较基于无效的指标，例如所讨论的效果的绝对大小或其T分数。这种对不当方法的依赖可以掩盖真正解释大多数行为改变的过程。同样，对群体特异性介导作用的粗略比较可能表明，一个组不会从组成部分中受益，这一结论可以通过更严格的统计检查来支持或驳斥。这项研究将通过解决两个具体目标，为适当地进行介导效果的比较所需的工具提供应用的药物使用研究人员。首先是一项广泛的仿真研究，它将检查所有五个已知的对比度测试的统计特性（WALD，PESTORILE和偏置校正后的引导程序，基于似然置信区间和虚拟潜在变量测试）。这些测试的统计属性（例如，功率，I型错误率）是未知的或不清楚的，因此该信息将提供有关应采用这些各种测试的情况（例如，假设的类型，数据结构的类型）的指导。然后，仿真结果将为这项研究的第二部分提供信息：对比度方法的彻底应用来自两个多组分物质使用预防程序的现有预防数据。这两个程序都代表了许多预防设计，具有多个调解人和结果以及纵向自我报告的数据收集等功能。这些功能以及以前在两个数据集中进行了重大调解的发现，使它们非常适合于如何制定和测试介导的效果对比的教学演示。 公共卫生相关性：这项研究将在公共卫生研究人员试图发现和改变发生药物使用的机制时增加可用的工具。这些机制的比较，也称为介导的效果，对于确定治疗和预防计划如何实现其效果以及程序疗效如何根据性别和年龄等因素来确定方案的效率如何不同。这项研究的结果将确定进行这些比较的最佳方法，并提供具体的教学示例，研究人员可以用来利用物质的使用物质来使自己的评估受益。