Controlling for Endogeneity Biases in Estimating AA Effects on Drinking Outcomes

描述（由申请人提供）：互助的随机对照试验（RCT）非常难以进行。现有的，主要是相关的，研究酗酒者匿名（AA）的有效性容易受到两种主要类型的文物，由于潜在的内偏的变量，定义为当被视为外源性的变量可能实际上是内源性的。也就是说，他们假设遗漏了需要在因果模型中明确表示的原因;这也被称为规范错误。一个这样的人工制品是自我选择偏差，即，不同类型的人选择参加或不参加AA。这方面的一个例子是AA参与和饮酒之间的虚假关系，因为有动机停止饮酒的人更有可能参加AA并停止饮酒;也就是说，高动机可以很好地“解释”AA参与和饮酒行为之间的相关性。第二种可能的伪影类型是反向因果关系，即，当减少或停止饮酒导致AA参与增加。通过控制这些可能的内源性偏倚，确定AA参与和饮酒行为之间关系的真实效应大小和因果方向是至关重要的，研究的总体目标是使用三种统计技术对Project MATCH酒精中毒治疗数据库中的AA参与和饮酒行为进行二次分析，这些统计技术旨在控制相关性中潜在的内源性偏倚。数据类型：倾向评分匹配（PSM）、工具变量（IV）分析以及具有交叉滞后效应的面板数据的结构方程模型（SEM）。还将进行模拟建模，以测试分析在违反假设方面的稳健性。研究结果可以大大加强匿名酗酒者和12步促进疗法的证据基础，并为康复社区提供更多的证据，以鼓励消费者继续参与互助。 公共卫生相关性：这项研究的结果可以提高12步促进疗法和12步互助计划的利用率，如匿名酗酒者，以减少过度和危险饮酒造成的公共卫生和社会问题。

DESCRIPTION (provided by applicant): Randomized controlled trials (RCTs) of mutual aid are extremely difficult to conduct. The existing, mainly correlational, studies of Alcoholics Anonymous (AA) effectiveness are susceptible to two main kinds of artifacts due to potential endogeneity bias in variables, defined as when variables treated as exogenous may actually be endogenous. That is, they have presumed omitted causes that need to be explicitly represented in a causal model; this is also termed specification error. One such artifact is self-selection bias, i.e., where different types of people choose to participate or not participate in AA. An example of this would be a spurious relation between AA participation and drinking due to the possibility that individuals who develop motivation to stop drinking are more likely both to attend AA and to stop drinking; that is, high motivation could well "explain" the observed correlation between AA participation and drinking behavior. The second possible type of artifact is reverse causation, i.e., when reducing or stopping drinking leads to increased AA participation. It is essential to determine the true magnitude of effect and causal direction in the relation between AA participation and drinking behavior by controlling for these possible endogeneity biases, The overall objective of the study is to conduct a secondary analysis of AA participation and drinking behavior in the Project MATCH alcoholism treatment database using three statistical techniques which are designed to control for potential endogeneity biases in correlational data: propensity score matching (PSM), instrumental variable (IV) analysis, and structural equation modeling (SEM) of panel data with cross-lagged effects. Simulation modeling will also be conducted to test the robustness of the analyses with respect to violation of assumptions. The results could greatly strengthen the evidence base for Alcoholics Anonymous and 12 step facilitation therapy, as well as provide the recovery community with additional evidence useful for encouraging consumers to stay involved in mutual aid. PUBLIC HEALTH RELEVANCE: The results of this study could increase the utilization of 12 step facilitation therapies and 12 step mutual aid programs such as Alcoholics Anonymous to reduce public health and social problems attributable to excessive and hazardous alcohol consumption.