Modern Longitudinal Mediation Methods for Prevention Studies

项目摘要 对美国公众健康至关重要的是采取干预措施，鼓励健康促进行为， 阻止损害健康的行为。设计干预措施并评估其长期影响 需要了解干预措施带来行为改变的过程。统计 调解分析是用来揭示这些进程，并确定影响的各个组成部分， 导致健康促进行为干预，并检测可能产生反作用的成分， 导致健康下降的行为。对随时间推移出现的结果进行统计中介分析 在干预之后（例如，持续锻炼和健康饮食、减少饮酒）构成特殊 来自混淆变量的挑战，这些变量可能会导致行为发生变化，而这些变化不是由于 干预随着时间的推移，分离这些混杂变量对行为的影响很重要， 评估真正的干预效果。该建议解决了一类混杂变量-时变 混杂因素（受干预影响并同时影响中介者和 结果）。拟议的研究涉及统计调解的两个发展方向：传统的 预防科学中使用的方法和流行病学中使用的潜在结果方法， 生物统计学，并评估他们的能力，准确地分离混杂的影响，从纵向效应 治疗干预。这项工作将改进评估长期治疗效果的统计方法 健康保护措施。拟议的研究培训计划将弥合各种方法之间的差距 预防科学的传统方法和流行病学和生物统计学的新方法， 中介效应的目的如下：1）描述和比较统计和因果推理 传统方法和新的潜在结果方法之间的假设， 时变混杂的介导效应。2)进行蒙特卡罗模拟研究，以调查 所有方法的纵向中介效应估计量的统计特性。3)将这些方法应用于 从三个NIH资助的数据集中提取更多信息，比较纵向介导效应估计， 物质使用预防数据集。

Project Summary Critical to the health of the American public are interventions to encourage health promoting behaviors and to discourage health diminishing behaviors. Designing interventions and evaluating their impact over time requires an understanding of the processes by which interventions bring about behavior change. Statistical mediation analysis is used to reveal these processes and to identify the impact of individual components of the intervention that lead to health promoting behaviors and to detect possible counterproductive components that lead to health diminishing behaviors. Statistical mediation analysis of outcomes that emerge over time following an intervention (e.g., sustained exercise and healthy diet, reduced alcohol consumption) pose special challenges from confounding variables that may produce changes in behavior that are not due to the intervention. Separating the effects of these confounding variables on behavior over time is important for assessing true intervention effects. This proposal addresses a class of confounding variables—time-varying confounders (variables over time that are affected by the intervention and affect both the mediator and the outcome). The proposed research addresses two lines of development in statistical mediation; traditional approaches used in prevention science and potential outcomes approaches used in epidemiology and biostatistics, and evaluates their ability to accurately separate confounding influences from longitudinal effects of treatment interventions. The work will improve statistical methods for evaluating long-term treatment effects of health protective interventions. The proposed research training plan will bridge the gap between methods traditional in prevention science and new methods in epidemiology and biostatistics for estimating longitudinal mediated effects in the following aims: 1) Delineate and compare the statistical and causal inference assumptions across traditional methods and new potential outcomes methods for estimating longitudinal mediated effects with time-varying confounding. 2) Conduct a Monte Carlo simulation study to investigate the statistical properties of longitudinal mediated effect estimators of all methods. 3) Apply these methods to extract more information from three NIH funded datasets to compare longitudinal mediated effect estimates on substance use prevention datasets.