Causal mediation of a human immunodeficiency virus preventive intervention.

Nursing Research
Donna L Coffman, Kari C Kugler

Abstract

Assessing mediation is important because most interventions are designed to affect an intermediate variable or mediator; this mediator, in turn, is hypothesized to affect outcome behaviors. Although there may be randomization to the intervention, randomization to levels of the mediator is not generally possible. Therefore, drawing causal inferences about the effect of the mediator on the outcome is not straightforward. The aim of this study was to introduce an approach to causal mediation analysis using the potential outcomes framework for causal inference and then discuss this approach in terms of the scientific questions addressed and the assumptions needed for identifying and estimating the effects. The approach is illustrated using data from the Criminal Justice Drug Abuse Treatment Studies: Reducing Risky Relationships-HIV intervention implemented with 243 incarcerated women re-entering the community. The intervention was designed to affect various mediators at 30 days postintervention, including risky relationship thoughts, beliefs, and attitudes, which were then hypothesized to affect engagement in risky sexual behaviors, such as unprotected sex, at 90 days postintervention. Using propensity score weighting, we found the...Continue Reading

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Citations

Jan 1, 2013·Multivariate Behavioral Research·Lance M RappaportDavid C Zuroff
Feb 14, 2013·Prevention Science : the Official Journal of the Society for Prevention Research·Anna R SolmeyerDamon E Jones
May 16, 2013·Journal of the American Geriatrics Society·Sherif EltonsyLucie Blais
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Apr 7, 2016·Issues in Mental Health Nursing·Annette T Maruca, Deborah Shelton

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