Mediation of Neighborhood Effects on Adolescent Substance Use by the School and Peer Environments

Epidemiology
Kara E RudolphTheresa L Osypuk

Abstract

Evidence suggests that aspects of the neighborhood environment may influence risk of problematic drug use among adolescents. Our objective was to examine mediating roles of aspects of the school and peer environments on the effect of receiving a Section 8 housing voucher and using it to move out of public housing on adolescent substance use outcomes. We used data from the Moving to Opportunity (MTO) experiment that randomized receipt of a Section 8 housing voucher. Hypothesized mediators included school climate, safety, peer drug use, and participation in an after-school sport or club. We applied a doubly robust, semiparametric estimator to longitudinal MTO data to estimate stochastic direct and indirect effects of randomization on cigarette use, marijuana use, and problematic drug use. Stochastic direct and indirect effects differ from natural direct and indirect effects in that they do not require assuming no posttreatment confounder of the mediator-outcome relationship. Such an assumption would be at odds with any causal model that reflects an intervention affecting a mediator and outcome through adherence to treatment assignment. Having friends who use drugs and involvement in after-school sports or clubs partially mediated...Continue Reading

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Citations

Jul 3, 2019·International Journal of Epidemiology·Brian J FairmanStephen E Gilman
May 18, 2020·American Journal of Epidemiology·Kara E RudolphElizabeth A Stuart
Dec 20, 2019·Prevention Science : the Official Journal of the Society for Prevention Research·Christopher CambronJ David Hawkins
Dec 4, 2019·JAMA : the Journal of the American Medical Association·Craig Evan PollackBradley Herring
Apr 14, 2021·Social Science & Medicine·Jose Eos Trinidad

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