@article{4040b79f55ab4bf6ae07050bb26d6e24,
title = "Causal mediation analysis with observational data: Considerations and illustration examining mechanisms linking neighborhood poverty to adolescent substance use",
abstract = "Understanding the mediation mechanisms by which an exposure or intervention affects an outcome can provide a look into what has been called a {"}black box{"} of many epidemiologic associations, thereby providing further evidence of a relationship and possible points of intervention. Rapid methodologic developments in mediation analyses mean that there are a growing number of approaches for researchers to consider, each with its own set of assumptions, advantages, and disadvantages. This has understandably resulted in some confusion among applied researchers. Here, we provide a brief overview of the mediation methods available and discuss points for consideration when choosing a method. We provide an in-depth explication of 2 of the many potential estimators for illustrative purposes: the Baron and Kenny mediation approach, because it is the most commonly used, and a recently developed approach for estimating stochastic direct and indirect effects, because it relies on far fewer assumptions. We illustrate the decision process and analytical procedure by estimating potential school- and peer-based mechanisms linking neighborhood poverty to adolescent substance use in the National Comorbidity Survey Adolescent Supplement.",
keywords = "adolescent, mediation, neighborhood, stochastic intervention, substance use",
author = "Rudolph, {Kara E.} and Goin, {Dana E.} and Diana Paksarian and Rebecca Crowder and Merikangas, {Kathleen R.} and Stuart, {Elizabeth A.}",
note = "Funding Information: Author affiliations: Department of Emergency Medicine, University of California, Davis, Sacramento, California (Kara E. Rudolph); Division of Epidemiology, University of California, Berkeley, Berkeley, California (Kara E. Rudolph, Dana E. Goin, Rebecca Crowder); Division of Genetic Epidemiology, National Institute of Mental Health, Bethesda, Maryland (Diana Paksarian, Kathleen R. Merikangas); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Elizabeth A. Stuart); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Elizabeth A. Stuart); and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Elizabeth A. Stuart). This work was supported by the National Institute on Drug Abuse (grant R00DA042127; PI: K.E.R.) and the National Institute of Mental Health (grant R01MH099010; PI: E.A.S.). The National Comorbidity Survey Replication Adolescent Supplement and the larger program of related National Comorbidity Surveys are supported by the National Institute of Mental Health (grants U01-MH60220 and ZIA MH002808-11) and the National Institute of Drug Abuse (grants R01 DA016558) at the National Institutes of Health. The National Comorbidity Survey Replication Adolescent Supplement was carried out in conjunction with the World Health Organization World Mental Health Survey Initiative. Conflict of interest: none declared. Publisher Copyright: {\textcopyright} Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2018.",
year = "2019",
month = mar,
day = "1",
doi = "10.1093/aje/kwy248",
language = "English (US)",
volume = "188",
pages = "598--608",
journal = "American journal of epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "3",
}