Prevention Science最新文献

Recently, Baseline Target Moderated Mediation (BTMM) has received a lot of attention in the field of prevention science. Prevention scientists are interested in BTMM because the model goes beyond whether an intervention achieves effects but also details how and for whom the intervention is most effective. In BTMM, baseline measures are used to investigate potential baseline-by-treatment interactions. However, BTMM has some important challenges including how to incorporate multiple moderator variables when identifying subgroups that benefit the most from the intervention and how to interpret subgroup effects in the presence of multiple moderator variables. Further, with the emergence of causal mediation analysis, it is important to investigate potential treatment-by-mediator interactions which allow the posttest mediator-outcome relation to vary in magnitude across intervention groups. Few methodological developments have addressed the challenges of assessing BTMM in the presence of multiple baseline-by-treatment interactions and the treatment-by-posttest mediator interaction. If the goal is to identify subgroups of individuals who respond better/worse to the intervention, it is important to use a method that can handle the many possible interactions while capturing the heterogeneity within the subgroups of interest. There are three aims of this paper. First, we describe the methodological challenges and substantive interpretation of mediation effects in the presence of multiple moderating variables. Second, we describe two statistical methods to estimate conditional mediation effects in the presence of multiple moderating variables. Third, the methods are applied to an empirical example from the ATLAS study. Implications for BTMM are discussed.

The COVID-19 pandemic instigated changes in almost all aspects of youth's life. While numerous studies have been implemented to understand how these changes are related to youth's development, few concerned large representative samples. This study introduces the methodology and initial results of the Quebec (Canada) Resilience Project (QRP), a representative longitudinal study. The QRP encompassed three phases: (a) 2017 census survey assessing school readiness in kindergarteners before the pandemic (n = 83,335, aged 6 years); (b) 2021 questionnaire study assessing family functioning during COVID-19-related lockdowns (n = 4524, aged 10 years); and (c) 2022 questionnaire survey assessing children's school performance and mental health post-lockdowns (n = 8217, aged 11 years). In total, 3871 children were assessed either by parents or teachers in the three phases. We explored factors associated with children school performance (maths, reading, and writing) and mental health (emotional, withdrawal, hyperactivity/impulsivity/inattention, and conduct problems symptoms). Population weights were estimated from census data to maintain the representativeness of the population. School readiness vulnerability in kindergarten and parental anxiety and depression during lockdowns were associated with both children's lower school performances and higher levels of all mental health symptoms post-lockdown. Loss in family income and parental difficulties in maintaining work-life balance during lockdowns were associated with children's lower school performance and higher levels of some mental health symptoms (emotional and hyperactivity/impulsivity/inattention) post-lockdown. The results underscore that pandemic-related disruptions were negatively associated with children's school performance, emphasizing the need for interventions in the school environment. Associations between pandemic-related disruptions and children mental health were less consistent yet emphasize the importance of parental mental health.

The COVID-19 pandemic disrupted the ability to receive health care services. Field-based health services became a logistically feasible alternative to medical center-based care. We compared two different field-based approaches to the delivery of SARS-CoV-2 testing and health education services for Latine communities using a quasi-experimental design that included propensity score matching to accommodate the challenges posed to research by the pandemic. From September 2021 through October 2022, we held 434 testing events, of which 234 used a geolocation approach and 200 used a partner-located approach to determine the location of the health services (n = 68 field sites in Oregon). We hypothesized that partner-located sites would obtain higher numbers of tests collected relative to geolocated sites, and that longer drive times to testing sites would be associated with lower testing rates. There were no differences in the number of tests collected by geolocated versus partner-located sites, controlling for population size and time-varying pandemic vulnerabilities measured as COVID-19 cases and deaths. Prior to propensity score weighting, a longer drive time to the testing site (both site types) was associated with a lower likelihood of total tests (IRR = .87, p < .01, CI [0.54, 0.92]), of Latine tests (IRR = .69, p < .001, CI [0.56, 0.84]), and of male tests collected (IRR = .67, p < .05, CI [0.47, 0.94]). The site's number of prior tests was associated with a significant 2% increase in tests collected and the prior week's number of county deaths was associated with a roughly 30% decrease in the likelihood of tests collected. However, the reduced testing rate when the death rate was higher was less likely in geolocated sites (IRR = 1.55, p < .001, CI [1.20, 2.01]). Implications for the utility of propensity score matching and time-varying covariates to accommodate pandemic challenges posed to research are discussed. Clinicaltrials.gov registration number: NCT05082935. Date of registration: 10/15/2021.

Coping Power (CP) is an empirically supported school-based intervention for children at risk for aggression. A child's social status with peers and the extent to which they accurately perceive it are important aspects of preadolescent social development that may influence how intervention format affects disruptive behavior outcomes. Further, reactive (RA) and proactive (PA) functional subtypes of aggression have differential relations with peer acceptance. This study is the first to test whether the effects of group (GCP) and individual (ICP) format of CP on RA and PA differed based on children's actual social status (aim 1) and whether they over- or underestimated their acceptance relative to their actual social status (perceptual accuracy; aim 2). This study involved secondary data analyses using a large-scale randomized controlled trial that assigned 360 children ages 9 to 11 (M = 9.74, SD = .62), predominantly male (n = 234, 65%), and Black (n = 273, 75.8%), with elevated levels of aggression to either ICP or GCP condition. Polynomial regression analyses and three-dimensional response surface plots tested and probed significant (p < .05) interactions between either actual acceptance or perceptual accuracy and intervention format on postintervention reactive and proactive aggression. Actual acceptance moderated the effects of GCP on RA, such that those with higher acceptance showed smaller reductions in RA from either preintervention or postintervention to follow-up. Perceptual accuracy also moderated the effects of ICP on PA, with those underestimating their acceptance showing smaller decreases in PA from postintervention to follow-up. These findings provide valuable insights into how children's actual peer acceptance and perceptual accuracy influence CP outcomes for different functional subtypes of aggression based on intervention format, raising important questions about potential mechanisms.

This study examined whether the Seoul Premarital Education Program (S-PEP) was effective when it was delivered via videoconferencing (VC) during the early COVID-19 period. S-PEP is a city-wide educational program designed to prevent marital distress by enhancing premarital readiness and relationship quality for couples. Because a randomized controlled trial was not realistic due to the pandemic, we recruited an intervention group and a no-intervention comparison group independently, who completed both the pre- and posttests. We then employed inverse probability of treatment weighting to derive two comparable groups. The weighted samples of 291 women and 228 men were analyzed separately using linear mixed models. The results showed that S-PEP via VC was effective in increasing levels of marital readiness for both women and men and in enhancing relationship confidence and satisfaction for women. Our findings suggest that VC can be a promising delivery strategy for curriculum-based group interventions for couples.

Retention of early career teachers is a critical issue in education, with burnout and self-efficacy serving as important precursors to teachers leaving the field. An integration of the PAX Good Behavior Game (GBG; Barrish et al., 1969) and MyTeachingPartner (MTP; Allen et al., 2015) was tested in a randomized controlled trial (RCT) to investigate whether the combined programs would improve long-term outcomes for early career teachers. However, due to the COVID-19 pandemic, there was a higher proportion of missing data and attrition in follow-up data collection than otherwise would have been expected. The current paper focused specifically on intervention impacts on teacher-reported burnout and self-efficacy through the COVID-19 pandemic and explored various approaches for addressing missing data as an illustrative example for other researchers who may similarly have faced missing data challenges due to the pandemic. Participants included in the original trial were N = 188 early career teachers (grades K-3) who were randomly assigned to either the intervention (i.e., GBG + MTP; n = 94 teachers) or control condition (n = 94) and provided baseline data. Specifically, teachers reported on their burnout and self-efficacy at pre-intervention (Fall), post-intervention (Spring), 1-year post intervention (in Fall and Spring), COVID Year 1 (Spring 2021), and COVID Year 2 (Spring 2022). We conducted a series of outcomes analyses under varying missing data assumptions (i.e., MCAR, MAR, NMAR). There were mixed findings (i.e., both null and beneficial) regarding GBG + MTP impacts on burnout, which varied across missing data assumptions; however, there were no GBG + MTP impacts on self-efficacy. This study may also provide insight for other researchers encountering similar challenges when analyzing follow-up data collected during the COVID-19 pandemic, as we highlight pros and cons of several different approaches for modeling missing data related to attrition due to the COVID-19 pandemic and related school closures.

Marijuana use in adolescence is associated with significant adverse outcomes. Romantic relationships are an important context for marijuana use. Prior research suggests a bi-directional relationship between marijuana use and relationship functioning; however, the complex interplay between adolescent relationship dynamics and marijuana use remains unclear. We engaged youth to participate in group model building, a system science approach, to understand from their perspective how social complexities influence the uptake, continuation, and escalation of marijuana use. Two independent groups of clinic and community-recruited youth aged 15-20 participated in a series of four 2-h workshops. Through structured activities, participants generated a causal loop diagram (CLD) representing critical features of the complex and dynamic social system impacting marijuana use for youth in their community. The CLD that emerged represents the mental models of youth and features fourteen feedback loops, including balancing and reinforcing loops, across three domains. These interrelated domains span within-relationship behaviors, factors proximal to marijuana use, and influences on the partner pool, which impact the quality of adolescent romantic relationships and contribute to a high prevalence of marijuana use among youth. Applying a system perspective offers new insights on how stress, and behaviors within relationships in response to stress, feed back to magnify relationship dysfunction and fuel marijuana use. This model provides a new foundation for future research and data collection to better understand and test the identified relationships and feedback loops. Our findings further underscore the importance of educational programs that teach youth about healthy relationship dynamics and stress-coping approaches that do not involve substance use. Understanding how factors function as a system provides important information toward illuminating relationship dynamics and designing more impactful and synergistic interventions.

This paper reviews evidence about the impact of marketing on ill health. We summarize evidence that marketing practices in six industries (tobacco, alcohol, pharmaceutical, processed food, firearm, and fossil fuel) are causal influences on the occurrence of injury, disease, and premature death. For each industry, we provide a brief overview on the extent of harmful marketing, efforts from each industry to obscure or otherwise conceal the impact of their marketing strategies, and efforts to counter the impact of harmful marketing in these industries. However, considering the ubiquitous belief that regulation is harmful to society, little headway has been made in reducing harmful marketing. We propose the substitution of a public health framework for the currently dominant free market ideology. Doing so would situate harmful marketing as a social determinant of health and consolidate the disparate efforts to regulate marketing of harmful products. Implications for future policy and research efforts are discussed.

Anti-bullying programs can create more positive classroom environments by fostering the development of positive leaders who establish constructive norms. The social identity theory of leadership addresses stability and change within different leader profiles and identifies leader group prototypicality: the extent to which leaders are perceived to embody the group identity, including standards, values, and norms. This study focuses on two key areas: (1) examining stability and change within positive and negative leader profiles, and (2) comparing transition probabilities between the KiVa anti-bullying intervention condition and a control condition. A sample of 6,629 children (2057 in the control condition and 4572 in the intervention condition) were followed from age 9 to age 11 in three waves of data collection. At each wave, latent profile analysis was used to identify two distinct leader profiles and three non-leader profiles based on peer nominations that included leadership, popularity, and both positive (defending) and negative (bullying) behavior. These profiles included (a) positive leaders, (b) negative leaders, (c) defenders, (d) bullies, and (e) modal children. Latent transition analysis for the full sample revealed more changing roles for negative leaders compared with positive leaders. In the intervention condition, negative leaders were more likely to make the transition to positive leaders than to bullies. This study shows that, in late childhood, positive leaders are perceived as more representative of the group leader prototypicality than negative leaders. These findings enhance understanding of leader profile evolution and may inform tailored leadership interventions.

In task-shared, mental health, and psychosocial support interventions, monitoring the quality of delivery (fidelity and competence) of nonspecialist providers is critical. Quality of delivery is frequently reported in brief, summary statistics, and while both fidelity and competence scores tend to be high, rarely have factors associated with quality of delivery in low-resource, mental health, and psychosocial support interventions been examined using inferential statistics. Understanding both modifiable and non-modifiable predictors of quality of delivery is important for adapting training and supervision approaches throughout intervention delivery. In this study, we use a parallel process latent growth model to examine the association of non-modifiable, demographic characteristics of nonspecialists and changes in both fidelity and competence over time. We find that nonspecialist age is significantly associated with higher initial fidelity and competence scores and smaller improvements in fidelity and competence over time, although this finding is interpreted in the presence of ceiling effects. In addition, nonspecialists in a certain district were more likely to have higher initial fidelity and competence scores but also see smaller changes over time. Fidelity and competence were found to significantly co-vary. This study provides conceptual and measurement guidance regarding quality of delivery, suggesting that fidelity and competence are theoretically distinct and must be measured separately, but linked together under the umbrella of quality of delivery. This study also has implications for recruiting, training, and supporting nonspecialists delivering behavioral interventions, suggesting that future implementation teams can further contribute to research on how to better support high-quality training, supervision, and personal and professional growth among the growing nonspecialist workforce globally.