Mediation analysis can be applied to data from randomized trials of health and social interventions to draw causal inference concerning their mechanisms. We used data from a cluster-randomized trial in Nicaragua, fielded between 2000 and 2002, to investigate whether the impact of providing access to a conditional cash-transfer program on child nutritional outcomes was mediated by child health check-ups and household dietary diversity. In a sample of 443 children 6-35 months old, we estimated the controlled direct (CDE) effect of random assignment on measured height-for-age z scores had we intervened so that all children received a health check-up and had the same level of household dietary diversity, using inverse-probability weighted marginal structural models to account for mediator-outcome confounding. Sensitivity analyses corrected the CDE for potential nondifferential error in the measurement of dietary diversity. Treatment assignment increased height-for-age z score by 0.37 (95% CI: 0.05, 0.69) standard deviations. The CDE was 0.20 (95% CI: -0.17, 0.57) standard deviations, suggesting nearly one-half of the program's impact on child nutrition would be eliminated had we intervened on these factors, although estimates were relatively imprecise. This study provides an illustration of how causal mediation analysis can be applied to examine the mechanisms of multifaceted interventions.
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http://dx.doi.org/10.1093/aje/kwac165 | DOI Listing |
Digit Health
January 2025
Department of Communication, Institute of Collaborative Innovation, Center for Research in Greater Bay Area, University of Macau, Macau, China.
Background: China is experiencing a rapid increase in its aging population, leading to the emergence of significant challenges to improve the quality of life (QoL) of older adults. The study aims to explore the potential benefits of using mobile health technology in improving the QoL for older Chinese adults.
Method: This study utilized a subsample of adults aged 60 and above from a cross-sectional, population-based national survey conducted among Chinese adults (N = 852).
BMC Health Serv Res
January 2025
Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Introduction: Healthcare organizations experience difficult challenges as a result of nursing staff turnover. This is because it not only interrupts continuity of service but also its financial implications.
Aim: The purpose of the study was to find out the effects of work engagement on nurses' intentions to leave their jobs while considering resilience as a mediating factor.
J Transl Med
January 2025
Department of Rheumatology and Immunology, Peking University Third Hospital, No. 49, North Garden Road, Beijing, 100191, China.
Background: Sjogren syndrome (SS) is a chronic systemic autoimmune disease and its pathogenesis often involves the participation of numerous immune cells and inflammatory factors. Despite increased researches and studies recently focusing on this area, it remains to be fully elucidated. We decide to incorporate genetic insight into investigation of the causal link between various immune cells, inflammatory factors and pathogenesis of Sjogren syndrome (SS).
View Article and Find Full Text PDFEnviron Health Prev Med
January 2025
Department of Public Health, School of Medicine, International University of Health and Welfare.
Background: High levels of attention-deficit/hyperactivity disorder (ADHD) traits are associated with various outcomes, including depressive symptoms, functional impairment, and low self-esteem. Additionally, individuals with high levels of ADHD traits are reported to be more adversely affected by fear of coronavirus disease 2019 (COVID-19). The current study aimed to examine whether the association between ADHD traits and outcomes was partially mediated by fear of COVID-19 using mediation analysis.
View Article and Find Full Text PDFNurs Health Sci
March 2025
College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
The study utilized a cross-sectional design to determine the relationship between positive and negative mentoring experiences and intentions to engage in future formal mentoring and the mediating role of aspects of social exchange theory particularly Negotiated Exchange Orientation and Perceived Organization Support. The study was conducted among 303 nurses and midwives working in acute care hospitals in Uganda. The results showed that, in the negative mentoring model, Perceived Organization Support fully mediated the relationship between lack of mentor expertise and willingness to participate in formal mentoring programs (B = -0.
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