The IGNITE (Investigation to Guide New Insight Into Translational Effectiveness) Trial: Protocol for a Translational Study of an Evidenced-Based Wellness Program in Fire Departments

129027-Thumbnail Image.png
Description

Background: Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery…

Background: Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery Act Challenge Topic 'Pathways for Translational Research,' to define and prioritize determinants that enable and hinder translation of evidenced-based health interventions in well-defined settings.

Methods: The IGNITE (investigation to guide new insights for translational effectiveness) trial is a prospective cohort study of a worksite wellness and injury reduction program from adoption to final outcomes among 12 fire departments. It will employ a mixed methods strategy to define a translational model. We will assess decision to adopt, installation, use, and outcomes (reach, individual outcomes, and economic effects) using onsite measurements, surveys, focus groups, and key informant interviews. Quantitative data will be used to define the model and conduct mediation analysis of each translational phase. Qualitative data will expand on, challenge, and confirm survey findings and allow a more thorough understanding and convergent validity by overcoming biases in qualitative and quantitative methods used alone.

Discussion: Findings will inform worksite wellness in fire departments. The resultant prioritized influences and model of effective translation can be validated and manipulated in these and other settings to more efficiently move science to service.

Date Created
2010-10-08
Agent

Contextual effects on relations among alcohol outcome expectancies, subjective response, and drinking behavior

154839-Thumbnail Image.png
Description
Positive alcohol outcome expectancies (AOEs) are consistent longitudinal predictors of later alcohol use; however, exclusion of solitary drinking contexts in the measurement of AOEs may have resulted in an underestimation of the importance of low arousal positive (LAP) effects. The…

Positive alcohol outcome expectancies (AOEs) are consistent longitudinal predictors of later alcohol use; however, exclusion of solitary drinking contexts in the measurement of AOEs may have resulted in an underestimation of the importance of low arousal positive (LAP) effects. The current study aimed to clarify the literature on the association between AOEs and drinking outcomes by examining the role of drinking context in AOE measurement. Further, exclusion of contextual influences has also limited understanding of the unique effects of AOEs relative to subjective responses (SR) to alcohol. The present study addressed this important question by exploring relations between AOEs and SR when drinking context was held constant across parallel measures of these constructs. Understanding which of these factors drives relations between alcohol effects and drinking behavior has important implications for intervention. After conducting confirmatory factor analysis (CFA) and tests of measurement invariance for the AOE and SR measures, 4 aims collectively examined the role of context in reporting of AOEs (Aims 1 and 2), the extent to which context specific AOEs uniquely relate to drinking outcomes (Aim 3), and the importance of context effects on correspondence between AOEs and SR (Aim 4). Results of Aims 1 and 2 demonstrated that participants are imagining contexts when reporting on measures of AOEs that do not specify the context, and found significant mean differences in high and low arousal positive AOEs across contexts. Contrary to the hypotheses of Aim 3, context-specific AOEs were not significantly associated with drinking behavior. Results of Aim 4 indicated that while LAP AOEs for both unspecified and solitary contexts were associated with LAP SR in a solitary setting, unspecified context AOEs had a stronger relation than the solitary context AOEs. No significant relations between high arousal positive (HAP) AOEs and HAP SR emerged. The findings suggest that further investigation of the relation between context-specific AOEs and drinking outcomes/SR is warranted. Future studies of these hypotheses in samples with a wider range of drinking behavior, or at different stages of alcohol involvement, will elucidate whether mean level differences in context specific AOEs are important in understanding alcohol related outcomes.
Date Created
2016
Agent

Identifying mediators of youth anxiety and depression intervention outcomes: a meta-analytic path analysis

154067-Thumbnail Image.png
Description
Anxiety and depression are among the most prevalent disorders in youth, with prevalence rates ranging from 15% to 25% for anxiety and 5% to 14% for depression. Anxiety and depressive disorders cause significant impairment, fail to spontaneously remit, and have…

Anxiety and depression are among the most prevalent disorders in youth, with prevalence rates ranging from 15% to 25% for anxiety and 5% to 14% for depression. Anxiety and depressive disorders cause significant impairment, fail to spontaneously remit, and have been prospectively linked to problematic substance use and legal problems in adulthood. These disorders often share a high-degree of comorbidity in both clinical and community samples, with anxiety disorders typically preceding the onset of depression. Given the nature and consequences of anxiety and depressive disorders, a plethora of treatment and preventative interventions have been developed and tested with data showing significant pre to post to follow-up reductions in anxiety and depressive symptoms. However, little is known about the mediators by which these interventions achieve their effects. To address this gap in the literature, the present thesis study combined meta-analytic methods and path analysis to evaluate the effects of youth anxiety and depression interventions on outcomes and four theory-driven mediators using data from 55 randomized controlled trials (N = 11,413). The mediators included: (1) information-processing biases, (2) coping strategies, (3) social competence, and (4) physiological hyperarousal. Meta-analytic results showed that treatment and preventative interventions reliably produced moderate effect sizes on outcomes and three of the four mediators (information-processing biases, coping strategies, social competence). Most importantly, findings from the path analysis showed that changes in information-processing biases and coping strategies consistently mediated changes in outcomes for anxiety and depression at both levels of intervention, whereas gains in social competence and reductions in physiological hyperarousal did not emerge as significant mediators. Knowledge of the mediators underlying intervention effects is important because they can refine testable models of treatment and prevention efforts and identify which anxiety and depression components need to be packaged or strengthened to maximize intervention effects. Allocating additional resources to significant mediators has the potential to reduce costs associated with adopting and implementing evidence-based interventions and improve dissemination and sustainability in real-world settings, thus setting the stage to be more readily integrated into clinical and non-clinical settings on a large scale.
Date Created
2015
Agent

When the Test of Mediation is More Powerful Than the Test of the Total Effect

129151-Thumbnail Image.png
Description

Although previous research has studied power in mediation models, the extent to which the inclusion of a mediator will increase power has not been investigated. To address this deficit, in a first study we compared the analytical power values of…

Although previous research has studied power in mediation models, the extent to which the inclusion of a mediator will increase power has not been investigated. To address this deficit, in a first study we compared the analytical power values of the mediated effect and the total effect in a single-mediator model, to identify the situations in which the inclusion of one mediator increased statistical power. The results from this first study indicated that including a mediator increased statistical power in small samples with large coefficients and in large samples with small coefficients, and when coefficients were nonzero and equal across models. Next, we identified conditions under which power was greater for the test of the total mediated effect than for the test of the total effect in the parallel two-mediator model. These results indicated that including two mediators increased power in small samples with large coefficients and in large samples with small coefficients, the same pattern of results that had been found in the first study. Finally, we assessed the analytical power for a sequential (three-path) two-mediator model and compared the power to detect the three-path mediated effect to the power to detect both the test of the total effect and the test of the mediated effect for the single-mediator model. The results indicated that the three-path mediated effect had more power than the mediated effect from the single-mediator model and the test of the total effect. Practical implications of these results for researchers are then discussed.

Date Created
2015-06-01
Agent

Parent and peer influences on emerging adult substance use disorder: a genetically informed study

153998-Thumbnail Image.png
Description
The present study utilized longitudinal data from a high-risk community sample (n=254, 52.8% female, 47.2% children of alcoholics, 74% non-Hispanic Caucasian) to test questions concerning the effects of genetic risk, parental knowledge, and peer substance use on emerging adult substance…

The present study utilized longitudinal data from a high-risk community sample (n=254, 52.8% female, 47.2% children of alcoholics, 74% non-Hispanic Caucasian) to test questions concerning the effects of genetic risk, parental knowledge, and peer substance use on emerging adult substance use disorders (SUDs). Specifically, this study examined whether parental knowledge and peer substance use mediated the effects of parent alcohol use disorder (AUD) and genetic risk for behavioral undercontrol on SUD. The current study also examined whether genetic risk moderated effects of parental knowledge and peer substance use on risk for SUD. Finally, this study examined these questions over and above a genetic "control" which explained a large proportion of variance in the outcome, thereby providing a stricter test of environmental influences.

Analyses were performed in a path analysis framework. To test these research questions, the current study employed two polygenic risk scores. The first, a theory-based score, was formed using single-nucleotide polymorphisms (SNPs) from receptor systems implicated in the amplification of positive effects in the presence of new/exciting stimuli and/or pleasure derived from using substances. The second, an empirically-based score, was formed using a data-driven approach that explained a large amount of variance in SUDs. Together, these scores allowed the present study to test explanations for the relations among parent AUD, parental knowledge, peer substance use, and SUDs.

Results of the current study found that having parents with less knowledge or an AUD conferred greater risk for SUDs, but only for those at higher genetic risk for behavioral undercontrol. The current study replicated research findings suggesting that peer substance use mediated the effect of parental AUD on SUD. However, it adds to this literature by suggesting that some mechanism other than increased behavioral undercontrol explains relations among parental AUD, peer substance use, and emerging adult SUD. Taken together, these findings indicate that children of parents with AUDs comprise a particularly risky group, although likelihood of SUD within this group is not uniform. These findings also suggest that some of the most important environmental risk factors for SUDs exert effects that vary across level of genetic propensity.
Date Created
2015
Agent

Individual differences in subjective response to alcohol: pharmacokinetic and pharmacodynamic factors

153996-Thumbnail Image.png
Description
Variability in subjective response to alcohol has been shown to predict drinking behavior as well as the development of alcohol use disorders. The current study examined the extent to which individual differences in alcohol pharmacokinetics impact subjective response and…

Variability in subjective response to alcohol has been shown to predict drinking behavior as well as the development of alcohol use disorders. The current study examined the extent to which individual differences in alcohol pharmacokinetics impact subjective response and drinking behavior during a single session alcohol administration paradigm. Participants (N = 98) completed measures of subjective response at two time points following alcohol consumption. Pharmacokinetic properties (rate of absorption and metabolism) were inferred using multiple BAC readings to calculate the area under the curve during the ascending limb for absorption and descending limb for metabolism. Following the completion of the subjective response measures, an ad-libitum taste rating task was implemented in which participants were permitted to consume additional alcoholic beverages. The amount consumed during the taste rating task served as the primary outcome variable. Results of the study indicated that participants who metabolized alcohol more quickly maintained a greater level of subjective stimulation as blood alcohol levels declined and reported greater reductions in subjective sedation. Although metabolism did not have a direct influence on within session alcohol consumption, a faster metabolism did relate to increased ad-libitum consumption indirectly through greater acute tolerance to sedative effects and greater maintenance of stimulant effects. Rate of absorption did not significantly predict subjective response or within session drinking. The results of the study add clarity to theories of subjective response to alcohol, and suggest that those at highest risk for alcohol problems experience a more rapid reduction in sedation following alcohol consumption while simultaneously experiencing heightened levels of stimulation. Variability in pharmacokinetics, namely how quickly one metabolizes alcohol, may be an identifiable biomarker of subjective response and may be used to infer risk for alcohol problems.
Date Created
2014
Agent

Multilevel potential outcome models for causal inference in jury research

153904-Thumbnail Image.png
Description
Recent advances in hierarchical or multilevel statistical models and causal inference using the potential outcomes framework hold tremendous promise for mock and real jury research. These advances enable researchers to explore how individual jurors can exert a bottom-up effect on…

Recent advances in hierarchical or multilevel statistical models and causal inference using the potential outcomes framework hold tremendous promise for mock and real jury research. These advances enable researchers to explore how individual jurors can exert a bottom-up effect on the jury’s verdict and how case-level features can exert a top-down effect on a juror’s perception of the parties at trial. This dissertation explains and then applies these technical advances to a pre-existing mock jury dataset to provide worked examples in an effort to spur the adoption of these techniques. In particular, the paper introduces two new cross-level mediated effects and then describes how to conduct ecological validity tests with these mediated effects. The first cross-level mediated effect, the a1b1 mediated effect, is the juror level mediated effect for a jury level manipulation. The second cross-level mediated effect, the a2bc mediated effect, is the unique contextual effect that being in a jury has on the individual the juror. When a mock jury study includes a deliberation versus non-deliberation manipulation, the a1b1 can be compared for the two conditions, enabling a general test of ecological validity. If deliberating in a group generally influences the individual, then the two indirect effects should be significantly different. The a2bc can also be interpreted as a specific test of how much changes in jury level means of this specific mediator effect juror level decision-making.
Date Created
2015
Agent

Testing the mediated effect in the pretest-posttest control group design

153461-Thumbnail Image.png
Description
Methods to test hypotheses of mediated effects in the pretest-posttest control group design are understudied in the behavioral sciences (MacKinnon, 2008). Because many studies aim to answer questions about mediating processes in the pretest-posttest control group design, there is…

Methods to test hypotheses of mediated effects in the pretest-posttest control group design are understudied in the behavioral sciences (MacKinnon, 2008). Because many studies aim to answer questions about mediating processes in the pretest-posttest control group design, there is a need to determine which model is most appropriate to test hypotheses about mediating processes and what happens to estimates of the mediated effect when model assumptions are violated in this design. The goal of this project was to outline estimator characteristics of four longitudinal mediation models and the cross-sectional mediation model. Models were compared on type 1 error rates, statistical power, accuracy of confidence interval coverage, and bias of parameter estimates. Four traditional longitudinal models and the cross-sectional model were assessed. The four longitudinal models were analysis of covariance (ANCOVA) using pretest scores as a covariate, path analysis, difference scores, and residualized change scores. A Monte Carlo simulation study was conducted to evaluate the different models across a wide range of sample sizes and effect sizes. All models performed well in terms of type 1 error rates and the ANCOVA and path analysis models performed best in terms of bias and empirical power. The difference score, residualized change score, and cross-sectional models all performed well given certain conditions held about the pretest measures. These conditions and future directions are discussed.
Date Created
2015
Agent

A prospective study of childhood negative events, temperament, adolescent coping, and stress reactivity in young adulthood

152144-Thumbnail Image.png
Description
Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally…

Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent and voluntary self-regulation, and physiological reactivity among a longitudinal sample of youth who experienced parental divorce. Participants were drawn from a larger randomized controlled trial of a preventive intervention for children of divorce between the ages of 9 and 12. The current sample included 159 young adults (mean age = 25.5 years; 53% male; 94% Caucasian) who participated in six waves of data collection, including a 15-year follow-up study. Participants reported on exposure to negative life events (four times over a 9-month period) during childhood, and mothers rated child temperament. Six years later, youth reported on the use of active and avoidant coping strategies, and 15 years later, they participated in a standardized psychosocial stress task and provided salivary cortisol samples prior to and following the task. Path analyses within a structural equation framework revealed that a multiple mediation model best fit the data. It was found that children with better mother-rated self-regulation (i.e. low impulsivity, low negative emotionality, and high attentional focus) exhibited lower total cortisol output 15 years later. In addition, greater self-regulation in childhood predicted greater use of active coping in adolescence, whereas a greater number of negative life events predicted increased use of avoidant coping in adolescence. Finally, a greater number of negative events in childhood predicted marginally lower total cortisol output, and higher levels of active coping in adolescence were associated with greater total cortisol output in young adulthood. Findings suggest that children of divorce who exhibit better self-regulation evidence lower cortisol output during a standardized psychosocial stress task relative to those who have higher impulsivity, lower attentional focus, and/or higher negative emotionality. The conceptual significance of the current findings, including the lack of evidence for hypothesized relations, methodological issues that arose, and issues in need of future research are discussed.
Date Created
2013
Agent

Impact of violations of longitudinal measurement invariance in latent growth models and autoregressive quasi-simplex models

152032-Thumbnail Image.png
Description
In order to analyze data from an instrument administered at multiple time points it is a common practice to form composites of the items at each wave and to fit a longitudinal model to the composites. The advantage of using…

In order to analyze data from an instrument administered at multiple time points it is a common practice to form composites of the items at each wave and to fit a longitudinal model to the composites. The advantage of using composites of items is that smaller sample sizes are required in contrast to second order models that include the measurement and the structural relationships among the variables. However, the use of composites assumes that longitudinal measurement invariance holds; that is, it is assumed that that the relationships among the items and the latent variables remain constant over time. Previous studies conducted on latent growth models (LGM) have shown that when longitudinal metric invariance is violated, the parameter estimates are biased and that mistaken conclusions about growth can be made. The purpose of the current study was to examine the impact of non-invariant loadings and non-invariant intercepts on two longitudinal models: the LGM and the autoregressive quasi-simplex model (AR quasi-simplex). A second purpose was to determine if there are conditions in which researchers can reach adequate conclusions about stability and growth even in the presence of violations of invariance. A Monte Carlo simulation study was conducted to achieve the purposes. The method consisted of generating items under a linear curve of factors model (COFM) or under the AR quasi-simplex. Composites of the items were formed at each time point and analyzed with a linear LGM or an AR quasi-simplex model. The results showed that AR quasi-simplex model yielded biased path coefficients only in the conditions with large violations of invariance. The fit of the AR quasi-simplex was not affected by violations of invariance. In general, the growth parameter estimates of the LGM were biased under violations of invariance. Further, in the presence of non-invariant loadings the rejection rates of the hypothesis of linear growth increased as the proportion of non-invariant items and as the magnitude of violations of invariance increased. A discussion of the results and limitations of the study are provided as well as general recommendations.
Date Created
2013
Agent
Subscribe to MacKinnon, David