Reducing disparities in behavioral health treatment in pediatric primary care: a randomized controlled trial comparing Partnering to Achieve School Success (PASS) to usual ADHD care for children ages 5 to 11 - study protocol.
(Three to ten) attention-deficit/hyperactivity disorder
Behavior therapy
Family engagement
Pediatric primary care
Reducing disparities
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
22 Jun 2024
22 Jun 2024
Historique:
received:
25
04
2024
accepted:
10
06
2024
medline:
23
6
2024
pubmed:
23
6
2024
entrez:
22
6
2024
Statut:
epublish
Résumé
Integrating behavioral health services into pediatric primary care can improve access to care, especially for children marginalized by poverty and racial/ethnic minority status. In primary care, a common presenting concern is attention-deficit/hyperactivity disorder (ADHD). Services in primary care for marginalized children with ADHD typically include medication alone; therapy to improve skills and build relationships is less available. This study evaluates the effectiveness of a behavioral intervention offered through primary care for marginalized families coping with ADHD (Partnering to Achieve School Success, PASS) compared to treatment as usual (TAU). Three hundred participants will be randomly assigned to PASS or TAU. Participants include children ages 5 to 11 who have ADHD and are from economically marginalized families. PASS is a personalized, enhanced behavioral intervention that includes evidence-based behavior therapy strategies and enhancements to promote family engagement, increase caregiver distress tolerance, and provide team-based care to improve academic and behavioral functioning. TAU includes services offered by primary care providers and referral for integrated behavioral health or community mental health services. Outcomes will be assessed at mid-treatment (8 weeks after baseline), post-treatment (16 weeks), and follow-up (32 weeks) using parent- and teacher-report measures of service use, child academic, behavioral, and social functioning, parenting practices, family empowerment, and team-based care. Mixed effects models will examine between-group differences at post-treatment and follow-up. Analyses will examine the mediating role of parenting practices, family empowerment, and team-based care. Subgroup analyses will examine differential effects of intervention by child clinical characteristics and socioeconomic factors. This study is unique in targeting a population of children with ADHD marginalized by low socioeconomic resources and examining an intervention designed to address the challenges of families coping with chronic stress related to poverty. This study was registered on clinicaltrials.gov (NCT04082234) on September 5, 2019, prior to enrollment of the first participant. The current version of the protocol and IRB approval date is October 4, 2023. Results will be submitted to ClinicalTrials.gov no later than 30 days prior to the due date for the submission of the draft of the final research report to the Patient-Centered Outcomes Research Institute.
Sections du résumé
BACKGROUND
BACKGROUND
Integrating behavioral health services into pediatric primary care can improve access to care, especially for children marginalized by poverty and racial/ethnic minority status. In primary care, a common presenting concern is attention-deficit/hyperactivity disorder (ADHD). Services in primary care for marginalized children with ADHD typically include medication alone; therapy to improve skills and build relationships is less available. This study evaluates the effectiveness of a behavioral intervention offered through primary care for marginalized families coping with ADHD (Partnering to Achieve School Success, PASS) compared to treatment as usual (TAU).
METHOD
METHODS
Three hundred participants will be randomly assigned to PASS or TAU. Participants include children ages 5 to 11 who have ADHD and are from economically marginalized families. PASS is a personalized, enhanced behavioral intervention that includes evidence-based behavior therapy strategies and enhancements to promote family engagement, increase caregiver distress tolerance, and provide team-based care to improve academic and behavioral functioning. TAU includes services offered by primary care providers and referral for integrated behavioral health or community mental health services. Outcomes will be assessed at mid-treatment (8 weeks after baseline), post-treatment (16 weeks), and follow-up (32 weeks) using parent- and teacher-report measures of service use, child academic, behavioral, and social functioning, parenting practices, family empowerment, and team-based care. Mixed effects models will examine between-group differences at post-treatment and follow-up. Analyses will examine the mediating role of parenting practices, family empowerment, and team-based care. Subgroup analyses will examine differential effects of intervention by child clinical characteristics and socioeconomic factors.
DISCUSSION
CONCLUSIONS
This study is unique in targeting a population of children with ADHD marginalized by low socioeconomic resources and examining an intervention designed to address the challenges of families coping with chronic stress related to poverty.
TRIAL REGISTRATION
BACKGROUND
This study was registered on clinicaltrials.gov (NCT04082234) on September 5, 2019, prior to enrollment of the first participant. The current version of the protocol and IRB approval date is October 4, 2023. Results will be submitted to ClinicalTrials.gov no later than 30 days prior to the due date for the submission of the draft of the final research report to the Patient-Centered Outcomes Research Institute.
Identifiants
pubmed: 38909215
doi: 10.1186/s12875-024-02473-7
pii: 10.1186/s12875-024-02473-7
doi:
Banques de données
ClinicalTrials.gov
['NCT04082234']
Types de publication
Journal Article
Randomized Controlled Trial
Clinical Trial Protocol
Langues
eng
Sous-ensembles de citation
IM
Pagination
225Informations de copyright
© 2024. The Author(s).
Références
Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.
pubmed: 20855043
pmcid: 2946114
doi: 10.1016/j.jaac.2010.05.017
Costello EJ, He JP, Sampson NA, Kessler RC, Merikangas KR. Services for Adolescents With Psychiatric Disorders: 12-Month Data From the National Comorbidity Survey-Adolescent. Psychiatr Serv. 2014Mar;65(3):359–66.
pubmed: 24233052
pmcid: 4123755
doi: 10.1176/appi.ps.201100518
Shahidullah JD, Hostutler CA, Coker TR, Allman Dixson A, Okoroji C, Mautone JA. Child Health Equity and Primary Care. Am Psychol. 2023;78(2):93–106. https://doi.org/10.1037/amp0001064 .
Cummings JR, Ji X, Lally C, Druss BG. Racial and Ethnic Differences in Minimally Adequate Depression Care Among Medicaid-Enrolled Youth. J Am Acad Child Adolesc Psychiatry. 2019;58(1):128–38.
pubmed: 30577928
doi: 10.1016/j.jaac.2018.04.025
Trent M, Dooley DG, Dougé J, Section on Adolescent Health, Council on Community Pediatrics, Committee on Adolescence, et al. The Impact of Racism on Child and Adolescent Health. Pediatrics. 2019;144(2):e20191765.
pubmed: 31358665
doi: 10.1542/peds.2019-1765
Beauchaine TP, McNulty T. Comorbidities and continuities as ontogenic processes: toward a developmental spectrum model of externalizing psychopathology. Dev Psychopathol. 2013;25(4 Pt 2):1505–28.
pubmed: 24342853
pmcid: 4008972
doi: 10.1017/S0954579413000746
Santiago CD, Kaltman S, Miranda J. Poverty and mental health: how do low-income adults and children fare in psychotherapy? J Clin Psychol. 2013;69(2):115–26.
pubmed: 23280880
doi: 10.1002/jclp.21951
Power TJ, Mautone JA, Manz PH, Frye L, Blum NJ. Managing attention-deficit/hyperactivity disorder in primary care: a systematic analysis of roles and challenges. Pediatrics. 2008;121(1):e65–72.
pubmed: 18166546
doi: 10.1542/peds.2007-0383
Institute of Medicine. Initial National Priorities for Comparative Effectiveness Research. Washington, D.C.: National Academies Press; 2009. Available from: http://www.nap.edu/catalog/12648 . Cited 2023 Dec
Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div 53. 2018;47(2):199–212.
Power TJ, Watkins MW, Anastopoulos AD, Reid R, Lambert MC, DuPaul GJ. Multi-Informant Assessment of ADHD Symptom-Related Impairments Among Children and Adolescents. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div 53. 2017;46(5):661–74.
Okoroji C, Mack Kolsky R, Williamson AA, Integrated MJA, Health B, in Pediatric Primary Care: Rates of Consultation Requests and Treatment Duration. Child Youth Care Forum [Internet]. cited 2023 Nov 1. Available from: 2023. https://doi.org/10.1007/s10566-023-09769-2 .
Bussing R, Mason DM, Bell L, Porter P, Garvan C. Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample. J Am Acad Child Adolesc Psychiatry. 2010;49(6):595–605.
pubmed: 20494269
pmcid: 2876093
Molina BSG, Pelham WE. Substance Use, Substance Abuse, and LD Among Adolescents with a Childhood History of ADHD. J Learn Disabil. 2001;34(4):333–51.
pubmed: 15503577
pmcid: 4871605
doi: 10.1177/002221940103400408
Winston FK, McDonald CC, McGehee DV. Are we doing enough to prevent the perfect storm?: novice drivers, ADHD, and distracted driving. JAMA Pediatr. 2013;167(10):892–4.
pubmed: 23939682
doi: 10.1001/jamapediatrics.2013.2315
Guevara J, Lozano P, Wickizer T, Mell L, Gephart H. Utilization and cost of health care services for children with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108(1):71–8.
pubmed: 11433056
doi: 10.1542/peds.108.1.71
Hinshaw SP, Scheffler RM. The ADHD Explosion: Myths, Medication, Money, and Today’s Push for Performance. Oxford, New York: Oxford University Press; 2014. p. 288.
Robb JA, Sibley MH, Pelham WE, Foster EM, Molina BSG, Gnagy EM, et al. The Estimated Annual Cost of ADHD to the U.S. Education System. School Ment Health. 2011 Sep 1;3(3):169–77.
Wolraich ML, Hagan JF Jr, Allan C, Chan E, Davison D, Earls M, et al. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4): e20192528.
pubmed: 31570648
doi: 10.1542/peds.2019-2528
Power TJ, Blum NJ, Guevara JP, Jones HA, Leslie LK. Coordinating mental health care across primary care and schools: ADHD as a case example. Adv Sch Ment Health Promot. 2013;6(1):68–80.
pubmed: 23459527
pmcid: 3582374
doi: 10.1080/1754730X.2013.749089
MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999;56(12):1073–86.
doi: 10.1001/archpsyc.56.12.1073
Conners CK, Epstein JN, March JS, Angold A, Wells KC, Klaric J, et al. Multimodal treatment of ADHD in the MTA: an alternative outcome analysis. J Am Acad Child Adolesc Psychiatry. 2001;40(2):159–67.
pubmed: 11211364
doi: 10.1097/00004583-200102000-00010
Pelham WE, Fabiano GA, Waxmonsky JG, Greiner AR, Gnagy EM, Pelham WE, et al. Treatment Sequencing for Childhood ADHD: A Multiple-Randomization Study of Adaptive Medication and Behavioral Interventions. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div 53. 2016;45(4):396–415.
Krain AL, Kendall PC, Power TJ. The role of treatment acceptability in the initiation of treatment for ADHD. J Atten Disord. 2005;9(2):425–34.
pubmed: 16371665
doi: 10.1177/1087054705279996
Valleley RJ, Leja A, Clarke B, Grennan A, Burt J, Menousek K, et al. Promoting earlier access to pediatric behavioral health services with colocated care. J Dev Behav Pediatr. 2019;40(4):240–8.
pubmed: 30908426
doi: 10.1097/DBP.0000000000000662
Asarnow JR, Rozenman M, Wiblin J, Zeltzer L. Integrated Medical-Behavioral Care Compared With Usual Primary Care for Child and Adolescent Behavioral Health: A Meta-analysis. JAMA Pediatr. 2015;169(10):929.
pubmed: 26259143
doi: 10.1001/jamapediatrics.2015.1141
Kolko DJ, Campo J, Kilbourne AM, Hart J, Sakolsky D, Wisniewski S. Collaborative Care Outcomes for Pediatric Behavioral Health Problems: A Cluster Randomized Trial. Pediatrics. 2014;133(4):e981–92.
pubmed: 24664093
pmcid: 3966503
doi: 10.1542/peds.2013-2516
Silverstein M, Hironaka LK, Walter HJ, Feinberg E, Sandler J, Pellicer M, et al. Collaborative care for children with ADHD symptoms: a randomized comparative effectiveness trial. Pediatrics. 2015;135(4):e858–867.
pubmed: 25802346
doi: 10.1542/peds.2014-3221
Lavigne JV, Lebailly SA, Gouze KR, Cicchetti C, Pochyly J, Arend R, et al. Treating oppositional defiant disorder in primary care: a comparison of three models. J Pediatr Psychol. 2008;33(5):449–61.
pubmed: 17956932
doi: 10.1093/jpepsy/jsm074
Godoy L, Hodgkinson S, Robertson HA, Sham E, Druskin L, Wambach CG, et al. Increasing Mental Health Engagement From Primary Care: The Potential Role of Family Navigation. Pediatrics. 2019;143(4): e20182418.
pubmed: 30877145
doi: 10.1542/peds.2018-2418
Power TJ, Bradley-Klug KL. Routledge & CRC Press. Pediatric School Psychology: Conceptualization, Applications, and Strategies for Leadership Development. Available from: https://www.routledge.com/Pediatric-School-Psychology-Conceptualization-Applications-and-Strategies/Power-Bradley-Klug/p/book/9780415871105 . Cited 2023 Dec 5
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.
pubmed: 11392867
doi: 10.1037/0003-066X.55.1.68
Booster GD, Mautone JA, Nissley-Tsiopinis J, Van Dyke D, Power TJ. Reductions in Negative Parenting Practices Mediate the Effect of a Family-School Intervention for Children with Attention Deficit Hyperactivity Disorder. Sch Psychol Rev. 2016;45(2):192–208.
doi: 10.17105/SPR45-2.192-208
Leyro TM, Zvolensky MJ, Bernstein A. Distress Tolerance and Psychopathological Symptoms and Disorders: A Review of the Empirical Literature among Adults. Psychol Bull. 2010;136(4):576–600.
pubmed: 20565169
pmcid: 2891552
doi: 10.1037/a0019712
Power TJ, Mautone JA, Marshall SA, Jones HA, Cacia J, Tresco K, et al. Feasibility and potential effectiveness of integrated services for children with ADHD in urban primary care practices. Clin Pract Pediatr Psychol. 2014;2(4):412–26.
Petts RA, McClain MB, Azad G, Shahidullah JD. System navigation models to facilitate engagement in pediatric behavioral health services: A systematic review. Fam Syst Health J Collab Fam Healthc. 2021;39(4):618–31.
doi: 10.1037/fsh0000643
Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6(4):284–90.
doi: 10.1037/1040-3590.6.4.284
Dumas JE, Lynch AM, Laughlin JE, Phillips Smith E, Prinz RJ. Promoting intervention fidelity. Conceptual issues, methods, and preliminary results from the EARLY ALLIANCE prevention trial. Am J Prev Med. 2001;20(1 Suppl):38–47.
pubmed: 11146259
doi: 10.1016/S0749-3797(00)00272-5
Anesko KM, Schoiock G, Ramirez R, Levine FM. The Homework Problem Checklist: Assessing children’s homework difficulties. Behav Assess. 1987;9(2):179–85.
Power TJ, Werba BE, Watkins MW, Angelucci JG, Eiraldi RB. Patterns of parent-reported homework problems among ADHD-referred and non-referred children. Sch Psychol Q. 2006;21(1):13–33.
doi: 10.1521/scpq.2006.21.1.13
Power TJ, Mautone JA, Soffer SL, Clarke AT, Marshall SA, Sharman J, et al. A family-school intervention for children with ADHD: results of a randomized clinical trial. J Consult Clin Psychol. 2012;80(4):611–23.
pubmed: 22506793
pmcid: 3404236
doi: 10.1037/a0028188
Langberg JM, Arnold LE, Flowers AM, Altaye M, Epstein JN, Molina BSG. Assessing Homework Problems in Children with ADHD: Validation of a Parent-Report Measure and Evaluation of Homework Performance Patterns. School Ment Health. 2010;2(1):3–12.
pubmed: 21544228
pmcid: 3085461
doi: 10.1007/s12310-009-9021-x
Wolraich ML, Feurer ID, Hannah JN, Baumgaertel A, Pinnock TY. Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV. J Abnorm Child Psychol. 1998;26(2):141–52.
pubmed: 9634136
doi: 10.1023/A:1022673906401
Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K. Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol. 2003;28(8):559–67.
pubmed: 14602846
doi: 10.1093/jpepsy/jsg046
Horwitz SM, Hoagwood K, Stiffman AR, Summerfeld T, Weisz JR, Costello EJ, et al. Reliability of the services assessment for children and adolescents. Psychiatr Serv Wash DC. 2001;52(8):1088–94.
doi: 10.1176/appi.ps.52.8.1088
DuPaul GJ, Reid R, Anastopoulos AD, Lambert MC, Watkins MW, Power TJ. Parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms: Factor structure and normative data. Psychol Assess. 2016;28(2):214–25.
pubmed: 26011476
doi: 10.1037/pas0000166
Swanson JM, Kraemer HC, Hinshaw SP, Arnold LE, Conners CK, Abikoff HB, et al. Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. J Am Acad Child Adolesc Psychiatry. 2001;40(2):168–79.
pubmed: 11211365
doi: 10.1097/00004583-200102000-00011
Abikoff H, Gallagher R, Wells KC, Murray DW, Huang L, Lu F, et al. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. J Consult Clin Psychol. 2013;81(1):113–28.
pubmed: 22889336
doi: 10.1037/a0029648
Varni JW, Thissen D, Stucky BD, Liu Y, Gorder H, Irwin DE, et al. PROMIS® Parent Proxy Report Scales: an item response theory analysis of the parent proxy report item banks. Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2012;21(7):1223–40.
doi: 10.1007/s11136-011-0025-2
Forrest CB, Bevans KB, Tucker C, Riley AW, Ravens-Sieberer U, Gardner W, et al. Commentary: the patient-reported outcome measurement information system (PROMIS®) for children and youth: application to pediatric psychology. J Pediatr Psychol. 2012;37(6):614–21.
pubmed: 22362923
pmcid: 3381710
doi: 10.1093/jpepsy/jss038
Furman W, Giberson RS. Identifying the links between parents and their children's sibling relationships. In S. Shulman (Ed.). Close relationships and socioemotional development. New York: NY: Ablex Publishing; 1995. pp. 95–108.
Clarke AT, Marshall SA, Mautone JA, Soffer SL, Jones HA, Costigan TE, et al. Parent attendance and homework adherence predict response to a family-school intervention for children with ADHD. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div 53. 2015;44(1):58–67.
Koren PE, DeChillo N, Friesen BJ. Measuring empowerment in families whose children have emotional disabilities: A brief questionnaire. Rehabil Psychol. 1992;37(4):305–21.
doi: 10.1037/h0079106
Kohl GO, Lengua LJ, McMahon RJ. Parent Involvement in School Conceptualizing Multiple Dimensions and Their Relations with Family and Demographic Risk Factors. J Sch Psychol. 2000;38(6):501–23.
pubmed: 20357900
pmcid: 2847291
doi: 10.1016/S0022-4405(00)00050-9
Mautone JA, Marcelle E, Tresco KE, Power TJ. Assessing the Quality of Parent-Teacher Relationships for Students with ADHD. Psychol Sch. 2015;52(2):196–207.
pubmed: 25663718
doi: 10.1002/pits.21817
Hall MH, Matthews KA, Kravitz HM, Gold EB, Buysse DJ, Bromberger JT, et al. Race and Financial Strain are Independent Correlates of Sleep in Midlife Women: The SWAN Sleep Study. Sleep. 2009;32(1):73–82.
pubmed: 19189781
pmcid: 2625326
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.
pubmed: 6668417
doi: 10.2307/2136404
Lee J, Shute VJ. Personal and Social-Contextual Factors in K–12 Academic Performance: An Integrative Perspective on Student Learning. Educ Psychol. 2010;45(3):185–202.
doi: 10.1080/00461520.2010.493471
Kelley ML, Heffer RW, Gresham FM, Elliott SN. Development of a modified Treatment Evaluation Inventory. J Psychopathol Behav Assess. 1989;11(3):235–47.
doi: 10.1007/BF00960495
Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, et al. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017;12(1):108.
pubmed: 28851459
pmcid: 5576104
doi: 10.1186/s13012-017-0635-3
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.
pubmed: 18929686
doi: 10.1016/j.jbi.2008.08.010
Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;1(95): 103208.
doi: 10.1016/j.jbi.2019.103208
Allison P. Handling Missing Data by Maximum Likelihood. In 2012. Available from: https://www.semanticscholar.org/paper/Handling-Missing-Data-by-Maximum-Likelihood-Allison/f2de0d551978821a6ac64f85d084fd19e0c1947d . Cited 2024 Feb 7
Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behav Res Ther. 2017;98:39–57.
pubmed: 27865431
doi: 10.1016/j.brat.2016.11.001
Wang R, Ware JH. Detecting moderator effects using subgroup analyses. Prev Sci Off J Soc Prev Res. 2013;14(2):111–20.
doi: 10.1007/s11121-011-0221-x
Benjamini Y, Yekutieli D. The Control of the False Discovery Rate in Multiple Testing under Dependency. Ann Stat. 2001;29(4):1165–88.
doi: 10.1214/aos/1013699998
Benjamini Y, Hochberg Y. Controlling the false discovery rate: A practical and powerful approach to multiple testing. J Roy Statist Soc Ser B. 1995;57:289–300.
doi: 10.1111/j.2517-6161.1995.tb02031.x
Sobel ME. Some New Results on Indirect Effects and Their Standard Errors in Covariance Structure Models. Sociol Methodol. 1986;16:159–86.
doi: 10.2307/270922
Sobel ME. Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models. Sociol Methodol. 1982;13:290–312.
doi: 10.2307/270723
VanderWeele TJ. Mediation Analysis: A Practitioner’s Guide. Annu Rev Public Health. 2016;37:17–32.
pubmed: 26653405
doi: 10.1146/annurev-publhealth-032315-021402
Ding P, Vanderweele TJ. Sharp sensitivity bounds for mediation under unmeasured mediator-outcome confounding. Biometrika. 2016;103(2):483–90.
pubmed: 27279672
doi: 10.1093/biomet/asw012
Fairchild AJ, MacKinnon DP. A general model for testing mediation and moderation effects. Prev Sci Off J Soc Prev Res. 2009;10(2):87–99.
doi: 10.1007/s11121-008-0109-6
Hayes, A. PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. 2012. Available from: https://www.afhayes.com/public/process2012.pdf . Cited 2024 Jan 31.