TY - JOUR
T1 - Evaluating the Impact of Implementation Factors on Family-Based Prevention Programming
T2 - Methods for Strengthening Causal Inference
AU - Crowley, D. Max
AU - Coffman, Donna L.
AU - Feinberg, Mark E.
AU - Greenberg, Mark T.
AU - Spoth, Richard L.
N1 - Funding Information:
This project was supported by the National Institute on Drug Abuse (NIDA) grants P50-DA010075-15, R03-DA026543, and T32-DA 0176. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA or the National Institutes of Health.
PY - 2014/4
Y1 - 2014/4
N2 - Despite growing recognition of the important role implementation plays in successful prevention efforts, relatively little work has sought to demonstrate a causal relationship between implementation factors and participant outcomes. In turn, failure to explore the implementation-to-outcome link limits our understanding of the mechanisms essential to successful programming. This gap is partially due to the inability of current methodological procedures within prevention science to account for the multitude of confounders responsible for variation in implementation factors (i.e., selection bias). The current paper illustrates how propensity and marginal structural models can be used to improve causal inferences involving implementation factors not easily randomized (e.g., participant attendance). We first present analytic steps for simultaneously evaluating the impact of multiple implementation factors on prevention program outcome. Then, we demonstrate this approach for evaluating the impact of enrollment and attendance in a family program, over and above the impact of a school-based program, within PROSPER, a large-scale real-world prevention trial. Findings illustrate the capacity of this approach to successfully account for confounders that influence enrollment and attendance, thereby more accurately representing true causal relations. For instance, after accounting for selection bias, we observed a 5 % reduction in the prevalence of 11th grade underage drinking for those who chose to receive a family program and school program compared to those who received only the school program. Further, we detected a 7 % reduction in underage drinking for those with high attendance in the family program.
AB - Despite growing recognition of the important role implementation plays in successful prevention efforts, relatively little work has sought to demonstrate a causal relationship between implementation factors and participant outcomes. In turn, failure to explore the implementation-to-outcome link limits our understanding of the mechanisms essential to successful programming. This gap is partially due to the inability of current methodological procedures within prevention science to account for the multitude of confounders responsible for variation in implementation factors (i.e., selection bias). The current paper illustrates how propensity and marginal structural models can be used to improve causal inferences involving implementation factors not easily randomized (e.g., participant attendance). We first present analytic steps for simultaneously evaluating the impact of multiple implementation factors on prevention program outcome. Then, we demonstrate this approach for evaluating the impact of enrollment and attendance in a family program, over and above the impact of a school-based program, within PROSPER, a large-scale real-world prevention trial. Findings illustrate the capacity of this approach to successfully account for confounders that influence enrollment and attendance, thereby more accurately representing true causal relations. For instance, after accounting for selection bias, we observed a 5 % reduction in the prevalence of 11th grade underage drinking for those who chose to receive a family program and school program compared to those who received only the school program. Further, we detected a 7 % reduction in underage drinking for those with high attendance in the family program.
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U2 - 10.1007/s11121-012-0352-8
DO - 10.1007/s11121-012-0352-8
M3 - Article
C2 - 23430578
AN - SCOPUS:84897023845
SN - 1389-4986
VL - 15
SP - 246
EP - 255
JO - Prevention Science
JF - Prevention Science
IS - 2
ER -