Statistical analysis for identifying mediating variables in public health dentistry interventions
Open accessAbstract
OBJECTIVE: This article provides an overview of statistical mediation analysis methods in the evaluation of public health dentistry interventions. METHODS AND RESULTS: First, reasons for conducting mediation analysis are outlined, followed by a discussion of the link between the mediation model and theoretical bases of interventions. Second, the basic statistical procedures in mediation analysis are presented. An example application to data from a hypothetical intervention is provided in Appendix A. Third, interpretation of the results from statistical mediation analysis is described along with additional information pertinent to identifying true mediation relations. CONCLUSIONS: Guidelines for describing mediation analyses in research articles related to public health dentistry intervention studies are outlined.
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Reported frequencies of adverse effects from meditation in MBIs range from 3.7% to 33.2%, depending on methodological approach.
“Different frequencies of adverse effects from meditation in a mindfulness-based intervention (MBI) have been reported dependent on methodological approach ranging from 3.7 to 33.2% (60).”
From Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial (2022) · cites this paper as [60]
The Abstract’s Methods and Results and the section on steps in statistical mediation analysis describe methods for evaluating dental-health interventions, not adverse effects of meditation. Searches for mindfulness, meditation, adverse effects, and the 3.7%–33.2% range found no passage addressing the claim in our copy. (LLM, conf=0.78)
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Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models
Sobel, M. E. (1982) · Sociological Methodology · doi:10.2307/270723 · Cited by 12,810 · see citing works
A comparison of methods to test mediation and other intervening variable effects
MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002) · Psychological Methods · doi:10.1037/1082-989x.7.1.83 · Cited by 9,406 · see citing works
Self-citationIntroduction to Statistical Mediation Analysis
MacKinnon, D. P. (2012) · doi:10.4324/9780203809556 · Cited by 5,618 · see citing works
Self-citationRequired sample size to detect the mediated effect
Fritz, M. S., & MacKinnon, D. P. (2007) · Psychological Science · doi:10.1111/j.1467-9280.2007.01882.x · Cited by 4,810 · see citing works
Self-citationEquivalence of the Mediation, Confounding and Suppression Effect
MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000) · Prevention Science · doi:10.1023/a:1026595011371 · Cited by 4,188 · see citing works
Self-citationCole, D. A., & Maxwell, S. E. (2003) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.112.4.558 · Cited by 3,605 · see citing works
Bias in cross-sectional analyses of longitudinal mediation
Maxwell, S. E., & Cole, D. A. (2007) · Psychological Methods · doi:10.1037/1082-989x.12.1.23 · Cited by 3,401 · see citing works
Mediators and Moderators of Treatment Effects in Randomized Clinical Trials
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.10.877 · Cited by 2,562 · see citing works
Process Analysis: Estimating Mediation in Treatment Evaluations
Judd, C. M., & Kenny, D. A. (1981) · Evaluation Review · doi:10.1177/0193841x8100500502 · Cited by 2,442 · see citing works
Estimating Mediated Effects in Prevention Studies
MacKinnon, D. P., & Dwyer, J. H. (1993) · Evaluation Review · doi:10.1177/0193841x9301700202 · Cited by 1,936 · see citing works
Self-citationTotal, Direct, and Indirect Effects in Structural Equation Models
Bollen, K. A. (1987) · Sociological Methodology · doi:10.2307/271028 · Cited by 453 · see citing works
Investigation of Mediational Processes Using Parallel Process Latent Growth Curve Modeling
Cheong, J., MacKinnon, D. P., & Khoo, S. T. (2003) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1207/s15328007sem1002_5 · Cited by 442 · see citing works
Self-citationHow and for whom? Mediation and moderation in health psychology.
MacKinnon, D. P., & Luecken, L. J. (2008) · Health Psychology · doi:10.1037/0278-6133.27.2(suppl.).s99 · Cited by 426 · see citing works
Self-citationPower Analysis for Complex Mediational Designs Using Monte Carlo Methods
Thoemmes, F. J., MacKinnon, D. P., & Reiser, M. (2010) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705511.2010.489379 · Cited by 305 · see citing works
Self-citationAnalysis of Mediating Variables in Prevention and Intervention Research
MacKinnon, D. P. (1994) · PsycEXTRA Dataset · doi:10.1037/e495892006-009 · Cited by 274 · see citing works
Self-citationEffectiveness of Water Fluoridation
Newbrun, E. (1989) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.1989.tb02086.x · Cited by 145 · see citing works
[Effectiveness of water fluoridation].
Kn, K., Rudinskaia, L. A., Mizina, I. K., Tz, K., & Vakulenko, L. V. (1986) · PubMed · Cited by 113 · see citing works
West, S. G., Sandler, I. N., Pillow, D. R., Baca, L. M., & Gersten, J. C. (1991) · American Journal of Community Psychology · doi:10.1007/bf00937987 · Cited by 104 · see citing works
Gordon, J. S., Andrews, J. A., Crews, K. M., Payne, T. J., & Severson, H. H. (2007) · Tobacco Control · doi:10.1136/tc.2007.020271 · Cited by 80 · see citing works
Sohn, W., Ismail, A. I., & Téllez, M. (2004) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2004.tb02747.x · Cited by 71 · see citing works
Motivational interviewing to decrease parental risk-related behaviors for early childhood caries.
Freudenthal, J. J., & Bowen, D. M. (2010) · PubMed · Cited by 62 · see citing works
Theory‐based screening for prevention: Focusing on mediating processes in children of divorce
Pillow, D. R., Sandler, I. N., Braver, S. L., Wolchik, S. A., & Gersten, J. C. (1991) · American Journal of Community Psychology · doi:10.1007/bf00937883 · Cited by 56 · see citing works
Statistical Methods for Risk-Outcome Research: Being Sensitive to Longitudinal Structure
Cole, D. A., & Maxwell, S. E. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-060508-130357 · Cited by 51 · see citing works
A Healthy Weight Intervention for Children in a Dental Setting
Tavares, M. A., & Chomitz, V. R. (2009) · The Journal of the American Dental Association · doi:10.14219/jada.archive.2009.0160 · Cited by 49 · see citing works
Milgrom, P., Ludwig, S., Shirtcliff, R. M., Smolen, D., Sutherland, M., Gates, P. A., & Weinstein, P. (2008) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2007.00049.x · Cited by 37 · see citing works
Folmer, H. (1981) · Environment and Planning A Economy and Space · doi:10.1068/a131435 · Cited by 33 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Demirtaş, Ö., & Akdoğan, A. A. (2014) · Journal of Business Ethics · doi:10.1007/s10551-014-2196-6 · Cited by 495 · see citing works
Integrating Mediators and Moderators in Research Design
MacKinnon, D. P. (2011) · Research on Social Work Practice · doi:10.1177/1049731511414148 · Cited by 417 · see citing works
Self-citationAyala, G. X., & Elder, J. P. (2011) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2011.00241.x · Cited by 280 · see citing works
Lee, J. Y., Divaris, K., Baker, A. D., Rozier, R. G., & Vann, W. F. (2011) · American Journal of Public Health · doi:10.2105/ajph.2011.300291 · Cited by 200 · see citing works
Nadeem, M. A., Liu, Z., Pitafi, A. H., Younis, A., & Xu, Y. (2021) · SAGE Open · doi:10.1177/2158244021998704 · Cited by 161 · see citing works
Streber, R., Peters, S., & Pfeifer, K. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.11.020 · Cited by 90 · see citing works
Buldur, B., & Güvendi, Ö. N. (2019) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.12583 · Cited by 91 · see citing works
Arrow, P., Raheb, J., & Miller, M. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-245 · Cited by 83 · see citing works
Mediating role of employee green behaviour towards sustainability performance of banks
Malsha, K. P. P. H. G. N., Arulrajah, A. A., & Senthilnathan, S. (2020) · Journal of Governance and Regulation · doi:10.22495/jgrv9i2art7 · Cited by 70 · see citing works
Liu, Y., Miao, W., Guo, L., Guo, Y., Zhu, Y., & He, Y. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14761 · Cited by 47 · see citing works
Workplace spirituality and employee incivility: Exploring the role of ethical climate and narcissism
Lata, M., & Chaudhary, R. (2022) · International Journal of Hospitality Management · doi:10.1016/j.ijhm.2022.103178 · Cited by 51 · see citing works
Francis, S. E. B., Shawyer, F., Cayoun, B., Enticott, J., & Meadows, G. N. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.815170 · Cited by 45 · see citing works
“Following correlation analysis of the model variables using Pearson’s correlation coefficients, model building commenced with a series of single mediation models to identify relevant mediators for the final model (60, 61).”
MethodCheng, J., Chaffee, B. W., Cheng, N. F., Gansky, S. A., & Featherstone, J. D. B. (2014) · Journal of Dental Research · doi:10.1177/0022034514555365 · Cited by 42 · see citing works
Steindorf, K., Wiskemann, J., Ulrich, C. M., & Schmidt, M. E. (2017) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4141-8 · Cited by 42 · see citing works
Perceived stress and depression amongst older stroke patients: Sense of coherence as a mediator?
Guo, L., Liu, Y.-J., McCallum, J., Söderhamn, U., Ding, X., Yv, S., Zhu, Y., & Guo, Y. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.08.010 · Cited by 35 · see citing works
Akdoğan, A. A., Arslan, A., & Demirtaş, Ö. (2016) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2016.11.029 · Cited by 36 · see citing works
Mediation analysis for count and zero-inflated count data
Cheng, J., Cheng, N. F., Guo, Z., Gregorich, S. E., Ismail, A. I., & Gansky, S. A. (2017) · Statistical Methods in Medical Research · doi:10.1177/0962280216686131 · Cited by 34 · see citing works
Mediators of Exercise Effects on HRQoL in Cancer Survivors after Chemotherapy
Kalter, J., Kampshoff, C. S., Chinapaw, M. J. M., van Mechelen, W., Galindo‐Garre, F., Schep, G., Leeuw, I. M. V., Brug, J., & Buffart, L. M. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000976 · Cited by 32 · see citing works
Oral health behavioral and social intervention research concepts and methods
Martino, S. (2011) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2011.00217.x · Cited by 32 · see citing works
Estimation of mediation effects for zero‐inflated regression models
Wang, W., & Albert, J. M. (2012) · Statistics in Medicine · doi:10.1002/sim.5380 · Cited by 28 · see citing works
The impact of contingency fit on organisational performance: an empirical study
Amhalhal, A. M. A., Anchor, J. R., Tipi, N. S., & Elgazzar, S. H. (2021) · International Journal of Productivity and Performance Management · doi:10.1108/ijppm-01-2021-0016 · Cited by 27 · see citing works
Front-Loaded Versus Weekly Counseling for Treatment of Tobacco Addiction
Garvey, A. J., Kalman, D., Hoskinson, R. A., Kinnunen, T., Wadler, B. M., Thomson, C. C., & ROSNER, B. A. (2011) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr256 · Cited by 25 · see citing works
The effect of training on the use of tobacco-use cessation guidelines in dental settings
Walsh, M. M., Belek, M. G., Prakash, P., Grimes, B. A., Heckman, B., Kaufman, N., Meckstroth, R. L., Kavanagh, C., Murray, J. L., Weintraub, J. A., et al. (2012) · The Journal of the American Dental Association · doi:10.14219/jada.archive.2012.0239 · Cited by 23 · see citing works
Miao, W., Guo, L., Zhu, Y., Guo, Y., Yv, S., Namassevayam, G., Xue, W., Li, J., Li, L., Shen, Z., et al. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s230278 · Cited by 18 · see citing works
Dosanjh, L. H., Lauby, S. C., Fuentes‐Balderrama, J., Castro, Y., Conway, F. N., Champagne, F. A., Franklin, C., & Goosby, B. J. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106062 · Cited by 16 · see citing works
Buldur, B., & Oguz, E. (2022) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.13025 · Cited by 16 · see citing works
Guo, Z., Small, D. S., Gansky, S. A., & Cheng, J. (2017) · Journal of the Royal Statistical Society Series C (Applied Statistics) · doi:10.1111/rssc.12233 · Cited by 11 · see citing works
Vargas-Nieto, J. C., Montorio, I., Gantiva, C., Froufe, M., Fundación Universitaria Konrad Lorenz, B., Universidad Autónoma de Madrid, M., Universidad de los Andes, B., & Universidad Autónoma de Madrid, M. (2022) · Revista Latinoamericana de Psicología · doi:10.14349/rlp.2022.v54.23 · Cited by 8 · see citing works
The associations between management control systems, market orientation and CSR use
Bhuiyan, F., Baird, K. M., & Munir, R. (2022) · Journal of Management Control · doi:10.1007/s00187-021-00332-5 · Cited by 7 · see citing works
Are Dental Health Behaviors Rational, after All?
Slade, G. D. (2012) · Journal of Dental Research · doi:10.1177/0022034512462579 · Cited by 7 · see citing works
Green information technology and environmental performance of the banks
Arulrajah, A. A., Senthilnathan, S., & Rathnayake, M. P. (2020) · Journal of Governance and Regulation · doi:10.22495/jgrv9i3art2 · Cited by 7 · see citing works
Schmidt, M. E., Wiskemann, J., Johnson, T., Habermann, N., Schneeweiß, A., & Steindorf, K. (2018) · Supportive Care in Cancer · doi:10.1007/s00520-018-4095-3 · Cited by 6 · see citing works
Constructing a Conceptual Framework for Quantitative Data Analysis in Social Science Research
Mugizi, W. (2021) · Interdisciplinary Journal of Education · doi:10.53449/ije.v2i1.77 · Cited by 5 · see citing works
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Tsheko, G. N., Koyabe, B. W., Gabaitiri, L., Molebatsi, K., Chilisa, B., Major, T. E., Losike-Sedimo, N. C., Jemmott, J. B., & Jemmott, L. S. (2021) · Prevention Science · doi:10.1007/s11121-021-01306-8 · Cited by 5 · see citing works
Woo, J. L., Gandhi, R., Laternser, C., Iyengar, T., Yee, L. M., Grobman, W. A., Davis, M. M., Patel, A., & Johnson, J. T. (2024) · Prenatal Diagnosis · doi:10.1002/pd.6675 · Cited by 4 · see citing works
Be prepared: capitalizing on opportunities to advance theory and practice
Rothman, A. J. (2011) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2011.00240.x · Cited by 4 · see citing works
Noar, S. M. (2012) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2012.00361.x · Cited by 4 · see citing works
Stone, L., Ding, L., Hirpa, M., Amsalu, B. A., Getnet, B. A., Eshete, H., Baye, T. M., & Vaughn, L. M. (2026) · JMIR Research Protocols · doi:10.2196/85971 · Cited by 2 · see citing works
Taskaya, B., & Buldur, B. (2025) · BMC Oral Health · doi:10.1186/s12903-024-05159-9 · Cited by 2 · see citing works
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Buldur, B., & Yıldız, Y. (2025) · BMC Oral Health · doi:10.1186/s12903-025-05718-8 · Cited by 2 · see citing works
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Haedr, A. R., & Mehafdi, M. (2017) · Athens Journal of Business & Economics · doi:10.30958/ajbe.3.3.4 · Cited by 2 · see citing works
Mediation in the development of early childhood caries
Litt, M. D. (2011) · Journal of Public Health Dentistry · doi:10.1111/j.1752-7325.2011.00237.x · Cited by 2 · see citing works
Mbawalla, H. S. (2013) · NORA - Norwegian Open Research Archives · Cited by 2 · see citing works
Woo, J. L., Gotteiner, N. L., Anderson, B. R., Yee, L. M., Grobman, W. A., Davis, M. M., & Laternser, C. (2025) · Pregnancy · doi:10.1002/pmf2.70011 · Cited by 1 · see citing works
Kotowska, A., Kułaga, Z., Socha, P., Iotova, V., Galcheva, S., Cardon, G., Craemer, M. D., Androutsos, O., Giménez-Legarre, N., Koletzko, B., et al. (2026) · European Journal of Nutrition · doi:10.1007/s00394-026-03897-w · Cited by 1 · see citing works
Mediation Modeling in Randomized Trials with Non-normal Outcome Variables
Cheng, J., & Gansky, S. A. (2018) · ICSA book series in statistics · doi:10.1007/978-981-10-7820-0_10 · Cited by 1 · see citing works
Market sophistication and metacognition of workers in collectivistic vs. individualistic countries
Brycz, M., & Brycz, H. W. (2022) · Economics & Sociology · doi:10.14254/2071-789x.2022/15-2/8 · Cited by 1 · see citing works
Brimacombe, M. B. (2024) · Bioengineering · doi:10.3390/bioengineering11121189 · Cited by 1 · see citing works
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Nohlert, E. (2013) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 1 · see citing works
Luecken, L. J., & Tanaka, R. (2012) · Wiley eBooks · doi:10.1002/9781118133880.hop202009 · Cited by 1 · see citing works
Self-citationExploring the Risk Factors that Influence the Parental Dental Deferment Decision
White, M. (2015) · ScholarWorks (Walden University)
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Zhou, K., Khairuddin, A. N. M., Gallagher, J. E., Masao, I. D. E., & Kang, J. (2026) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-026-01166-2
Guo, Q., & Peng, C. F. (2026) · Journal of Psycholinguistic Research · doi:10.1007/s10936-026-10311-3
- Authors
- MacKinnon, D. P., & Luecken, L. J.
- Affiliations
- Arizona State University (US)
- Corresponding author
- MacKinnon, David P.
- Venue
- Journal of Public Health Dentistry
- Publisher
- Wiley
- Published
- 2011-01
- Volume
- 71
- Issue
- s1
- Pages
- S37-46
- ISSN
- 0022-4006 (ISSN-L)
- 1752-7325
- PMC
- PMC3366631
- OpenAlex
- W1721043408
- Cited by
- 54
- References
- 27
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 2 · 2022: 6 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 1 · 2014: 2 · 2013: 3 · 2012: 5
- FWCI
- 4.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Public Health Dentistry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA009757, DA0957)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- mediation analysis, intervention evaluation, mediation model, reporting guidelines
- MeSH terms
- Behavior Therapy, Health Promotion, Humans, Oral Health, Psychological Theory, Public Health Dentistry, Research Design, Models, Statistical, Health Behavior, Guidelines as Topic, Behavioral Research
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