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Cited by 268Advanced Causal Inference TechniquesSubstance Abuse Treatment and OutcomesBehavioral Health and Interventions

Reasons for Testing Mediation in the Absence of an Intervention Effect: A Research Imperative in Prevention and Intervention Research

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O’Rourke, Holly P., MacKinnon, David P.·2018·Journal of Studies on Alcohol and Drugs
DOI 10.15288/jsad.2018.79.171PMC PMC6019768
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Abstract

OBJECTIVE: Mediation models are used in prevention and intervention research to assess the mechanisms by which interventions influence outcomes. However, researchers may not investigate mediators in the absence of intervention effects on the primary outcome variable. There is emerging evidence that in some situations, tests of mediated effects can be statistically significant when the total intervention effect is not statistically significant. In addition, there are important conceptual and practical reasons for investigating mediation when the intervention effect is nonsignificant. METHOD: This article discusses the conditions under which mediation may be present when an intervention effect does not have a statistically significant effect and why mediation should always be considered important. RESULTS: Mediation may be present in the following conditions: when the total and mediated effects are equal in value, when the mediated and direct effects have opposing signs, when mediated effects are equal across single and multiple-mediator models, and when specific mediated effects have opposing signs. Mediation should be conducted in every study because it provides the opportunity to test known and replicable mediators, to use mediators as an intervention manipulation check, and to address action and conceptual theory in intervention models. CONCLUSIONS: Mediators are central to intervention programs, and mediators should be investigated for the valuable information they provide about the success or failure of interventions.

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Authors
O’Rourke, H. P., & MacKinnon, D. P.
Affiliations
Arizona State University (US)
ORCID
Venue
Journal of Studies on Alcohol and Drugs
Publisher
Alcohol Research Documentation, Inc.
Published
2018-03
Volume
79
Issue
2
Pages
171-181
ISSN
  • 1937-1888 (ISSN-L)
  • 1938-4114
DOI
10.15288/jsad.2018.79.171
PMC
PMC6019768
OpenAlex
W2793680641
Cited by
268
References
64
Citations by year
2026: 45 · 2025: 47 · 2024: 45 · 2023: 35 · 2022: 34 · 2021: 18 · 2020: 21 · 2019: 19 · 2018: 4
FWCI
12.86
Type
journal article
Language
en
Open access
Locations
  • Journal of Studies on Alcohol and Drugs (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (R01DA009757, R37DA009757, T32DA039772)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
mediation analysis, intervention effects, prevention research, intervention research, intervention mechanisms, multiple mediators, manipulation checks, intervention model, alcohol and drug prevention
MeSH terms
Alcoholism, Female, Humans, Research Design, Cognitive Behavioral Therapy, Negotiating

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