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Activity Number: 447
Type: Topic Contributed
Date/Time: Wednesday, August 6, 2014 : 8:30 AM to 10:20 AM
Sponsor: Biometrics Section
Abstract #312298 View Presentation
Title: Mediation in Cluster Randomized Trials: Insights from Modern Causal Inference vs. Traditional Approaches
Author(s): Elizabeth Turner*+ and Matthew Jukes and Elizabeth Adelman and Magaret Dubeck
Companies: Duke University and Room To Read and Harvard Graduate School of Education and University of Virginia
Keywords: Cluster randomized trial ; Mediation ; Education ; Complex intervention ; Causal inference

Cluster randomized trials are commonly used to evaluate the effectiveness of interventions with multiple components, which are often referred to as 'complex' interventions. When effectiveness of such a complex intervention is demonstrated, it is important to determine which components contribute most by assessing changes in cluster- and individual-level mediators on the causal pathway from the intervention to the outcome. Yet a number of challenges arise with such mediation analyses, including likely confounding of the mediators and outcome, the challenges of analyzing multiple mediator variables and complexity in the data structure due to the clustered nature of the study design. Using data from an educational intervention trial in Kenya, we present insights in to these challenges and solutions from modern causal inference methods, which we contrast with traditional mediation approaches (including the Baron and Kenny approach). These methods will be elucidated in light of recent analytic advances in the broader field of analysis of cluster randomized trials.

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