An Application of the Complier Average Causal Effect Analysis to Examine the Effects of a Family Intervention in Reducing Illicit Drug Use among High‐Risk Hispanic Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107494/1/famp12068.pd

Is Fun For Wellness Engaging? Evaluation of User Experience of an Online Intervention to Promote Well-Being and Physical Activity

Online well-being interventions demonstrate great promise in terms of both engagement and outcomes. Fun For Wellness (FFW) is a novel online intervention grounded in self-efficacy theory and intended to improve multidimensional well-being and physical activity through multi-modal methods. These strategies include capability-enhancing opportunities, learning experiences such as games, video vignettes, and self-assessments. RCT studies have suggested that FFW is efficacious in improving subjective and domain-specific well-being, and effective in improving mental health, physical health, physical activity, and self-efficacy in United States. adults who are overweight and in the general population. The present study uses qualitative and quantitative user experience data collected during two RCT trials to understand and evaluate engagement with FFW, its drivers, and its outcomes. Results suggest that FFW is enjoyable, moderately engaging, and easy to use; and contributes to positive outcomes including skill development and enhanced confidence, for both overweight individuals and the general adult population. Drivers of engagement appear to include rewards, gamification, scenario-based learning, visual tracking for self-monitoring, ease of use and simple communications, and the entertaining, interactive nature of program activities. Findings indicate that there are opportunities to streamline and simplify the experience. These results can help improve FFW and contribute to the science of engagement with online interventions designed to improve well-being

A Tutorial on Centering in Cross-Sectional Two-Level Models

The primary purpose of this tutorial is to succinctly review some options for, and consequences of, centering Level 1 predictors in commonly applied cross-sectional two-level models. It is geared toward both practitioners and researchers. A general understanding of multilevel modeling is necessary prior to understanding the subtleties of centering decisions. A review of some high-quality journals within the broad discipline of exercise science provides evidence that multilevel modeling is used relatively infrequently in this field. Therefore, a secondary purpose is to introduce Measurement in Physical Education and Exercise Science readers to some core facets of multilevel modeling within the framework of this tutorial. A relevant dataset is used to demonstrate potential consequences of different centering decisions within a multilevel model. Depending on the model and the data, different centering decisions can exert non-trivial influence on the meaning of some model parameters, results from fitting the model, and subsequent conclusions

Modeling Site Effects in the Design and Analysis of Multi-site Trials

Background: Careful consideration of site effects is important in the analysis of multi-site clinical trials for drug abuse treatment. The statistical choices for modeling these effects have implications for both trial planning and interpretation of findings. Objectives: Three broad approaches for modeling site effects are presented: omitting site from the analysis; modeling site as a fixed effect; and modeling site as a random effect. Both the direct effect of site and the interaction of site and treatment are considered. Methods: The statistical model, and consequences, for each approach are presented along with examples from existing clinical trials. Power analysis calculations provide sample size requirements for adequate statistical power for studies utilizing 6, 8, 10, 12, 14, and 16 treatment sites. Results: Results of the power analyses showed that the total sample required falls rapidly as the number of sites increases in the random effect approach. In the fixed effect approach in which the interaction of site and treatment is considered, the required number of participants per site decreases as the number of sites increases. Conclusions: Ignoring site effects is not a viable option in multi-site clinical trials. There are advantages and disadvantages to the fixed effect and random effect approaches to modeling site effects. Scientific Significance: The distinction between efficacy trials and effectiveness trials is rarely sharp. The choice between random effect and fixed effect statistical modeling can provide different benefits depending on the goals of the study

Reducing Screen-Based Sedentary Behavior Among Overweight and Obese Hispanic Adolescents Through a Family-Based Intervention.

Sedentary behaviors, including screen-based activities, are associated with obesity, cardiovascular, and mental health risks. In the US, minority and socioeconomically disadvantaged youth engage in substantial sedentariness, requiring targeted interventions. Familias Unidas for Health and Wellness (FUHW) is a family intervention to reduce risks among Hispanic youth with overweight and obesity. Analyses examined (1) FUHW's impact on parent and adolescent screen-based sedentary behavior and (2) differential intervention effects by adolescent gender, internalizing symptoms, and body mass index. A total of 280 overweight/obese Hispanic middle schoolers and parents were randomized to FUHW or control and assessed at baseline, 6, 12, and 24 months between 2015 and 2019. Linear growth models showed that exposure to FUHW was not associated with parent sedentary behavior over time (b = -0.11, P = .32) but was associated with decreases in adolescent sedentary behavior (b = -0.27, P = .03). Neither gender nor internalizing symptoms moderated intervention effects, but there were differential effects by body mass index. Compared to controls, FUHW showed significant decreases in sedentary behavior among overweight (b = -0.85, P FUHW reduced youth screen-based sedentary behavior. Youth with severe obesity require additional intervention.</AbstractText

Initial Validity Evidence for Responses to the Newly Developed Well-Being Actions Self-Efficacy Scale from Adults with Obesity under an Exploratory Latent Variable Approach

The objective of this study was to provide initial validity evidence for responses to the newly developed Well-Being Actions Self-Efficacy (WBASE) scale from adults with obesity under an exploratory latent variable approach. Longitudinal data (N baseline  = 667 and N 30 days post-baseline  = 550) from the Well-Being and Physical Activity study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness (FFW) intervention, were analyzed. The a priori measurement model exhibited close fit to baseline data within an exploratory framework. Similarly, there was strong evidence for at least partial temporal measurement invariance for the a priori WBASE scale measurement model. Convergent (and divergent) correlations between concordant (and discordant) pairs of well-being actions scores at baseline and latent well-being actions self-efficacy factors at 30 days post-baseline were observed. There was mixed evidence for the effectiveness of the FFW intervention to exert a direct effect on latent well-being actions self-efficacy at 30 days post-baseline

The Efficacy of Structural Ecosystems Therapy for HIV Medication Adherence with African American Women

A systemic family therapy intervention, Structural Ecosystems Therapy (SET), has been shown to promote adaptation to living with HIV by reducing psychological distress and family hassles. This investigation examines the effect of SET on HIV medication adherence relative to a person-centered condition and a community control condition. Medication adherence was assessed on 156 trial participants. Results of a two-part model showed that SET was significantly more likely to move women to high levels of adherence (defined as at least 95% adherence) than a person-centered therapy. Family hassles was also significantly reduced by SET, though the effect of SET on medication adherence did not appear related to this change in family hassles

Measuring Multidimensional Well-being Actions with the Newly Expanded Version of the I COPPE Actions Scale in Adults with Obesity

The objective of this study was to provide initial validity evidence for responses to the newly expanded version of the I COPPE Actions scale from adults with obesity under an exploratory latent variable approach. Longitudinal data from the 2018 Fun For Wellness Effectiveness Trial (ClinicalTrials.gov, identifier: NCT03194854) were reanalyzed in the current study. The a priori measurement theory specified a six-dimensional correlated structure of well-being actions to govern responses to the I COPPE Actions scale: Interpersonal, Occupational, Community, Physical, Psychological, and Economic. The a priori measurement model exhibited exact fit to well-being actions data at baseline within an exploratory latent variable approach. There was strong evidence for at least partial measurement invariance by time for responses to the scale. Convergent (or divergent) correlations between concordant (or discordant) pairs of well-being actions self-efficacy scores and latent well-being action factors provided strong evidence for hypothesized relationships to other theoretically relevant variables