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JAMA Guide to Statistics and Methods
January 25, 2019

Mediation Analysis

Author Affiliations
  • 1Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
  • 2School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
  • 3Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
  • 4School of Medical Sciences, Faculty of Medicine, University of New South Wales, Australia
JAMA. 2019;321(7):697-698. doi:10.1001/jama.2018.21973

In a 2018 study published in JAMA Network Open, Silverstein et al1 used mediation analysis to investigate how a problem-solving educational program prevented depressive symptoms in low-income mothers. Using data from a randomized trial, the authors tested 8 plausible mechanisms by which the intervention could have its effects. They concluded that problem-solving education reduced the risk of depressive symptoms in low-income mothers primarily by reducing maternal stress.