PMID- 29611093 OWN - NLM STAT- MEDLINE DCOM- 20181217 LR - 20231115 IS - 1860-0980 (Electronic) IS - 0033-3123 (Print) IS - 0033-3123 (Linking) VI - 83 IP - 4 DP - 2018 Dec TI - Nonlinear Predictive Models for Multiple Mediation Analysis: With an Application to Explore Ethnic Disparities in Anxiety and Depression Among Cancer Survivors. PG - 991-1006 LID - 10.1007/s11336-018-9612-2 [doi] AB - Mediation analysis allows the examination of effects of a third variable (mediator/confounder) in the causal pathway between an exposure and an outcome. The general multiple mediation analysis method (MMA), proposed by Yu et al., improves traditional methods (e.g., estimation of natural and controlled direct effects) to enable consideration of multiple mediators/confounders simultaneously and the use of linear and nonlinear predictive models for estimating mediation/confounding effects. Previous studies find that compared with non-Hispanic cancer survivors, Hispanic survivors are more likely to endure anxiety and depression after cancer diagnoses. In this paper, we applied MMA on MY-Health study to identify mediators/confounders and quantify the indirect effect of each identified mediator/confounder in explaining ethnic disparities in anxiety and depression among cancer survivors who enrolled in the study. We considered a number of socio-demographic variables, tumor characteristics, and treatment factors as potential mediators/confounders and found that most of the ethnic differences in anxiety or depression between Hispanic and non-Hispanic white cancer survivors were explained by younger diagnosis age, lower education level, lower proportions of employment, less likely of being born in the USA, less insurance, and less social support among Hispanic patients. FAU - Yu, Qingzhao AU - Yu Q AUID- ORCID: 0000-0001-8194-0798 AD - Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, 3rd Floor, 2020 Gravier Street, New Orleans, LA, 70112, USA. qyu@lsuhsc.edu. FAU - Medeiros, Kaelen L AU - Medeiros KL AD - American College of Surgeon, Chicago, IL, USA. FAU - Wu, Xiaocheng AU - Wu X AD - Louisiana Tumor Registry, 2020 Gravier Street, New Orleans, LA, 70112, USA. FAU - Jensen, Roxanne E AU - Jensen RE AD - Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA. LA - eng GR - R01 CA275089/CA/NCI NIH HHS/United States GR - R15 MD012387/MD/NIMHD NIH HHS/United States GR - 1R15MD012387/MD/NIMHD NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20180402 PL - United States TA - Psychometrika JT - Psychometrika JID - 0376503 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Anxiety/ethnology MH - Cancer Survivors/psychology MH - *Data Interpretation, Statistical MH - Depression/ethnology MH - Female MH - Follow-Up Studies MH - Hispanic or Latino/psychology MH - Humans MH - Male MH - Middle Aged MH - *Models, Statistical MH - Nonlinear Dynamics MH - Psychometrics MH - Quality of Life MH - Socioeconomic Factors MH - Young Adult PMC - PMC6168435 MID - NIHMS988177 OTO - NOTNLM OT - MY-Health study OT - ethnic disparity OT - health-related quality of life OT - mediation/confounding analysis OT - nonlinear models COIS- Conflict of interest The authors declare that they have no conflict of interest. EDAT- 2018/04/04 06:00 MHDA- 2018/12/18 06:00 PMCR- 2019/12/01 CRDT- 2018/04/04 06:00 PHST- 2017/07/13 00:00 [received] PHST- 2018/02/23 00:00 [revised] PHST- 2018/04/04 06:00 [pubmed] PHST- 2018/12/18 06:00 [medline] PHST- 2018/04/04 06:00 [entrez] PHST- 2019/12/01 00:00 [pmc-release] AID - 10.1007/s11336-018-9612-2 [pii] AID - 10.1007/s11336-018-9612-2 [doi] PST - ppublish SO - Psychometrika. 2018 Dec;83(4):991-1006. doi: 10.1007/s11336-018-9612-2. Epub 2018 Apr 2.