Evidence map›Paper›PMID 34507584›Full record

Trial reportBMC public health2021

Mediation pathways for reduced substance use among parents in South Africa: a randomized controlled trial.

Adeem Ahmad Massarwi, Lucie Cluver, Franziska Meinck, Jenny Doubt, Jamie M Lachman, Yulia Shenderovich, Ohad Green

Open access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Practical challenges in mediation analysis: a guide for applied researchers.Health services & outcomes research methodology · 2025
    Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Adeem Ahmad MassarwiCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK. adeemass@bgu.ac.il.
Lucie CluverCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Franziska MeinckSchool of Social & Political Sciences, University of Edinburgh, Edinburgh, UK.
Jenny DoubtCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Jamie M LachmanCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Yulia ShenderovichCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Ohad GreenCentre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, UK.
Oxford Policy Management · GBUniversity of Edinburgh · GBUniversity of Oxford · GB

Funding

Chief Scientist Office SPHSU14Chief Scientist Office SPHSU16Medical Research Council MC_UU_00022/1Medical Research Council MC_UU_00022/3Medical Research Council MR/K023233/1
6 · The paper itself

Abstract

backgroundSubstance use is a major public health concern worldwide. Alcohol and drug use have increased during recent decades in many low- and middle-income countries, with South Africa, where this study was conducted, having among the highest rates in the world. Despite existing evidence on the effectiveness of family-based interventions in reducing substance use among parents and caregivers in low- and middle-income countries, little is known about the mechanism of change that contributes to the reduction. This study investigated mediators of change in a parenting programme (Parenting for Lifelong Health [PLH]) on reducing substance use among parents and caregivers of adolescents through three potential mediators: parental depression, parenting stress and family poverty.

methodsThe current study used a pragmatic cluster randomized controlled trial design. The total sample comprised 552 parent and caregiver of adolescents M = 49.37(SD = 14.69) who were recruited from 40 communities in South Africa's Eastern Cape. Participants completed a structured confidential self-report questionnaire at baseline and a follow-up test 5 to 9 months after the intervention. Structural equation modeling was conducted to investigate direct and indirect effects.

resultsAnalyses indicated that the effect of the PLH intervention on reducing parental substance use was mediated in one indirect pathway: improvement in parental mental health (reduction in parental depression levels). No mediation pathways from the PLH intervention on parental substance use could be associated with parenting stress or family poverty.

conclusionsThe findings of the study suggest that intervention approaches targeting mental health among parents and caregivers have promise for reducing parental substance use. These findings emphasize the need to create supportive environments and systems for parents who suffer from emotional strain and mental health problems, particularly within families experiencing adversity.

trial registrationPan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. The trial can be found by searching for the key word 'Sinovuyo' on the Pan-African Clinical Trials Registry website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_windowLabel=BasicSearchUpdateController_1&BasicSearchUpdateController_1_actionOverride=%2Fpageflows%2Ftrial%2FbasicSearchUpdate%2FviewTrail&BasicSearchUpdateController_1id=1119.

Indexed as

ParentsSubstance-Related DisordersAdolescentCaregiversHumansParentingSouth AfricaParental depressionParenting interventionSubstance use

Identifiers

PMID34507584
PMCPMC8434729
OpenAlexW3196933230

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.