Using causal mediation models to examine multi-sectoral health and nutrition program impact paths and moderation by agricultural interventions and equity

Project Summary

Principal investigator(s):

Kenda Cunningham Helen Keller International

Duration:

24 months (from April 2022)

Value:

£245,057

Countries of research:

Nepal

Helen Keller International

Co-Principal investigators:

Edward Frongillo, University of South Carolina
Ben Kelcey, University of Cincinnati

This project will apply causal mediation methods that allow for moderated mediation, into agriculture-nutrition-health implementation science. The aim is to use one multi-sectoral program’s theoretical program impact paths and determine the extent to which these paths materialized and whether the intervention paths to impact (reductions in maternal and child undernutrition) varied across sub-populations, as a case study for the application of these methods. The project has five specific objectives:

To test multiple program impact paths, each with multiple mediators;
To test how agricultural interventions moderate the multiple program impact paths, each with multiple mediators;
To test how dimensions of equity (e.g. gender, wealth, caste/ethnicity, and remoteness) moderate the multiple program impact paths, each with multiple mediators;
To develop a global inter-disciplinary community of practice for causal mediation, particularly related to agriculture-nutrition-health to raise awareness of the possibilities of these method for implementation science; and
To develop and disseminate an interactive toolkit to facilitate uptake of causal mediation methods among applied researchers.

Application of mediation analytic methods within the ANH context will improve upon traditional path analyses by facilitating simultaneous testing of multiple paths, with their multiple mediators, and following this up with moderated mediation analyses, using both agricultural interventions and equity (gender, caste/ethnicity, geographic remoteness, and socioeconomics) as moderators. This research will help answer urgent implementation science questions of interest to researchers, as well implementers, donors, and governments, related to where along the paths from intervention to impact to investments succeed or fail and how theoretical paths operate differently (or not) for different sub-populations, and so on.

This project will also develop a global community of practice, involving researchers engaged in implementation science for ANH, to raise awareness and adoption of these methods.