Prevention Science

, Volume 13, Issue 4, pp 437–447 | Cite as

Introducing the At-Risk Average Causal Effect with Application to HealthWise South Africa

  • Donna L. Coffman
  • Linda L. Caldwell
  • Edward A. Smith


Researchers often hypothesize that a causal variable, whether randomly assigned or not, has an effect on an outcome behavior and that this effect may vary across levels of initial risk of engaging in the outcome behavior. In this paper, we propose a method for quantifying initial risk status. We then illustrate the use of this risk-status variable as a moderator of the causal effect of leisure boredom, a non-randomized continuous variable, on cigarette smoking initiation. The data come from the HealthWise South Africa study. We define the causal effects using marginal structural models and estimate the causal effects using inverse propensity weights. Indeed, we found leisure boredom had a differential causal effect on smoking initiation across different risk statuses. The proposed method may be useful for prevention scientists evaluating causal effects that may vary across levels of initial risk.


Causal inference Marginal Structural Models Leisure boredom Cigarette smoking initiation 


Authors’ note

Preparation of this article was supported by NIDA Center Grant P50 DA100075, NIDA R03 DA026543, and NIDDK 5R21DK082858-02. HealthWise was supported by NIDA grant R01 DA01749. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse (NIDA), the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK), or the National Institutes of Health (NIH).


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Copyright information

© Society for Prevention Research 2012

Authors and Affiliations

  • Donna L. Coffman
    • 1
  • Linda L. Caldwell
    • 2
  • Edward A. Smith
    • 3
  1. 1.The Methodology CenterThe Pennsylvania State UniversityState CollegeUSA
  2. 2.Dept. of Recreation, Park and Tourism ManagementThe Pennsylvania State UniversityUniversity ParkUSA
  3. 3.Prevention Research CenterThe Pennsylvania State UniversityUniversity ParkUSA

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