Meta-analytic structural equation modeling made easy: A tutorial and web application for one-stage MASEM

The links between parenting, self-esteem, and depressive symptoms: a meta-analysis

INTRODUCTION

Framed by attachment and cognitive theories, the current meta-analysis tested the direct and indirect links among parenting dimensions (parental support, authoritative control, psychological control, and behavioral control), self-esteem, and depressive symptoms for children and adolescents.

METHODS

Based on 53 studies, and 74 independent samples, the present study used One-Stage Meta-analytic Structural Equation Modeling (OSMASEM) to investigate these links, including testing a mediation effect by self-esteem between parental support-, authoritative control-, psychological control-, behavioral control-, and depressive symptoms. It also tested for potential moderation effects by several variables.

RESULTS

The evidence indicated that parental support (β = .29), authoritative control (β = .23), and behavioral control (β = .07) are positive correlates of self-esteem, while psychological control (β = -.26) is a negative one. It also found that self-esteem was negatively associated with depressive symptoms (β range: -.49 to -.53). Furthermore, parental support (β = -0.14), authoritative control (β = -0.10), and behavioral control (β = -0.05) are negative correlates of depressive symptoms, while psychological control is a positive correlate (β = .11). OSMASEM also provided evidence that parental support, authoritative control, psychological control, and behavioral control are indirectly associated with depressive symptoms, via self-esteem.

CONCLUSION

Parenting dimensions are associated with depressive symptoms both directly and indirectly. That is, self-esteem partially mediates the relationships between parental support, authoritative control, psychological control, and behavioral control with depressive symptoms. Furthermore, OSMASEM moderator tests provided evidence of several significant moderators, including age, sex, parenting measurement, and self-esteem measurement.

Comparison of life expectancy determinants among gulf cooperation council members

BACKGROUND

Understanding the determinants of life expectancy (LE) is essential for effective policy planning and enhancing public health in the Gulf Cooperation Council (GCC) countries. This study aims to elucidate the complex interactions among sociodemographic (SD), macroeconomic (ME), and health resource (HR) factors that influence LE among the GCC countries.

METHODS

We employed a Meta-Analytic Structural Equation Modeling to develop a comparative model across six GCC countries using annual data from 1990 to 2020. The pairwise comparison utilized Partial Least Squares Multi-Group Analysis, allowing us to examine the differences of SD, ME, and HR influences on LE among the GCC countries.

RESULTS

Our analysis highlighted that HR and ME factors directly impact LE across all GCC countries examined. We observed significant mediation effects where SD factors influenced ME or HR, affecting LE. Notably, the final pairwise comparisons revealed that the impact of SD on LE was particularly significant, with effect sizes ranging from 0.2679 (p = 0.0018) in the Oman-Kuwait comparison to 0.6686 (p < 0.0001) in the Emirate-Saudi comparison. Furthermore, while HR and ME factors consistently influenced LE in each model, the differences in their impacts across the six countries did not show significant variations between each pairing.

CONCLUSIONS

Generally, the findings highlight the critical need for GCC countries to strengthen the integrated framework of SD, ME, and HR factors rather than relying solely on HR improvements. Specifically, the findings highlight the importance of tailoring health policies to address specific sociodemographic contexts within the GCC to enhance LE effectively. The insights gained from our model could significantly inform targeted health policy initiatives and provide a valuable reference for future research in similar settings.

Does shame mediate the influence of trauma on psychosis? A systematic review and meta-analytic structural equation modelling approach

BACKGROUND

Meta-analytic evidence has linked shame separately to both potentially traumatic events (PTEs) and psychosis, but the influence of shame on the relationship between PTEs and psychosis has not yet been examined. This study used meta-analytic structural equation modelling (MASEM) to examine whether shame plays a mediatory role between PTEs and experiences of psychosis.

METHODS

A nested search was conducted within a previous systematic review on psychosis and shame to identify articles that contained a measure of PTEs. Included studies reported a quantitative association between psychosis and shame, and additionally a quantitative relationship between either i) PTEs and psychosis; or ii) PTEs and shame.

FINDINGS

Of the 40 articles initially included, 14 met criteria and 13 were included in the analyses. Overall, shame partially mediated the relationship between PTE's and psychosis, observed through a significant indirect effect (β = 0.15, 95 % CI: 0.11-0.19) and a reduction in the direct path that remained significant (β = 0.13, 95 % CI: 0.06-0.20). Indirect paths through shame between childhood PTEs and psychosis (β = 0.07, 95 % CI: 0.03-0.11), and between lifespan PTEs and psychosis (β = 0.09, 95 % CI: 0.03-0.11), were both small but significant. Both direct paths remained significant, suggesting that shame acts a partial mediator for both types of PTE.

CONCLUSIONS

Shame is one path through which potentially traumatic events may influence the experience of psychosis and should be considered alongside other affective types in future modelling of psychosis. Qualitative research may aid further understanding of the mechanisms by which shame operates in this relationship.

Narcissism and Wellbeing: A Cross-Cultural Meta-Analysis

Do narcissists enjoy better or worse wellbeing than others? Psychological theories disagree. In an attempt to reconcile them, we conducted a comprehensive cross-cultural meta-analysis testing the core hypotheses that grandiose narcissism would be associated with better wellbeing and vulnerable narcissism with worse wellbeing. We also hypothesized that these associations would be explained by self-esteem and would be stronger in countries higher on individualism. First, as hypothesized, grandiose narcissism was associated with better wellbeing and vulnerable narcissism with worse wellbeing. Second, as hypothesized, both associations became nonsignificant after controlling for self-esteem, suggesting that they are explained by self-esteem. Third, partly as hypothesized, the association between grandiose-but not vulnerable-narcissism and wellbeing was stronger in more individualistic countries. Results held across wellbeing forms (hedonic, eudaimonic) and methods (cross-sectional, longitudinal). Advancing psychological theory, we demonstrated that only grandiose narcissists enjoy better wellbeing, especially in individualistic countries, a phenomenon accounted for by their higher self-esteem.

Predicting risky driving behaviours using the theory of planned behaviour: A meta-analysis

The current meta-analysis explored the efficacy of the theory of planned behaviour (TPB) in predicting high-risk driving behaviours. Specifically, we examined speeding (in relation to exceeding the limit as well as speed compliance), driving under the influence, distracted driving, and seat belt use. We searched four electronic databases (i.e., PubMed, Web of Science, Scopus, and ProQuest) and included original studies that quantitatively measured the relationships between the TPB variables (attitude, subjective norm, perceived behavioural control [PBC], intention, and prospective/objective behaviour). The study identified 80 records with 94 independent samples. Studies were assessed for risk of bias using the JBI checklist for cross-sectional studies and compliance with the TPB guidelines. Together, attitude, subjective norm and PBC explained between 30 % and 51 % of variance found in intention, with attitude showing as the strongest predictor for intention across the different driving behaviours. The findings also showed that the model explained 36 %-48 % variance found in predicting the observed and/or prospective behaviours for distracted driving, speed compliance and speeding. Understanding the varying strengths and thus relative importance of TPB constructs in predicting different risky driving behaviours is crucial for developing targeted road safety interventions.

Trait self-control as a determinant of health behavior: Recent advances on mechanisms and future directions for research

We summarize theory and research testing a mechanistic explanation for the trait self-control-health behavior relationship. Specifically, social cognition constructs summarizing individuals' utility, normative, risk, and capacity beliefs with respect to future health behavior performance are proposed to mediate the self-control-health behavior relationship. The effect represents the informational function of self-control in decision making. We also specify a mechanism wherein trait self-control moderates the intention-behavior relationship such that 'good' self-control affords effective intention-to-action translation. Both effects have pervasive support in the extent literature. We propose ongoing meta-analyses expected to provide further robust support for these mechanistic effects and the need for research employing designs enabling better directional and causal inferences in the effects, including experimental or types of cross-lagged panel design.

Checking the inventory: Illustrating different methods for individual participant data meta-analytic structural equation modeling

Researchers may have at their disposal the raw data of the studies they wish to meta-analyze. The goal of this study is to identify, illustrate, and compare a range of possible analysis options for researchers to whom raw data are available, wanting to fit a structural equation model (SEM) to these data. This study illustrates techniques that directly analyze the raw data, such as multilevel and multigroup SEM, and techniques based on summary statistics, such as correlation-based meta-analytical structural equation modeling (MASEM), discussing differences in procedures, capabilities, and outcomes. This is done by analyzing a previously published collection of datasets using open source software. A path model reflecting the theory of planned behavior is fitted to these datasets using different techniques involving SEM. Apart from differences in handling of missing data, the ability to include study-level moderators, and conceptualization of heterogeneity, results show differences in parameter estimates and standard errors across methods. Further research is needed to properly formulate guidelines for applied researchers looking to conduct individual participant data MASEM.

The happy personality revisited: Re-examining associations between Big Five personality traits and subjective well-being using meta-analytic structural equation modeling

OBJECTIVE/BACKGROUND

Using meta-analytic structural equation modeling (MASEM), we examined the link between Big Five personality traits and subjective well-being (SWB), operationalized as three separate components and as a latent factor indicated by life satisfaction (LS), positive affect (PA), and negative affect (NA). PA and NA were assessed based on frequency of a broad range of affective experiences, rather than intensity of high arousal affective experiences, thus excluding studies using the Positive and Negative Affect Schedule.

METHOD

35 samples were included, encompassing 22,135 participants from 14 countries, in which all eight variables were assessed.

RESULTS

Correlations among personality traits were moderate, on average, and the latent SWB factor had strong loadings from all three components. Personality traits together explained substantial variance in LS, PA, and NA, and in the latent SWB factor, with unique predictive effects on the latent factor from each personality trait except openness. Associations between personality traits and SWB components were fully accounted for by a latent SWB factor, with one exception: A specific association was found between neuroticism and unique variance in NA.

CONCLUSIONS

The present findings provide new insights concerning the notion of a 'happy personality' in showing that Big Five personality traits have unique associations with an underlying sense of SWB.

The Role of Parent-Child Attachment, Hostile Attribution Bias in Aggression: A Meta-Analytic Review

Parent-Child Attachment (PCA) and Hostile Attribution Bias (HAB) are closely related to aggression, but findings regarding their relationships are inconsistent. There is a lack of understanding of the underlying mechanism between PCA and aggression. This review employed meta-analysis approaches to investigate the associations between PCA and aggression, as well as between HAB and aggression, and the mechanism for the PCA-aggression association. An article search was conducted in CNKI, PubMed, PsycINFO, Web of Science, ProQuest, and Google Scholar. Totally, 118 studies involving general populations and those at high risk for aggression were included. Results revealed negative associations between Parent-Child Attachment Security (PCAS) and aggression (ρ = -.267, p < .001) and positive associations between Parent-Child Attachment Insecurity (PCAI) and aggression (ρ = .240, p < .05). HAB and aggression were found to be positively associated (ρ = .303, p < .001). As for the PCAS-aggression association, a larger effect size was found in females than in males. The HAB-reactive aggression association was stronger than the HAB-proactive aggression association. In Eastern culture, the association between HAB and aggression was stronger than in Western culture. HAB mediated the association between PCAS and aggression. Our findings contribute to the understanding of the occurrence and development of aggression by establishing an association between attachment theory and the social information processing model. The practical implications include interventions targeting cultivating PCAS and alleviating HAB, which might serve as effective ways to reduce aggression, yet aggression type, gender, and cultural background should be taken into consideration.

The relation between number line performance and mathematics outcomes: Two meta-analyses

Understanding the magnitudes represented by numerals is a core component of early mathematical development and is often assessed by accuracy in situating numerals and fractions on a number line. Performance on these measures is consistently related to performance in other mathematics domains, but the strength of these relations may be overestimated because general cognitive ability has not been fully controlled in prior studies. The first of two meta-analyses (162 studies, 33,101 participants) confirmed a relation between performance on whole number (r = 0.33) and fractions number (r = 0.41) lines and overall mathematics performance. These relations were generally consistent across content domains (e.g., algebra and computation) and other moderators. The second (71 studies, 14,543 participants) used meta-analytic structural equation modeling to confirm these relations while controlling general cognitive ability (defined by IQ and working memory measures) and, in one analysis, general mathematics competence. The relation between number line performance and general mathematics competence remained significant but reduced (β = 0.13). Controlling general cognitive ability, whole number line performance consistently predicted competence with fractions but not performance on numeracy or computations measures. The results suggest an understanding of the magnitudes represented by whole numbers might be particularly important for students' fractions learning. RESEARCH HIGHLIGHTS: Two meta-analyses examined the link between the number line and mathematics performance. The first revealed significant relations across domains (e.g., algebra and computation). The second controlled for general cognitive ability and resulted in reduced but still significant relations. The relation between number line and fractions performance was stronger than relations to other domains.

A comparison of univariate and meta-analytic structural equation modeling approaches to reliability generalization applied to the Maslach Burnout Inventory

Introduction

Reliability is a property of tests scores that varies from sample to sample. One way of generalizing reliability of a test is to perform a meta-analysis on some reliability estimator. In 2011, a reliability generalization meta-analysis on the Maslach Burnout Inventory (MBI) was conducted, concluding that average alpha values for the MBI dimensions ranged from 0.71 to 0.88. In the present study, we aimed to update the average reliability values of the MBI by conducting a literature search from 2010 until now and comparing to statistical procedures of meta-analysis: the Univariate approach, that were used in the previous study, and a novel meta-analytic approach based on structural equation modeling.

Method

An estimation of average reliability was done based on 69 independent primary reliability coefficients for the Univariate approach. The average reliability was based on 9 independent studies in the case of the Meta-analytic Structural Equation Modeling (MASEM) approach. Given that MASEM has the additional capability of testing the internal structure of a test, we also fitted several models.

Results

The data was well-suited to the bifactor model, revealing the dominance of the general factor over the domain-specific ones. Acceptable overall alpha and omega coefficients were achieved for the two of the MBI dimensions, having depersonalization reliability estimates below recommendations.

Discussion

In general, the MBI can be viewed as a highly interconnected three-factor scale, being its appropriate for research purposes.

Weighing the role of social cognition and executive functioning in pragmatics in the schizophrenia spectrum: A systematic review and meta-analysis

Pragmatic impairment is diffused in schizophrenia spectrum disorders, but the literature still debates its neurocognitive underpinnings. This systematic review and meta-analysis aimed to investigate the neurocognitive correlates of pragmatic disorders in schizophrenia and determine the weight of social cognition and executive functioning on such disorders. Of the 2,668 records retrieved from the literature, 16 papers were included in the systematic review, mostly focused on non-literal meanings and discourse production in schizophrenia. Ten studies were included in the meta-analysis: pragmatics was moderately associated with both social cognition and executive functions (especially inhibition), but the link with social cognition was stronger. The mediation analysis showed that social cognition mediated the relationship between executive functions and pragmatics. Based on this, we proposed a hierarchical neurocognitive model where pragmatics stems from social cognition, while executive functions are the fertile ground supporting the other two domains, and we discuss its theoretical and clinical implications.

Self-Care Behavior and Associated Factors of Nursing Students with Dysmenorrhea: A Structural Equation Model

Objective

To assess the factors influencing the self-care behavior among nursing students with dysmenorrhea.

Background

The practice of self-care behavior for dysmenorrhea has gradually attracted immense attention from society; however, thus far, only a few studies have been conducted to predict this behavior and analyze the associated factors by creating a structural equation model.

Methods

A cross-sectional multistage cluster sampling study was conducted among nursing students within six universities in Shaanxi province, China. A model was constructed, and structured questionnaires were adopted to measure model variables, including e-health literacy, negative emotion, self-efficacy, self-care agency, degree of dysmenorrhea, and self-care behavior for dysmenorrhea. Descriptive data analysis was performed using SPSS 23.0 software, and AMOS 23.0 was used to verify and analyze the structural model.

Results

In total, 1851 valid questionnaires were collected; the effective recovery rate was 93.15%, and the prevalence of dysmenorrhea was 64.51%. e-Health literacy (B = 0.171, P < 0.001), self-efficacy (B = 0.416, P < 0.001), self-care agency (B = 1.177, P < 0.001), and degree of dysmenorrhea (B = 0.310, P < 0.001) significantly influenced self-care behavior for dysmenorrhea. The total, direct, and indirect effects of e-health literacy and self-efficacy on self-care behavior for dysmenorrhea were 0.158 and 0.492, 0.128 and 0.248, and 0.030 and 0.244, respectively.

Conclusion

The self-care behavior for dysmenorrhea is affected by several factors and self-efficacy has the greatest effect on it. To promote girls to actively implement self-care behavior for dysmenorrhea, educators should strengthen the training of self-efficacy and self-care agency of the nursing students to alleviate the uncomfortable experience brought by dysmenorrhea and decrease the harm of dysmenorrhea. Implications for Nursing Management. Nursing managers should work with constant efforts to explore and optimize the management model for dysmenorrhea, encouraging young women to actively engage in self-care behavior for dysmenorrhea, to alleviate the discomfort experienced by individuals and improve women's overall health.

Myokines as mediators of exercise-induced cognitive changes in older adults: protocol for a comprehensive living systematic review and meta-analysis

Background

The world's population is aging, but life expectancy has risen more than healthy life expectancy (HALE). With respect to brain and cognition, the prevalence of neurodegenerative disorders increases with age, affecting health and quality of life, and imposing significant healthcare costs. Although the effects of physical exercise on cognition in advanced age have been widely explored, in-depth fundamental knowledge of the underlying mechanisms of the exercise-induced cognitive improvements is lacking. Recent research suggests that myokines, factors released into the blood circulation by contracting skeletal muscle, may play a role in mediating the beneficial effect of exercise on cognition. Our goal in this ongoing (living) review is to continuously map the rapidly accumulating knowledge on pathways between acute or chronic exercise-induced myokines and cognitive domains enhanced by exercise.

Method

Randomized controlled studies will be systematically collected at baseline and every 6 months for at least 5 years. Literature search will be performed online in PubMed, EMBASE, PsycINFO, Web of Science, SportDiscus, LILACS, IBECS, CINAHL, SCOPUS, ICTRP, and ClinicalTrials.gov. Risk of bias will be assessed using the Revised Cochrane Risk of Bias tool (ROB 2). A random effects meta-analysis with mediation analysis using meta-analytic structural equation modeling (MASEM) will be performed. The primary research question is to what extent exercise-induced myokines serve as mediators of cognitive function. Secondarily, the pooled effect size of specific exercise characteristics (e.g., mode of exercise) or specific older adults' populations (e.g., cognitively impaired) on the relationship between exercise, myokines, and cognition will be assessed. The review protocol was registered in PROSPERO (CRD42023416996).

Discussion

Understanding the triad relationship between exercise, myokines and cognition will expand the knowledge on multiple integrated network systems communicating between skeletal muscles and other organs such as the brain, thus mediating the beneficial effects of exercise on health and performance. It may also have practical implications, e.g., if a certain myokine is found to be a mediator between exercise and cognition, the optimal exercise characteristics for inducing this myokine can be prescribed. The living review is expected to improve our state of knowledge and refine exercise regimes for enhancing cognitive functioning in diverse older adults' populations.

Registration

Systematic review and meta-analysis protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on the 24th of April 2023 (registration number CRD42023416996).

Mediating effect of post-stroke depression between activities of daily living and health-related quality of life: meta-analytic structural equation modeling

BACKGROUND

Stroke survivors face various problems that affect their health-related quality of life (HRQoL). Reduced activities of daily living (ADL) may contribute to post-stroke depression (PSD) and low HRQoL, and depression might be associated with low HRQoL. However, these relationships are not well known. This study aimed to analyze correlations among ADL, PSD, and HRQoL in stroke survivors and further explore the mediating role of PSD between ADL and HRQoL.

METHODS

This study utilized meta-analytic structural equation modeling (MASEM) on systematically searched articles from six electronic databases, namely PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (China), Wanfang database (China), and SinoMed (China), from inception up to July 31, 2021. Two researchers independently assessed study eligibility, and data from the eligible studies were encoded and assessed for quality. MASEM was utilized to examine correlations among ADL, PSD, and HRQoL, with an estimation of a pooled correlation matrix under a random-effects model. The matrix was directly fitted to a structural equation model using webMASEM.

RESULTS

In total, 8580 articles were screened, and data from 27 studies involving 33 effect sizes were used in the MASEM analysis. Correlations among the three variables were significant (both P < 0.01). Furthermore, PSD partially mediated the correlation between ADL and HRQoL (β = 0.24, 95% confidence interval 0.15-0.30).

CONCLUSIONS

The findings suggest that both decreased ADL and PSD may reduce HRQoL, while a decrease in ADL tends to cause depression after stroke. Therefore, ADL and PSD reductions should be improved to achieve better HRQoL of stroke survivors. Future studies should continue to discuss other factors affecting HRQoL to achieve optimal recovery in stroke survivors.

Psychosocial family-level mediators in the intergenerational transmission of trauma: Protocol for a systematic review and meta-analysis

INTRODUCTION

Family-level psychosocial factors appear to play a critical role in mediating the intergenerational transmission of trauma; however, no review article has quantitatively synthesized causal mechanisms across a diversity of trauma types. This study aims to systematically consolidate the epidemiological research on family-level psychosocial mediators and moderators to ultimately produce causal diagram(s) of the intergenerational transmission of trauma.

METHODS

We will identify epidemiological peer-reviewed publications, dissertations, and conference abstracts that measure the impact of at least one psychosocial family-level factor mediating or moderating the relationship between parental trauma exposure and a child mental health outcome. English, French, Kinyarwanda, and Spanish articles will be eligible. We will search MEDLINE, PsycINFO, PTSDpubs, Scopus, and ProQuest Dissertations and Theses and will conduct forward citation chaining of included documents. Two reviewers will perform screening independently. We will extract reported mediators, moderators, and relevant study characteristics for included studies. Findings will be presented using narrative syntheses, descriptive analyses, mediation meta-analyses, moderating meta-analyses, and causal diagram(s), where possible. We will perform a risk of bias assessment and will assess for publication bias.

DISCUSSION

The development of evidence-based causal diagram(s) would provide more detailed understanding of the paths by which the psychological impacts of trauma can be transmitted intergenerationally at the family-level. This review could provide evidence to better support interventions that interrupt the cycle of intergenerational trauma.

TRIAL REGISTRATION

Systematic review registration: PROSPERO registration ID #CRD42021251053.

DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5-19 years-a protocol for systematic review and meta-analysis

INTRODUCTION

Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB.

METHODS AND ANALYSIS

A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used.

ETHICS AND DISSEMINATION

No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance.

SYSTEMATIC REVIEW REGISTRATION

CRD42021282874.

Modern Meta-Analytic Methods in Prevention Science: Introduction to the Special Issue

Meta-analyses that statistically synthesize evidence from multiple research studies can play an important role in advancing evidence-informed prevention science. When done in the context of a well-conducted systematic review, meta-analysis is a powerful tool for synthesizing evidence and exploring research questions that are difficult to address in individual studies, such as the association of individual study limitations on intervention effect estimates, replicability of empirical findings, and variation of effect estimates across populations and settings. Alongside the rapid growth in the number of published reviews and meta-analyses, there has been a parallel growth in the development of meta-analytic techniques to handle the increasingly complex types of questions and types of evidence relevant to prevention science. Despite this rapid evolution of meta-analytic techniques and approaches, there is still a lag between the development of new techniques and their uptake by researchers in the field. This paper serves as a brief introduction to this special issue of Prevention Science, entitled "Modern Meta-Analytic Methods in Prevention Science," which highlights recent developments in meta-analytic methods and demonstrates their application to prevention research. This special issue makes an important contribution to the field by ensuring these methodological advances are widely accessible to prevention science researchers, thereby improving their uptake and utilization, and ultimately improving the utility and rigor of research syntheses for informing evidence-based decision making in prevention.

Online Interventions to Improve Mental Health of Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis

Objective: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement. Methods: On June 25-30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis. Results: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04-0.66) and psychological well-being g = 0.32 (95% CI 0.09-0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI -0.13 to 0.47), anxiety g = 0.05 (95% CI -0.15 to 0.25), and pain g = 0.13 (95% CI -0.13 to 0.39). Conclusion: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn. The study protocol was registered in PROSPERO (CRD42021266276).