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Latent Class Analysis: An Alternative Perspective on Subgroup Analysis in Prevention and Treatment

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Abstract

The overall goal of this study is to introduce latent class analysis (LCA) as an alternative approach to latent subgroup analysis. Traditionally, subgroup analysis aims to determine whether individuals respond differently to a treatment based on one or more measured characteristics. LCA provides a way to identify a small set of underlying subgroups characterized by multiple dimensions which could, in turn, be used to examine differential treatment effects. This approach can help to address methodological challenges that arise in subgroup analysis, including a high Type I error rate, low statistical power, and limitations in examining higher-order interactions. An empirical example draws on N = 1,900 adolescents from the National Longitudinal Survey of Adolescent Health. Six characteristics (household poverty, single-parent status, peer cigarette use, peer alcohol use, neighborhood unemployment, and neighborhood poverty) are used to identify five latent subgroups: Low Risk, Peer Risk, Economic Risk, Household & Peer Risk, and Multi-Contextual Risk. Two approaches for examining differential treatment effects are demonstrated using a simulated outcome: 1) a classify-analyze approach and, 2) a model-based approach based on a reparameterization of the LCA with covariates model. Such approaches can facilitate targeting future intervention resources to subgroups that promise to show the maximum treatment response.

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Correspondence to Stephanie T. Lanza.

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This study was supported by Award Numbers P50-DA010075 and R03-DA023032 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The authors wish to thank John J. Dziak for helpful advice on the simulation of an outcome variable. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.

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Lanza, S.T., Rhoades, B.L. Latent Class Analysis: An Alternative Perspective on Subgroup Analysis in Prevention and Treatment. Prev Sci 14, 157–168 (2013). https://doi.org/10.1007/s11121-011-0201-1

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