The results also demonstrate that randomized prevention trials present a unique opportunity to test G×E hypotheses, an important emerging area in pediatric research and practice. Use of randomized control trials offer advantages over observational designs for detecting G×E interactions in children and adolescents. Observational designs are limited in their ability to identify a true environmental exposure or effect, particularly if the exposure occurs over an extended period of time. The use of intervention strategies such as randomized prevention trials is one means of determining whether an environmental factor has attained causal status. Through the implementation of trials such as SAAF, a causal relation between an environmental manipulation and the alteration of the course of a targeted outcome can be identified (24).
