Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
7458549 | Health & Place | 2014 | 8 Pages |
Abstract
Randomized controlled trials (RCTs) of interventions intended to modify health behaviors may be influenced by neighborhood effects which can impede unbiased estimation of intervention effects. Examining a RCT designed to increase colorectal cancer (CRC) screening (N=5628), we found statistically significant neighborhood effects: average CRC test use among neighboring study participants was significantly and positively associated with individual patient's CRC test use. This potentially important spatially-varying covariate has not previously been considered in a RCT. Our results suggest that future RCTs of health behavior interventions should assess potential social interactions between participants, which may cause intervention arm contamination and may bias effect size estimation.
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Authors
Sandi L. Pruitt, Tammy Leonard, James Murdoch, Amy Hughes, Amy McQueen, Samir Gupta,