Neighborhood effects in a behavioral randomized controlled trial

被引:6
作者
Pruitt, Sandi L. [1 ,2 ]
Leonard, Tammy [3 ]
Murdoch, James [4 ]
Hughes, Amy [1 ,4 ]
McQueen, Amy [5 ]
Gupta, Samir [6 ,7 ]
机构
[1] Univ Texas SW Med Ctr Dallas, Dept Clin Sci, Dallas, TX 75390 USA
[2] Harold C Simmons Comprehens Canc Ctr, Dallas, TX 75390 USA
[3] Univ Dallas, Dept Econ, Irving, TX 75026 USA
[4] Univ Texas Dallas, Sch Econ Polit & Policy Sci, Richardson, TX 75080 USA
[5] Washington Univ, Sch Med, Dept Med, Div Hlth Behav Res, St Louis, MO 63110 USA
[6] Univ Calif San Diego, Moores Canc Ctr, Dept Internal Med, Div Gastroenterol, San Diego, CA 92103 USA
[7] San Diego Healthcare Syst, Dept Vet Affairs, San Diego, CA 92161 USA
关键词
Neighborhood; Cancer screening; Peer relationships; Spatial autocorrelation; Randomized controlled trial; CAUSAL INFERENCE; SOCIAL EPIDEMIOLOGY; IDENTIFICATION; PREDICTORS; RELEVANCE; NETWORK; OBESITY; HEALTH;
D O I
10.1016/j.healthplace.2014.10.001
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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. (C) 2014 Elsevier Ltd. All rights reserved.
引用
收藏
页码:293 / 300
页数:8
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