Neighborhood effects in a behavioral randomized controlled trial

Sandi L. Pruitt, Tammy Leonard, James Murdoch, Amy Hughes, Amy McQueen, Samir Gupta

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)293-300
Number of pages8
JournalHealth and Place
StatePublished - Nov 1 2014


  • Cancer screening
  • Neighborhood
  • Peer relationships
  • Randomized controlled trial
  • Spatial autocorrelation

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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