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. 2017 Nov 2;47(1):332–347. doi: 10.1093/ije/dyx201
Importance of theory
  1. Choose a spillover parameter and study design based on theory about how the intervention’s effects diffuse through a population.

  2. Especially when theory to support spillovers of an intervention is weak, use rigorous designs, such as the double-randomized design, in order to make causal inferences.

Causal inferences about spillovers
  • 3.To estimate cluster-level spillovers, distance-based spillovers or spillovers conditional on treatment density, use a double-randomized design to maximize internal validity.

  • 4.If it is only possible to use a cluster-randomized design, consider using multivariate matching techniques to match untreated individuals in the control clusters to untreated individuals in the treatment clusters. Matching may improve balance for measured confounders; however, unmeasured confounding may remain, and external validity may decrease depending on the subset of the population that is matched.

  • 5.If a clustered study design is used, build in buffer zones between treated and control units in order to prevent contamination and ensure that there is a valid control group to serve as a counterfactual.

  • 6.Use individual-level outcomes to measure spillovers when possible. Group-level measurements can be useful for hypothesis generation when individual-level measurements are unavailable.

Pre-specifying analyses
  • 7.Pre-specify the specific spillover parameter(s) to be estimated.

  • 8.Pre-specify the scale at which spillovers are expected and the hypothesized mechanism(s) of spillover.

  • 9.If the spillover parameter incorporates measurement within specific distances or areas, pre-specify distance or area definitions and provide a rationale for them based on the hypothesized strength and scale of spillovers to avoid selectively choosing cutoffs that provide favourable results. For example, describe the specific distances in which measurement will take place or describe whether measurement will occur within quantiles of the observed distance distribution.

  • 10.If the study protocol is registered, use the terms ‘spillovers’ or ‘indirect effects’ to refer to spillovers in the protocol because these are the most commonly used terms in the literature, and they provide a direct link to the theoretical literature on this topic.