Would it be possible to estimate a 1-2-1 multilevel mediation model with Stan? A 1-2-1 multilevel mediation model is a model in which the exposure is measured at level 1 (e.g. individual study participant’s income), the mediator is measured at level 2 (e.g. neighborhood disorder), and the outcome is measured at level 1 (e.g. individual cardiovascular disease).
An approach to such models is given by Preacher, Zyphur and Zhang in A general multilevel SEM framework for assessing multilevel mediation. Psychological Methods. 2010;15(3):209-233. doi:[10.1037/a0020141]
Additionally, there is a survival-type outcome, there might be reason to expect spatial autocorrelation, and there is also reason to expect there is a variable that acts as an effect modifier for the association between exposure and mediator.