Doctoral Dissertation Research In Economics: Misinformed or In Denial? Explaining the Low Take-Up of Tuberculosis Preventative Therapy

经济学博士论文研究：误导还是否认？

• 批准号: 2242574
• 负责人: Debraj Ray
• 金额: $ 2.5万
• 依托单位: New York University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2024-03-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2242574&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Economics; Misinformed

Low adoption rates of preventative health technologies, such as immunization, around the world is a major public health problem, yet it is generally not understood why households underinvest in preventative health. This project uses field experiments to seek behavioral explanations for such under-investment using the Tuberculosis Preventative Therapy (TPT)—a course of medication that prevents the progression of latent Tuberculosis (TB) infection into disease---as a case study. TPT uptake among adult contacts is low, despite being offered at no cost to the recipient. This project investigates whether this is due to incorrect beliefs of low infection risk (misinformation), or if contacts do not take the therapy for fear of being stigmatized or fear of adverse drug reactions (motivated beliefs). While misinformation can be solved with targeted information campaigns, motivated beliefs may not be easily solved, hence it is important to disentangle these behavioral sources of under-investment in formulated effective public health policies. The results of this research will provide major guide to developing polices to increase investment in preventative health, thus improving the level of health and human capital generally. Improved health and general human capital would also lead to faster economic growth, further increasing the living standards of Americans. Two behavioral explanations for incorrect beliefs about low infection risk are hypothesized---lack of awareness about the risk of contracting the infection (misinformed beliefs) and deliberate underestimation of infection risk to cope with fears of stigmatization (motivated beliefs about low susceptibility). To test these hypotheses, adult household who have contacts with a recently diagnosed pulmonary TB patients will be surveyed to elicit beliefs about TB infection risk. The elicited beliefs will be used to empirically test theoretical predictions for motivated belief formation (against misinformation). To account for an alternate possibility of motivation by high non-monetary costs, the project also elicits how contacts trade off the non-monetary costs of TPT against the expected benefits, using discrete choice experiments with hypothetical TPT-taking scenarios. The beliefs and preferences thus elicited will then be used to estimate a model of contacts’ TPT uptake decisions; the estimates will be used to simulate contacts’ responses under various counterfactual policy scenarios. The results of this research will provide major guide to developing polices to increase investment in preventative health, thus improving the level of health and human capital generally.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

世界各地预防性健康技术（例如免疫接种）的采用率低是一个主要的公共卫生问题，但人们普遍不明白为什么家庭对预防性健康的投资不足。该项目使用现场实验，以结核病预防治疗（TPT）-一种防止潜伏性结核病（TB）感染发展为疾病的药物治疗过程-作为案例研究，寻求这种投资不足的行为解释。成人接触者的TPT摄取率很低，尽管接受者可以免费获得TPT。该项目调查这是否是由于低感染风险的错误信念（错误信息），或者如果接触者不采取治疗害怕被污名化或药物不良反应的恐惧（动机信念）。虽然错误的信息可以解决有针对性的信息运动，动机的信念可能不容易解决，因此，重要的是要解开这些行为的投资不足，制定有效的公共卫生政策的来源。 本研究结果将为制定政策增加预防性卫生投资，从而全面提高健康水平和人力资本水平提供重要指导。 健康和一般人力资本的改善也将导致更快的经济增长，进一步提高美国人的生活水平。 两种行为解释的不正确的信念低感染风险的假设-缺乏认识的风险感染（误导的信念）和故意低估的感染风险，以科普恐惧的耻辱（动机信念低易感性）。为了验证这些假设，将对与最近确诊的肺结核患者有接触的成年家庭进行调查，以了解他们对结核感染风险的看法。引出的信念将用于实证检验理论预测的动机信念形成（对错误信息）。为了解释高非货币成本激励的另一种可能性，该项目还利用假设TPT采取情景的离散选择实验，阐明了联系人如何权衡TPT的非货币成本与预期收益。由此引出的信念和偏好，然后将被用来估计接触的TPT摄取决策的模型，估计将被用来模拟各种反事实的政策情景下的接触的反应。 这项研究的结果将为制定政策以增加对预防性健康的投资提供重要指导，从而普遍提高健康水平和人力资本。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。