Subjective Expectations and Birth Control Choice

描述（由申请人提供）：尽管事实上避孕药具有可能几乎消除怀孕和性传播疾病（性病），但2002年全国家庭增长调查的数据显示，几乎一半的怀孕是意外的（其中大约一半以堕胎告终），性病仍然是一个主要的健康威胁（疾病控制和预防中心，2003年，每年发生1900万性病感染）。也许，如果我们更好地了解避孕选择，我们就可以向个别妇女推荐更适当的方法，制定更好的保健干预措施和社会营销活动，并构思更令人满意的避孕药具；从而减少意外怀孕和性病。该项目结合了数据收集和离散选择建模的最新进展，由首席研究员（PI）推进我们对避孕选择的理解。具体来说，虽然以前的避孕选择研究通常试图建立社会经济特征与方法选择之间的简化关系模型，但我们采取了更结构性的计量经济学方法。我们将选择避孕药具的差异建模为避孕药具属性的重要性差异（例如，预防受孕、预防性病传播、副作用和成本）以及这些避孕药具感知特征的差异。我们的数据（由pi设计的NLS-Y97的补充）直接测量了个人对避孕药属性和避孕药感知特征的感知（或期望）。我们的计量经济模型就是用来分析这种形式的数据的。由此产生的参数估计使我们能够模拟政策（例如，价格补贴或信息运动）对避孕选择和意外怀孕的影响。研究的具体目的是：(1)了解女性对避孕方法属性的主观期望如何随社会经济特征而变化；(2)通过与最佳临床证据进行比较，评估女性对节育方法有效性认知的准确性；(3)使用结构效用框架估计女性对节育方法属性的偏好；(4)评估可观察特征对偏好的影响，并量化各种属性在女性使用避孕方法决策中的相对权重；(5)模拟政策对避孕措施使用和意外怀孕的影响。

DESCRIPTION (provided by applicant): Despite the fact that contraceptives have the potential to nearly eliminate pregnancy and sexually transmitted diseases (STDs), data from the 2002 National Survey of Family Growth show that almost half the pregnancies are unintended (and approximately half of them end in an abortion) and STDs continue to be a major health threat (19 million STD infections occur annually, Centers for Disease Control and Prevention, 2003). Perhaps, if we better understood contraceptive choices, we could recommend more appropriate methods to individual women, develop better health interventions and social marketing campaigns, and conceive more satisfactory contraceptives; and thereby lower unintended pregnancies and STDs. This project combines recent advances in data collection and modeling of discrete choices by the principal investigator (PI) to advance our understanding of contraceptive choices. Specifically, while previous studies of contraceptive choice have usually sought to model the reduced-form relationship between socioeconomic characteristics and method choice, we take a more structural econometric approach. We model variation in contraceptives chosen as arising from differences in the importance of attributes of contraceptives (e.g., preventing conception, preventing transmission of STDs, side-effects, and cost) and differences in the perceived characteristics of those contraceptives. Our data-a supplement to the NLS-Y97 designed by the PI-directly measure individual perceptions (or expectations) of the attributes of contraceptives and the perceived characteristics of the contraceptives. Our econometric model is designed to analyze data of this form. The resulting parameter estimates allow us to simulate the effect of policies (e.g., price subsidies or information campaigns) on contraceptive choice and unintended pregnancy. The specific aims of the research are to: (1) understand how women's subjective expectations about birth control methods' attributes vary according to socioeconomic characteristics; (2) assess the accuracy of women's perceptions of the efficacy of birth control methods by comparing perceptions with the best clinical evidence, (3) estimate women's preferences about birth control methods' attributes using a structural utility framework, (4) evaluate how preferences vary by observable characteristics and quantify the relative weight of various attributes in a women's decision to use a method; and (5) simulate the effect of policies on contraception use and unintended pregnancies.