Subjective Expectations and Health-Related Behavior

主观期望和健康相关行为

• 批准号: 7849746
• 负责人: ADELINE DELAVANDE
• 金额: $ 9.52万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-22 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7849746
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Affect; Africa South of the Sahara; African; Anti-Retroviral Agents; Behavior; Behavior Therapy; Behavioral; Belief; Characteristics; Counseling; Country; Data; Decision Making; Developing Countries; Development; Disease; Economic Conditions; Effectiveness; Environment; Epidemic; Face; Family; Family health status; Family member; Funding; Future; Goals; HIV Infections; Health; Health Care Seeking Behavior; Health Status; Individual; Intervention; Knowledge; Life; Longitudinal Studies; Malawi; Measures; Morbidity - disease rate; Outcome; Perception; Probability; Process; Recommendation; Research; Respondent; Risk; Risk Factors; Risk Reduction; Risk-Taking; Rural; Schedule; Severity of illness; Sex Behavior; Social Interaction; Structural Models; Surveys; Systematic Bias; Techniques; Testing; Time; Treatment Effectiveness; Uncertainty; Update; Vision; base; burden of illness; design; expectation; fighting; innovation; literacy; mortality; public health relevance; response; socioeconomics; treatment strategy

DESCRIPTION (provided by applicant): Subjective expectations are an important determinant of health-related behaviors in developing country contexts as individuals face substantial uncertainty about their own and other family members' health, the relationships between health-inputs and health-outcomes, the effectiveness of treatment strategies and health-seeking behaviors, and the risk-environment affecting the severity of the disease burden and the consequences of behavioral choices. Yet, little is known about health-related expectations in these contexts. This lack of knowledge severely limits our ability to understand the decision processes affecting individual's health in developing countries and to devise effective health interventions. The overall goal of this project is therefore to analyze, for the first time in a sub-Saharan context, newly-collected, large-scale and exceptionally detailed data on probabilistic subjective expectations, that is, expectations that are measured on a numeric scale and can be interpreted as probabilities. These data have been collected in 2006 using an innovative interactive elicitation format, developed by this research team, from about 3,000 respondents living in rural Malawi, and include probabilistic subjective expectations about individual's own and family member's health, mortality, morbidity, changes in economic conditions, and perceptions of treatment effectiveness. In particular, this project will evaluate (i) whether respondents in sub-Saharan Africa have well-defined probabilistic expectations, and how those relate to expectations elicited using a verbal scale, (ii) whether subjective expectations are accurate and vary systematically with health risks and risk-taking behaviors, (iii) whether these expectations are determined and/or correlated with socioeconomic characteristics and measures of respondents prior behaviors, (iv) how subjective expectations reflect the perceived effectiveness of important health interventions that are currently being implemented in sub-Saharan African countries, and (iv) how subjective expectations are updated over time, including particularly after providing individuals knowledge about their objective health status. Finally, the findings of this project will be used to develop recommendations for the elicitation and analysis of health-related subjective expectations in developing country contexts, and the results of these analyses will inform a future R01 application by this research team that develops and estimates structural models of health decision-making under uncertainty to understand the mechanisms through which subjective expectations affect important health-outcomes in sub-Saharan contexts with high morbidity and mortality. PUBLIC HEALTH RELEVANCE: Subjective expectations are an important determinant of health-related behaviors in developing country contexts, yet little is known about health-related expectations in these contexts. This lack of knowledge not only limits our understanding of relevant behaviors, but also hampers the development of appropriate health-interventions. Utilizing data that has been collected during 2006 in rural Malawi using an innovative interactive elicitation technique, the proposed project promises to provide significant and important new in- sights to our knowledge of health-related expectations in sub-Saharan Africa.

描述（申请人提供）：在发展中国家，主观期望是健康相关行为的一个重要决定因素，因为个人对自己和其他家庭成员的健康、健康投入与健康结果之间的关系、治疗策略的有效性和寻求健康的行为都面临很大的不确定性，以及影响疾病负担严重程度和行为选择后果的风险环境。然而，在这些背景下，对健康相关的期望知之甚少。这种知识的缺乏严重限制了我们理解影响发展中国家个人健康的决策过程和制定有效卫生干预措施的能力。因此，该项目的总体目标是首次在撒哈拉以南地区分析新收集的关于概率性主观预期的大规模和非常详细的数据，即以数字尺度衡量并可解释为概率的预期。这些数据是在2006年使用本研究小组开发的创新互动启发式格式从马拉维农村地区约3 000名受访者中收集的，其中包括对个人自身和家庭成员健康、死亡率、发病率、经济条件变化以及对治疗效果的看法的概率主观预期。特别是，该项目将评估（i）撒哈拉以南非洲的受访者是否有明确的概率预期，以及这些预期与使用口头量表得出的预期之间的关系，（ii）主观预期是否准确，是否随健康风险和冒险行为而系统地变化，（iii）这些期望是否与社会经济特征和受访者先前行为的测量结果确定和/或相关，（iv）主观期望如何反映目前在撒哈拉以南非洲国家实施的重要健康干预措施的感知有效性，以及（iv）主观期望如何随着时间的推移而更新，特别是在向个人提供有关其客观健康状况的知识之后。最后，该项目的研究结果将用于制定建议，以启发和分析发展中国家与健康有关的主观期望，这些分析的结果将为该研究团队未来的R 01应用提供信息，该应用开发和估计不确定性下健康决策的结构模型，以了解主观期望影响重要健康的机制-在撒哈拉以南非洲发病率和死亡率高的情况下， 公共卫生关系：主观期望是发展中国家健康相关行为的一个重要决定因素，但对这些背景下的健康相关期望知之甚少。这种知识的缺乏不仅限制了我们对相关行为的理解，也阻碍了适当健康干预措施的发展。利用2006年在马拉维农村使用创新的互动启发技术收集的数据，拟议的项目有望为我们了解撒哈拉以南非洲地区与健康相关的期望提供重要的新见解。