Subjective Expectations and Birth Control Choice

说明(申请人提供)：尽管避孕药具有可能几乎消除怀孕和性传播疾病(STD)，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怀孕(其中大约一半以流产告终)，STD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1900万例STD感染)。也许，如果我们更好地了解避孕选择，我们可以向个别妇女推荐更适当的方法，制定更好的健康干预措施和社会营销活动，并构思更令人满意的避孕措施；从而降低意外怀孕和性传播疾病。该项目结合了首席调查员(PI)在数据收集和离散选择建模方面的最新进展，以促进我们对避孕选择的理解。具体地说，虽然以前关于避孕选择的研究通常试图模拟社会经济特征和方法选择之间的简化关系，但我们采取了更具结构性的计量经济学方法。我们根据避孕药具属性的重要性(例如，防止受孕、防止性病传播、副作用和成本)的不同以及这些避孕药具的感知特征的不同，来模拟所选择的避孕药具的差异。我们的数据是由PI设计的NLS-Y97的补充，直接衡量个人对避孕药具属性的感知(或期望)和避孕药具的感知特征。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。这项研究的具体目的是：(1)了解妇女对节育方法属性的主观期望如何随着社会经济特征的不同而变化；(2)通过将感知与最佳临床证据进行比较，评估妇女对节育方法有效性的认知的准确性；(3)使用结构性效用框架估计妇女对节育方法属性的偏好；(4)评估偏好如何因可观察到的特征而变化，并量化各种属性在妇女决定使用方法时的相对权重；以及(5)模拟关于避孕措施和意外怀孕的政策的影响。

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.