The Demand for Cancer Screening: Peer Effects or Learning

描述(申请人提供)：宫颈癌是一种重要的疾病负担，特别是在发展中国家。它是全世界女性中第二常见的癌症，也是发展中国家女性中最常见的癌症。虽然宫颈癌可以通过定期筛查来预防，但许多发展中国家的筛查率仍然很低；即使筛查是免费的。越来越多的研究强调了同伴网络在采取健康行为方面的重要性，但同伴影响对癌症筛查接受率的影响程度在很大程度上尚不清楚。这个项目的目的是研究同伴的影响如何影响宫颈癌筛查的需求，并阐明同伴效应的运作渠道。解开对等网络的影响在经验上是具有挑战性的，因为对等网络之间存在相互关联的不可观测问题。为了解决这个问题，我们设计了一个独特的随机实验，在这个实验中，我们收集了尼日利亚12个村庄女性同伴网络的详细信息，然后通过随机分配各种现金激励(以参与筛查为条件)，在网络中创建筛查采用的随机变量。然后，我们利用这种变异来确定女性的筛查决定对她的同龄人的影响。由于我们在各个网络的筛查接受率上存在外生差异，我们的结果具有因果解释。了解同伴效应在癌症筛查需求中的作用，不仅对提高癌症筛查率的战略有意义，还可能提出更有效地针对稀缺预防资源的方法。

DESCRIPTION (provided by applicant): Cervical cancer constitutes a significant disease burden, especially in developing countries. It is the second most common cancer among women worldwide, and the most common cancer among women in developing countries. Although cervical cancer is preventable through regular screening, screening rates in many developing countries remain low; even when screening is free. A growing body of research highlights the importance of peer networks on the adoption of health behaviors, but the extent to which peer influences affect cancer screening take-up is largely unknown. The aim of this project is to study how peer influences affect the demand for cervical cancer screening, and to shed some light on the channels through which peer effects operate. Untangling the effects of peer networks is empirically challenging because of the problem of correlated unobservables among peers. To overcome this problem, we design a unique randomized experiment in which we collect detailed information about women's peer networks in 12 villages in Nigeria and then create random variation in screening adoption across networks by randomly distributing various cash incentives (conditioned on participating in screening). We then exploit this variation to identify the impact f a woman's screening decision on that of her peers. Because we have exogenous variation in screening take-up across networks, our results have a causal interpretation. Understanding the role of peer effects in the demand for cancer screening not only has implications for strategies to increase cancer screening rates but may also suggest ways in which scarce prevention resources might be targeted more efficiently.