Kin Network Experiences, Mortality Perceptions, and Health Behaviors in Malawi

马拉维的 Kin 网络体验、死亡率认知和健康行为

基本信息

批准号：
10612907
负责人：
Emily Smith-Greenaway
金额：
$ 8.25万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10612907
关键词：
Address Adolescence Adult African Age Behavior Behavioral Birth Catalogs Cessation of life Child Child Mortality Childhood Cognitive Communities Country Data Demography Effectiveness Enrollment Ensure Form Perception HIV Health Health Campaign Health behavior Health care facility Healthcare Individual Intervention Knowledge Learning Life Life Cycle Stages Link Literature Malawi Measures Mediating Mediation Methods Modeling Mortality Decline Mortality Determinants Parents Pattern Perception Personality Traits Persons Population Positioning Attribute Probability Reaction Recording of previous events Report (document)Reproductive Behavior Research Respondent Sampling Siblings Social Change Social Network Stretching Techniques Time Trust Woman Women&apos s Health Work age difference catalyst cohort effective intervention experience grandparent health belief health care service utilization human old age (65+)improved infant death mortality novel population health psychosocial risk perception social social cognitive theory social factors sociodemographic factors statistics theories trait young adult

项目摘要

Project Summary Child mortality rates have declined dramatically over the past 40 years, especially in African countries like Malawi. Yet, research shows that many individuals in the communities experiencing this swift change do not perceive it but think instead that mortality levels are far higher than empirically true or even increasing. We lack a comprehensive assessment of the social experiences that encourage these distorted perceptions of community mortality conditions. Additionally, key but untested hypotheses hold that mortality perceptions may be entwined with schemas of healthcare; if elevated mortality perceptions correspond with lower trust in and use of formal healthcare, they could feed a cycle of stalled population health improvements. Given mortality perceptions are a causal lynchpin in theories of demographic change and may be a harbinger of skepticism about formal healthcare, identifying the social factors that inform such perceptions is of critical importance. Grounded in life course theory and social learning theory, the proposed study will leverage detailed kin history data to offer the first empirical analysis of whether kin network mortality experiences are principal determinants of mortality perceptions in adulthood. The project will also offer the first empirical assessment of whether mortality perceptions are intimately entwined with schemas of formal healthcare and use of health services. The project will rely on data from Tsogolo la Thanzi, a study of women in Balaka, Malawi (2009-2019), which features full kin history data; subjective probabilities elicited with an interactive technique; comprehensive information on women’s healthcare use; and rich measures of women’s recent network mortality, sociodemographic factors, personality traits, health, and additional subjective perceptions. The study will offer a comprehensive, life course overview of experiences of kin loss, including the type, intensity, and timing of deaths from before one’s birth through young adulthood (Aim 1). With multiple indicators of kin loss generated through the completion of Aim 1, the study will identify which experiences of kin loss pattern women’s subjective perceptions of community mortality conditions (Aim 2). The study will then establish how both kin mortality and mortality perceptions relate to perceptions and use of formal healthcare (Aim 3). Together, the results from this research will address a longstanding puzzle in demography by clarifying whether kin network experiences can complicate the potential for individuals to readily perceive and react to mortality decline and will clarify the broader relevance of this for population health. Given evidence that adults’ perceptions are modifiable, the proposed research will offer critical knowledge for the implementation of effective interventions in Malawi.

项目概要过去 40 年来，儿童死亡率急剧下降，尤其是在非洲国家，例如然而，研究表明，马拉维社区中的许多人并没有经历这种迅速的变化。感知到这一点，但认为死亡率远高于经验事实，甚至还在增加。对助长这些扭曲的社区认知的社会经历进行全面评估此外，关键但未经检验的假设认为，死亡率观念可能是相互交织的。与医疗保健模式有关；死亡率认知的升高是否与对正规医疗机构的信任度和使用率较低相对应鉴于死亡率认知是一个停滞的人口健康改善周期，它们可以促进医疗保健。人口变化理论中的因果关键，可能是对形式的怀疑的预兆医疗保健，确定影响这种看法的社会因素至关重要。课程理论和社会学习理论，拟议的研究将利用详细的亲属历史数据来提供关于亲属网络死亡经历是否是死亡主要决定因素的首次实证分析该项目还将首次对死亡率进行实证评估。观念与正规医疗保健和卫生服务的使用密切相关。将依赖 Tsogolo la Thanzi 的数据，这是一项针对马拉维巴拉卡妇女的研究（2009-2019 年），该研究全面亲属历史数据；通过交互技术得出的主观概率；妇女的医疗保健使用情况；以及妇女近期网络死亡率、社会人口因素的丰富衡量标准，该研究将提供全面的生命历程。概述失去亲人的经历，包括出生前死亡的类型、强度和时间到成年早期（目标 1），通过完成目标而产生多种亲属丧失指标。 1、本研究将确定哪些亲人丧失模式的经历影响了女性对社区的主观认知然后，该研究将确定亲属死亡率和死亡率认知之间的关系。这项研究的结果将共同解决对正规医疗保健的看法和使用（目标 3）。通过澄清亲属网络经历是否会使潜力复杂化，这是人口学中长期存在的难题使个人能够容易地感知死亡率下降并做出反应，并将阐明这一点对更广泛的相关性鉴于有证据表明成年人的看法是可以改变的，拟议的研究将提供重要的信息。在马拉维实施有效干预措施的知识。