How do risk preferences relate to malaria care-seeking behavior and the acceptability of a new health technology in Nigeria?

BMC Health Services Research

Dominic Montagu¹  Chinazo Ujuju²  Chinwoke Isiguzo²  Eric Schatzkin¹  Anna De La Cruz¹  Ernest Nwokolo²  Jennifer Anyanti²  Sepideh Modrek³  Jenny Liu¹ 

[1] Global Health Sciences, University of California, San Francisco, 550 16th Street, Mission Hall: Global Health & Clinical Sciences Building, San Francisco, CA 94158, USA;Society for Family Health, No 8 Port Harcourt Crescent, Area 11 Garki, Abuja, Nigeria;General Medical Disciplines, Stanford University, 1070 Arastradero Road Rm 311, Palo Alto, CA 94304-1334, USA

关键词: Nigeria;    Rapid diagnostic tests;    Care-seeking behavior;    Health behavior;    Risk preferences;    Malaria;   

Others  :  1126546
DOI  :  10.1186/1472-6963-14-374

 received in 2014-03-19, accepted in 2014-09-03,  发布年份 2014

【 摘 要 】

Background

To reduce the burden of disease from malaria, innovative approaches are needed to engender behavior change. One unobservable, but fundamental trait—preferences for risk—may influence individuals’ willingness to adopt new health technologies. We explore the association of risk preferences with malaria care-seeking behavior and the acceptability of malaria rapid diagnostic tests (RDTs) to inform RDT scale-up plans.

Methods

In Oyo State, Nigeria, adult customers purchasing anti-malarial medications at selected drug shops took surveys and received an RDT as they exited. After an initial risk preference assessment via a simple lottery game choice, individuals were given their RDT result and treatment advice, and called four days later to assess treatment adherence. We used bivariable and multivariable regression analysis to assess the association of risk game choices with malaria care-seeking behaviors and RDT acceptability.

Results

Of 448 respondents, 63.2% chose the lottery game with zero variance in expected payout, 27.9% chose the game with low variance, and 8.9% chose the game with high variance. Compared to participants who chose lower variance games, individuals choosing higher variance games were older, less educated, more likely to be male, and were more likely to patronize lower quality drug shops, seek care immediately, and report complete disability due to their illness. In contrast, individuals choosing lower variance games were more likely to follow the correct treatment directions and were more likely to report an increase in their willingness to pay for an RDT compared to other risk groups, our two measures of RDT acceptability. Differences in estimated associations between risk game choices and selected care-seeking behaviors remained after controlling sociodemographic confounders.

Conclusions

The uptake of health diagnostic information in terms of translating the RDT experience into willingness to pay for an RDT and treatment adherence to test results may vary according to risk preferences. Hence, health promotion communications may want to be crafted bearing in mind differences in uptake among people of different risk preferences to encourage wider RDT adoption and more rational malaria treatment. Estimates will serve as the basis for power calculations for an expanded study.

【 授权许可】

   
2014 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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