Context dependent preferences in prestige bias learning about vaccination in rural Namibian pastoralists

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
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Abstract

Extensive work in the social sciences suggests that vaccination decisions are subject to incentives, biases, and social learning processes, including prestige bias transmission. High status figures, like doctors and public health officials, can be effective messengers for vaccination information and uptake under certain conditions. In communities where there is significant medical mistrust and less interaction with markets and formal medical systems, prestige bias social learning may operate through different channels. Here, we examine the role of prestige bias on vaccine decisions in two ethnic groups (Himba and Herero) with varying levels of market integration and experiences with formal healthcare systems. Participants completed a ranking task, comparing the influence of four prestigious individuals on vaccine decisions and a survey on medical mistrust. Using Plackett-Luce models, we compare the influence of location, ethnic affiliation, and other covariates on rankings. A multi-level model compared the influence of those within and outside one's ethnic group, as well as specialist (doctor/healer) and generalist (chief/governor) prestige figures. Results indicate changes in the rank of prestigious individuals across the rural-urban gradient. Our results demonstrate significant variability in prestige-biased social learning about vaccine decision making. Medical mistrust did not impact rankings. Contrary to previous work, we find that whether a prestigious individual is locally prominent is more important than their expertise in the relevant domain (health and healing). These findings emphasize the need for more context-specific studies of prestige bias, which can improve our understanding of healthcare decision-making and guide public health messaging across diverse contexts.
纳米比亚农村牧民对疫苗接种的威望偏好取决于具体情况。
社会科学领域的大量研究表明,疫苗接种决定受制于激励、偏见和社会学习过程,包括声望偏见的传播。在某些条件下,医生和公共卫生官员等地位较高的人可以成为疫苗接种信息和接种率的有效传播者。在医疗不信任严重、与市场和正规医疗系统互动较少的社区,声望偏见的社会学习可能会通过不同的渠道进行。在此,我们研究了声望偏差对两个族群(辛巴族和赫雷罗族)疫苗接种决策的影响,这两个族群的市场一体化程度和与正规医疗系统的接触经验各不相同。受试者完成了一项排名任务,比较了四个有声望的人对疫苗接种决策的影响,并完成了一项关于医疗不信任的调查。利用 Plackett-Luce 模型,我们比较了地点、种族归属和其他协变量对排名的影响。一个多层次模型比较了族群内外的影响,以及专科医生(医生/治疗师)和全科医生(主任/州长)声望的影响。结果表明,在城乡梯度上,有名望的人的等级发生了变化。我们的研究结果表明,在疫苗决策方面,有威望的社会学习存在很大差异。医疗不信任并不影响排名。与以往的研究相反,我们发现有名望的人在当地是否有名望比他们在相关领域(健康和治疗)的专业知识更重要。这些发现强调了对声望偏差进行更多特定情境研究的必要性,这些研究可以提高我们对医疗决策的理解,并指导不同情境下的公共卫生信息传播。
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来源期刊
Social Science & Medicine
Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
9.10
自引率
5.60%
发文量
762
审稿时长
38 days
期刊介绍: Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.
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