The Longitudinal Egocentric Networks and Norms Study (LENNS) PI: Cristina Bicchieri

Transcription

1 The Longitudinal Egocentric Networks and Norms Study (LENNS) PI: Cristina Bicchieri Coinvestigators: S. Ashraf, U. Das, M. Delea, HP. Kohler, J. Kuang, P. McNally, A. Shpenev, E. Thulin

2 Outline Introduction of project Peter McNally Descriptive statistics Peter McNally Collective behavior profiles Erik Thulin Geospatial data Jinyi Kuang Social network data Alex Shpenev Intervention design Maryann Delea

3 Open defecation in India As of 2015, estimated 40% of Indians practiced open defecation 1 Current Indian government has made eliminating OD by 2019 their flagship campaign (Swachh Bharat Mission) Some efforts that succeeded in other countries were making less headway in India Prevalent OD despite access to toilets 2,3 Could the unique sociocultural landscape of the country be at play? 1 WHO/UNICEF 2015; 2 Coffey et al. 2017; 3 Barnard et al. 2013

4 What could be slowing latrine use in India? Many possible explanatory factors Social networks E.g., is the caste system impacting intervention deployment? How are networks impacting the flow of information and influence? Surrounding social norms? Gender norms? Caste-based intolerance? Norms of purity? Many possible contenders How can one tell? 4 Coffey 2014; 5 Routray et al. 2015; 6 Sahoo et al. 2015

5 The Longitudinal Egocentric Networks and Norms Study (LENNS) Goal: Determine social determinants of latrine use in India Diagnose collective patterns of behaviors around sanitation How norms surrounding OD are influenced by an individual's networks Assess egocentric networks in our sample communities Norms are embedded into networks Assess associations between networks and norms Why is this information useful?

6 Methods Time period Type of participant Number Tools Network survey Sep-Oct years old 3370 HH rosters Name generators Survey, observations FGDs March 2018 Men years old Women years old years old 6 groups (8-10 in each) 6 groups 6 groups 1 per PSU type (rural, periurban, urban) per State Total 18 Norms survey April-June years old 5052 Survey Observations Norms measurements

7 *N=5052 in wave 2 Use during last defecation

8 Toilet ownership (fall 2017 to spring 2018) *Self-report data; observational data also collected *N= 2987 in wave 1 and 2

9 Use given ownership of functional latrines *N=5052 in wave 2

10 Use given ownership of functional latrines *N=5052 in wave 2

11 Collective Patterns of Behavior Profiles

12 Social Norms Theory (Bicchieri, 2016) Personal normative beliefs Empirical expectations Factual beliefs Preference Normative expectations Choice

13 Four types of belief Non-social beliefs Social beliefs/expectations Non-normative beliefs Factual beliefs Empirical expectations Normative beliefs Personal normative beliefs Normative expectations

14 Diagnosis Observe a collective pattern of behavior People prefer to follow it irrespective of what others do People prefer to follow it if they have empirical expectations because it meets a need because of their (nonprudential) personal normative beliefs and empirical expectations suffice to motivate action.. but normative expectations are also needed to motivate action Collective Custom Shared Moral Rule Descriptive Norm Social Norm

15 Last defecation behavior Where did you defecate the last time you had to?

16 Last defecation empirical expectations Out of ten members of your community, how many do you think defecated in the open the last time they needed to defecate?

17 Open defecation personal normative beliefs Society may think it is right or wrong to defecate in the open. Do you personally think it is right, neither right nor wrong, or wrong for someone to defecate in the open?

18 Open defecation personal normative beliefs Those who are going outside [defecating in the open] are helpless, the ones who have a latrine in their house don t do that [...] They are helpless and don t have money to eat, then how can they construct a latrine? Do you personally think it is right, neither right nor wrong, or wrong for someone to defecate in the open? Do you personally think it is right, neither right nor wrong, or wrong for someone who does not have a toilet at home to defecate in the open?

19 Open defecation normative expectations Out of ten members of your community, how many do you think believe that it is wrong to defecate in the open?

20 Analysis of Conditionality Similar direction of findings observed in randomized vignettes

21 Key findings from diagnostics Latrine use appears to be a descriptive norm Avenues for intervention: Increasing empirical expectations Creating a social norm (i.e. creating conditionality on normative expectations) Increasing ownership as an avenue to increase social pressure

22 Surrounding collective practices assessed The emptying of latrine soak pits by non-dalits Latrines being constructed inside the house Imitation of the latrine ownership of the wealthy Women getting their family to build a toilet Male specific open defecation Young women going to defecate in the open alone Young women going to public toilets alone

23 Surrounding collective practices assessed The emptying of latrine soak pits by non-dalits Latrines being constructed inside the house Imitation of the latrine ownership of the wealthy Women getting their family to build a toilet Male specific open defecation Young women going to defecate in the open alone Young women going to public toilets alone

24 Surrounding practices: Women going to OD alone The world is bad.. Men are there to steal money and if a girl is alone imagining what he might do is scary To diagnose a collective behavior, we need information on: Last week behavior: 15% never went alone; 35% always went alone Last use behavior: 62% went alone Personal normative beliefs? Empirical expectations Normative expectations Social conditionality Much more leniency for women using a public toilet alone

25 Networks and norms

26 Are latrines clustered or randomly scattered? No latrine Latrine owner

27 Geographical Network Latrine owners are not randomly scattered in the sampled areas. Toilet owners tend to be close to other toilet owners. No latrine Latrine owner

28 Geographic distribution of latrines

29 Geographic distribution of caste groups

30 Take Away message We found: latrines are not randomly located within a community household is more likely to own a latrine if its neighbors own latrines households that share the same socioeconomic statuses tend to be located near each other These suggest: Relying only on individual level information might not be sufficient to understand the distribution of latrine users social influence might be present in households' latrine construction decision

31 How we collected information about the networks 1. Who would you contact in the event of various crises, such as crop failure or a flood? 2. Who do you respect the most in your community? 3. Who did you have conversations with about toilet use and open defecation? 4. Who would you ask for help if you needed to build a latrine? 5. Who would you ask for help if you needed to clean or repair a latrine?

32 What our networks look like We collected data on: 1. Ego characteristics e.g. sex, age, caste, beliefs 2. Proxy-reported alter characteristics e.g. sex, age, caste, proxy beliefs 1. Alter roles in the network e.g. strength of ties, type of ties, how ego knows the alter 2. Alter-alter ties e.g. directed/undirected, how strong the tie is

33 Who are in respondent's network? Who I talk to about financial problems? Who I respect the most?

34 Who are in respondent's network? Who I talk to about toilets and open defecation? Who I seek help from to build a latrine?

35 Who are in respondent's network? Even if government officials have conversations with individuals about toilet use, it is mostly the family that matters for building the toilet and even more so for repairing or maintaining it. The government is not seen as a useful resource to maintain existing toilets. Who I seek help from to maintain a latrine?

36 Age similarity in the networks

37 Sex similarity in the networks

38 Use similarity in the networks

39 Do networks predict behavior?

40 The proportion of individuals who use a latrine conditional on the age and usage of the alters. Alter toilet users Toilet usage of younger alters is more predictive of one's own usage than of older alters. While the effect is slightly diminished for older alters, it is still very substantial. Alter non-toilet users

41 The proportion of individuals who use a latrine conditional on age and alters' endorsement of OD The presence of normative expectations only has a minor association with one's own toilet use. Alter rejects OD Alter does not reject OD

42 Difference in probability of toilet use between respondents with alters using and not using a toilet Family members are extremely influential even if they don't reside with the respondent. Friends are the most influential non-family category. Neighbors have a limited effect if they are not members of the family or friends.

43 Difference in probability of toilet use between respondents with alters who are believed to endorse toilet use versus did not endorse The effect of normative expectations is much noisier than the effect of empirical expectations. "Other government official" includes retired local heads and their immediate family members. Their opinion (but not behavior) is influential. Aunt, sister, and uncle are the only family members who have a significant effect on behavior.

44 Do networks predict expectations?

45 Networks and expectations Moderate evidence of associations of network properties and empirical expectations No evidence of associations of network properties and normative expectations Effects are somewhat stronger for women BUT Networks are not exogenous We do not observe full networks -> need for sociocentric data

46 LENNS intervention design Theoretically-informed, evidence-based content & delivery

47 LENNS intervention design process Adapted from USAID s Theory of Change Curriculum* 1. Collating existing evidence, theory 2. Leveraging data to identify key barriers to exclusive latrine utilization 3. Completing intervention mapping 4. Conducting trials of improved practices 5. Finalizing LENNS intervention packages * Starr, L., and M. Fornoff Theory of Change: Facilitator s Guide. Washington, DC: TANGO International and The Technical and Operational Performance Support (TOPS) Program.

48 Collating existing evidence & theory What are the factors driving open defecation in India? Evidence What is known to date regarding factors driving OD, preventing exclusive toilet use Documented underlying/root causes of OD Psychosocial, technological, contextual factors Theoretical considerations Approach to theoretical application: purist vs. more inclusive Which behavioral factors from these theories are most applicable Is it important to consider stages of change

49 Approach to theoretical application Integrated, yet norms-centric Integrated theoretical application Emphasis on Social Norms Theory Stages of change considered Other factors, theories applied, as indicated via synthesis of findings

50 Leveraging data: Theory-driven analysis Deductive codes align with applied theories Data analyzed using codes derived from applicable theories Synthesized and organized according to COM-B framework (includes norms) Behavior-specific barriers and facilitators identified Yielded matrix of factors Foundation for problem trees Michie, S., Stralen, M.M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6:42.

51 Leveraging data: Theory-driven synthesis Problem and solution trees What: Visualization of the hierarchy of issues contributing to an undesirable behavior (e.g., OD) Why: Identification of pathways through which change may occur How: Mapping key findings linkages LENNS norms & networks surveys LENNS qualitative work Theory & evidence Lack of connection to network of users Insufficient belief about other people s toilet use Non-exclusive use of a safely managed, improved toilet False belief other ppl do not use toilets (bias) Unbiased belief other ppl do not use Root cause Underlying causes

52 LENNS problem tree development Mapping out root and underlying causes of OD

53 LENNS problem trees: Toilet coverage/access

54 LENNS problem trees: Toilet coverage/access, use

55 Translation of findings to inform intervention Targeting factors for intervention Determining factors related to clusters of root, underlying causes Identifying areas for intervention: Feasible to change Impactful Motivation Social opportunity

56 Intervention mapping Identifying appropriate intervention functions Problem statement Behavioral factors Potential intervention techniques Possible intervention activities Non-exclusive use of a safely managed, improved toilet Lack of coverage/access to a safely managed, improved toilet

57 Behavioral trials Giving a voice to participants Trialing intervention content, implementation approaches, tangibles Obtaining feedback from those who interacting with LENNS Finalizing intervention package Refinement of approaches, messaging, tangibles

58 LENNS intervention approach Focus: Norms-centric, addressing other key factors of OD, toilet use Scope: Urban, peri-urban Tamil Nadu and Bihar Value added: Assessing, addressing social determinants of OD by leveraging social networks and norms to inform intervention design Implementation approach: Addressing facilitators of open defecation Promoting latrine use

59 Conclusions LENNS study assesses social networks and social norms surrounding latrine use behavior Latrine use appears to be a descriptive norm (i.e. people follow what other people do, but not necessarily what others think should be done) Latrine behavior in communities is associated with geographic proximity to other latrine users, but at the core it signals social proximity These findings can be incorporated in the intervention design the team is currently working on.

60 Supplemental slides: Use by gender Last use by gender: 57% women last used a latrine; 59% men last used a latrine (overall) More women (58%) used a latrine the last time in rural areas compared to men (51%) Use in the last week by gender (overall) 54% women exclusively use a latrine in the last week; 48% men exclusively used latrine in last week Use in the last week by gender (among latrine owners, when at home) 76% women exclusively used in the last week; 66% men exclusively used in last week

61 Open defecation in India The Swachh Bharat Mission is leading a multisectoral effort to end open defecation by 2019 In 2015, estimated 40% of Indians practiced open defecation (WHO/UNICEF 2015) Despite increases in latrine coverage, usage rates have been poor (Clasen 2014, Coffey 2017) Studies have explored the unique context in India that perpetuates open defecation as well as the negative impact on health, safety and privacy of women (Coffey & Spears, 2014; Routray et al., 2015; Sahoo et al., 2015)

62 Outline Introduction / outline (10min) Why these data are important? What has been done so far? What have we looked at this time? How will these data be used? Descriptive stats (5min) "Collective pattern of behavior profiles" + FGDs (20min) Conceptual introduction Key findings Describe what we've found and point to how this is relevant to interventions Networks and norms (20min) Wave 1 findings Wave 2 findings Future directions (socio-centric and causal analyses) Intervention design approach (10min) Highlight some example of what this might look like?