Applying Cognitive Decision Theory to the Study of Regional Patterns of Illness Treatment Choice

This article argues for the utility of cognitive decision modeling in assessing regional patterns of health behavior and, when combined with the explanatory modeling approach, in describing and analyzing more effectively sources of intracultural variation in choice within a region. A decision model developed in two intensively studied communities in rural Costa Rica was used to predict treatment choice in a third one representative of the rapid social change occurring in the region. A subsequent analysis of the errors made in prediction pinpointed patterns of intracultural variation that were then investigated from the explanatory model perspective. The incorporation of these more qualitative data into the original decision model made it more sensitive to both the complexities of the decision context and the specifics of the individual illness experience while also enabling greater accuracy in the prediction of regional patterns of treatment choice.