Public Health and Social Desirability in Kazakhstan: Methodological Considerations

Main Article Content

Brett J. Craig
Martha C. Engstrom


Background: As the Republic of Kazakhstan undertakes new public health efforts to promote healthy lifestyles among its citizens, the local perceptions of health and health behaviors need to be examined and understood from the sociocultural and historical perspectives. The primary aim of this study is to examine the association between perception of control on one’s health and engagement in good and bad health behaviors.

Methods: Students enrolled in a health communication course surveyed 310 citizens of Kazakhstan on their perceptions of control over their own health and multiple health behaviors (i.e. smoking status, physical activity, etc.). Twenty-seven students were divided into groups and approached every third passerby as a potential participant during common shopping hours in nine popular marketplaces in Astana, Kazakhstan. Perception of control on one’s health was measured using a validated measure of health control: the multidimensional health locus of control scale (MHLC), developed by Wallston and colleagues. The MHLC measures three separate loci of control: internal, chance, and powerful others.

Results: Participants perceived themselves as having highest control over their health (MHLC subscale internal: 29.70±0.64), powerful others had second highest control (MHLC subscale power others: 23.72±0.77), and chance had the lowest but still some control on their health (MHLC subscale chance: 20.82±0.85). Most participants rated their current health as very good (18.1%), good (45.0%), or moderate (32.3%). Approximately 23.4% of participants were smokers, and 22.2% consumed alcohol. Physical activity averaged 3.63 days in the past week, and fruit and vegetable consumption averaged 2 servings of each per day.  Tobacco and the powerful others subscale were significantly negatively correlated (r=-0.17, p<0.05). 

Conclusions: Participant reports regarding personal health behaviors and lifestyle did not reflect the national reports regarding lifestyle behaviors. The relationship between powerful others subscale and tobacco smoking indicate that using healthcare providers may open up avenues to lowering tobacco use through patient education; however, social desirability is a notable concern for public health interventions. More importantly, the surveys uncovered future questions for conducting public health research with the general public, including issues of trust in the healthcare system and social desirability bias. Additional factors such as distrust in healthcare and government also may play a role in the public’s participation in social scientific research. The students who conducted the surveys reported a general skepticism from the public ranging from unfamiliarity with survey research to explicit distrust in the intentions and purpose of the research itself.

Article Details

How to Cite
Craig, B. J., & Engstrom, M. C. (2016). Public Health and Social Desirability in Kazakhstan: Methodological Considerations. Central Asian Journal of Global Health, 4(2).
Author Biography

Brett J. Craig, Department of Communication, Nazarbayev University

Dr. Brett J. Craig is an Assistant Professor of Communication in the School of Science & Technology at Nazarbayeb University in Astana, Kazakhstan.  He earned his Ph.D. (2011) in Communication Studies from the University of Kansas with emphases in intercultural communication and social influence.  His research applies intergroup communication perspectives to the applied context of health and development, examining the relationship between perceptions and communication of various stakeholders including practitioners, government organizations, NGOs, educational institutions, and the public in developing societies.


Bobak M, Pikhart, H, Rose, R, Hertzman, C, Marmot, M. Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Soc Sci & Med. 2000;51:1343-1350.

Sharman A. A new paradigm of primary health care in Kazakhstan: Personalized, community-based, standardized, and technology-driven. Cent Asian J Glob Health. 2014;3(1).

Wallerstein N. Powerlessness, empowerment, and health: implications for health promotion programs. Am J Health Promot. 1992;6(3):197-205.

Vaughn L, Jacquez, F, Baker, RC. Cultural health attributions, beliefs, and practices: Effects on healthcare and medical education. Open Med Ed J. 2009;2:64-74.

Steptoe A W, J. . Health behavior, risk awareness and emotional well-being in students from Eastern Europe and Western Europe. Soc Sci & Med. 2001;53:1622-1630.

Wrightson K, Wardle, J. Cultural variation in health locus of control. Ethnicity and Health. 1997;2:13-20.

Lundell H NJ, Clarke, C. Public views about health causation, attributions of responsibility, and inequality. J Health Comm: Intern Pers. 2013;0:1-15.

Bond A, Beresford, G. Healthcare development in the former Soviet Union Postgrad Medical J. 2003;79:551-552.

Perlman F, Bobak, M, Steptoe, A, Rose, R, Marmot, M. Do health control beliefs predict behavior in Russians? Prev Med. 2003;37:73-81.

Orynbassarova D. Family Medicine as a Model of Primary Health Services Delivery: A Pilot Study in Almaty, Kazakhstan. Cent Asian J of Glob Health. 2015;4(1).

Reilly J, Methven E, McDowell Z, et al. Health consequences of obesity. Archives of Disease in Childhood. 2003;88(9):748-752.

Wallston K, Wallston, BS, DeVellis, R. Development of multidimensional health locus of control (MHLC) scales. Health Ed Mon. 1978;6:160-170.

Wallston K. The validity of the multidimensional health locus of control scales. J Health Psych. 2005;10:623-631.

Johnson TP vdVF. Social desirability in cross-cultural research. In: Harkness JA vdVF, Mohler PP, ed. Cross-Cultural Survey Methods. Hoboken, NJ: Wiley; 2002.

Lalwani AK SL, Chiu C. . Motivated response styles: The role of cultural values, regulatory focus, and self-consciousness in socially desirable responding. J Per & Soc Psych. 2009;96:870-882.

Triandis H. Individualism and Collectivism. Boulder, CO: Westview Press; 1995.

Johnson T KP, Cho YI, Shavitt, S. . The relation between culture and response styles: Evidence from 19 countries. J Cross-Cultural Psych. 2005;36:264-277.

Smith P, Bond, MH. Social Psychology Across Cultures. 2nd ed. Hemel Hempstead, UK: Harvester Wheatsheaf; 1998.

Van Hemert D, Van de Vijver, FJR, Poortinga, YH, Georgas, J. Structure and score levels of the Eysenck Personality Questionnaire across individuals and countries. Person & Ind Diff. 2002;33:1229–1249.

Chang L. A psychometric evaluation of 4-point and 6-point Likert-type scales in relation to reliability and validity. App Psych Measurement. 1994;18(3):205-215.

Yu D, Lee, DTF, Woo, J. Issues and Challenges of Instrument Translation. Western J Nursing Res. 2004;26:307-320.

Brislin R. The wording and translation of research instrument. In: Lonner WJ BJ, ed. Field methods in cross-cultural research. Beverly Hills, CA: Sage; 1986.

Hui CH TH. Effects of culture and response format on extreme response style. J Cross-Cultural Psych. 1989;3:296-309.

Lee JW JP, Mineyama Y, Zhang XE. . Cultural differences in responses to a Likert scale. Res Nursing & Health. 2002;4:295-306.

Field M. The Soviet legacy: The past as prologue. In: Mckee M HJ, Falkingham J, ed. Health Care in Central Asia. Philadelphia, PA: Open University Press; 2002.

Aksholakova A, Ismailova, N. The Language Policy of Kazakhstan and the State Language in Government Service. . Procedia-Social and Behav Sci. 2013;93:1580-1586.

WHO. Risk Factors (Alcohol & Tobacco). 2014; Accessed May 30, 2014.

Aringazina A, Gulis, G, Allegrante, JP Public health challenges and priorities for Kazakhstan. Central Asian J Global Health. 2012;1:1.

Radin D. Too ill to find the cure?: Corruption, institutions, and health care sector performance in the new democracies of Central and Eastern Europe and Former Soviet Union. East Euro Pol & Soc. 2009;23:105-125.

Balabanova D, Roberts, B, Richardson, E, Haerpfer, C, McKee, M. Health care reform in the Former Soviet Union: Beyond the transition. Health Serv Res. 2012;47(2):840-864.

Most read articles by the same author(s)