Publics’ preferences for sharing health data: a discrete choice experiment (Preprint)

BACKGROUND The digital technological development in the last 20 years has led to a significant growth in collecting, using and sharing health data digitally. In order to maintain public trust in the digital society and for acceptable policy making in the future, it is important to investigate peoples’ preferences for sharing digital health data. OBJECTIVE The aim of this study was to elicit the publics’ preferences in different Northern-European countries (the UK, Norway, Iceland and Sweden) for sharing health information in different contexts. METHODS A discrete choice experiment was answered by 1,967 individuals. Respondents completed several ‘choice tasks’ which asked if data sharing in the described hypothetical situation was acceptable to them. Latent class logistic regression models were used to determine attribute level estimates and the heterogeneity in preferences. We calculated the relative importance of the attributes and the predicted acceptability for different contexts where data is shared from the estimates. RESULTS All attributes influenced the participants’ willingness to share health information. The most important attribute was whether the respondents will be informed about their data being shared. The possibility to opt-out from sharing data was preferred over the opportunity to consent (opt-in). CONCLUSIONS Participants from different countries have different preferences for sharing their health data regarding the value of a review process and the reason for the new use. Offering respondents information about the use of their data and the possibility to opt-out is the most preferred governance mechanism.

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Understanding what women want: eliciting preference for delivery health facility in a rural subcounty in Kenya, a discrete choice experiment

BMJ Open ◽

10.1136/bmjopen-2020-038865 ◽

2020 ◽

Vol 10 (12) ◽

pp. e038865

Author(s):

Jackline Oluoch-Aridi ◽

Mary B Adam ◽

Francis Wafula ◽

Gilbert Kokwaro

Keyword(s):

Quality Of Care ◽

Health Facility ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Home Delivery ◽

Process Indicator ◽

Opt Out ◽

Women’S Preferences

ObjectiveTo identify what women want in a delivery health facility and how they rank the attributes that influence the choice of a place of delivery.DesignA discrete choice experiment (DCE) was conducted to elicit rural women’s preferences for choice of delivery health facility. Data were analysed using a conditional logit model to evaluate the relative importance of the selected attributes. A mixed multinomial model evaluated how interactions with sociodemographic variables influence the choice of the selected attributes.SettingSix health facilities in a rural subcounty.ParticipantsWomen aged 18–49 years who had delivered within 6 weeks.Primary outcomeThe DCE required women to select from hypothetical health facility A or B or opt-out alternative.ResultsA total of 474 participants were sampled, 466 participants completed the survey (response rate 98%). The attribute with the strongest association with health facility preference was having a kind and supportive healthcare worker (β=1.184, p<0.001), second availability of medical equipment and drug supplies (β=1.073, p<0.001) and third quality of clinical services (β=0.826, p<0.001). Distance, availability of referral services and costs were ranked fourth, fifth and sixth, respectively (β=0.457, p<0.001; β=0.266, p<0.001; and β=0.000018, p<0.001). The opt-out alternative ranked last suggesting a disutility for home delivery (β=−0.849, p<0.001).ConclusionThe most highly valued attribute was a process indicator of quality of care followed by technical indicators. Policymakers need to consider women’s preferences to inform strategies that are person centred and lead to improvements in quality of care during delivery.

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Understanding uptake of digital health products: Methodology tutorial for a Discrete Choice Experiment using a Bayesian efficient design (Preprint)

10.2196/preprints.32365 ◽

2021 ◽

Author(s):

Dorothy Szinay ◽

Rory Cameron ◽

Felix Naughton ◽

Jennifer A. Whitty ◽

Jamie Brown ◽

...

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Stated Preference ◽

Digital Health ◽

Revealed Preferences ◽

Quantitative Methodology ◽

Efficient Design ◽

Trade Offs ◽

Health Products

UNSTRUCTURED Understanding the preferences of potential users of digital health products is beneficial for digital health policy and planning. Stated preference methods could help elicit individuals’ preferences in the absence of observational data. A discrete choice experiment (DCE) is a commonly used stated preference method; a quantitative methodology that argues that individuals make trade-offs when engaging in a decision by choosing an alternative of a product or service that offers the greatest utility, or benefit. This methodology is widely used in health economics in situations where revealed preferences are difficult to collect but is much less used in the field of digital health. This article outlines the stages involved in developing a discrete choice experiment. As a case study, it uses the application of a DCE for revealing preferences in targeting the uptake of smoking cessation apps. It describes the establishment of attributes, the construction of choice tasks of two or more alternatives, and the development of the experimental design. This tutorial offers a guide for researchers with no prior knowledge of this research technique.

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Environmental information disclosure and societal preferences for urban river restoration: Latent class modelling of a discrete-choice experiment

Journal of Cleaner Production ◽

10.1016/j.jclepro.2019.05.307 ◽

2019 ◽

Vol 231 ◽

pp. 1294-1306 ◽

Cited By ~ 4

Author(s):

Wendy Y. Chen ◽

Frankie Hin Ting Cho

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Information Disclosure ◽

Choice Experiment ◽

River Restoration ◽

Latent Class ◽

Environmental Information Disclosure ◽

Urban River Restoration ◽

Societal Preferences ◽

Latent Class Modelling

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Is “Localness” about Distance or Relationships? Evidence from Hard Cider

Journal of Wine Economics ◽

10.1017/jwe.2019.42 ◽

2019 ◽

Vol 14 (3) ◽

pp. 252-273 ◽

Cited By ~ 1

Author(s):

Jarrad Farris ◽

Trey Malone ◽

Lindon J. Robison ◽

Nikki L. Rothwell

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Latent Class ◽

Consumer Preferences ◽

Geographic Distance ◽

Social Capital Theory ◽

The State ◽

Travel Distance ◽

Local Foods

AbstractWhile many studies have evaluated consumer demand for local foods, fewer studies have focused on the mechanism that has created the positive willingness-to-pay for local foods. This article compares the role of geographic distance and attachment value in consumer preferences for locally produced hard cider. Consumer valuations are estimated via a “branded” discrete choice experiment where the respondents chose between an in-state hard cider, an out-of-state hard cider, and a no buy option. Our measure of travel distance is based on the optimal driving route between each consumer's GPS location and the locations of the cideries while our attachment value measure is based on social capital theory. This allows us to analyze individual-specific travel distance heterogeneity in consumer choice as it relates to attachment value. Based on a latent class logit model estimated from a discrete choice experiment with 441 participants, we show that attachment value is higher for a cider produced within the state than for a cider produced outside the state. Furthermore, we show that increases in attachment value increase demand for locally produced hard cider more than an equal increase in attachment value for non-locally produced hard cider. Our findings are consistent with “local” preferences based on geopolitical boundaries (e.g., the state of Michigan) and not distance. (JEL Classifications: B55, M3, Q13, C83)

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Incentivising doctor attendance in rural Bangladesh: a latent class analysis of a discrete choice experiment

BMJ Global Health ◽

10.1136/bmjgh-2021-006001 ◽

2021 ◽

Vol 6 (7) ◽

pp. e006001

Author(s):

Blake Angell ◽

Mushtaq Khan ◽

Raihanul Islam ◽

Kate Mandeville ◽

Nahitun Naher ◽

...

Keyword(s):

Latent Class Analysis ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Latent Class ◽

Latent Class Models ◽

Class Analysis ◽

Sustainable Solutions ◽

Rural Bangladesh ◽

Incentive Payments

ObjectiveDoctor absenteeism is widespread in Bangladesh, and the perspectives of the actors involved are insufficiently understood. This paper sought to elicit preferences of doctors over aspects of jobs in rural areas in Bangladesh that can help to inform the development of packages of policy interventions that may persuade them to stay at their posts.MethodsWe conducted a discrete choice experiment with 308 doctors across four hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (−0.63). Latent class analysis identified three groups of doctors who differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaviour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. We generated evidence suggesting that interventions considering the perspective of the doctors themselves could result in substantial reductions in absenteeism. Designing policy packages that take account of the different situations facing doctors could begin to improve their ability and motivation to be present at their job and generate sustainable solutions to absenteeism in rural Bangladesh.

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Public Preferences for Social Distancing Behaviors to Mitigate the Spread of COVID-19: A Discrete Choice Experiment

10.1101/2020.12.12.20248103 ◽

2020 ◽

Author(s):

Ingrid Eshun Wilson ◽

Aaloke Mody ◽

Ginger McKay ◽

Mati Hlatshwayo ◽

Cory Bradley ◽

...

Keyword(s):

Public Health ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Latent Class ◽

Latent Class Models ◽

Second Phase ◽

Sampling Weights ◽

Social Distancing ◽

The Public

AbstractPolicies to promote social distancing can minimize COVID-19 transmission, but come with substantial social and economic costs. Quantifying relative preferences of the public for such practices can inform policy prioritization and optimize uptake. We used a discrete choice experiment (DCE) to quantify relative “utilities” (preferences) for five COVID-19 pandemic social distances strategies (e.g., closure of restaurants, restriction of large gatherings) against the hypothetical risk of acquiring COVID-19 and anticipated income loss. The survey was distributed in Missouri in May-June, 2020. We applied inverse probability sampling weights to mixed logit and latent class models to generate mean preferences and identify preference classes. Overall (n=2,428), the strongest preference was for the prohibition of large gatherings, followed by preferences to keep outdoor venues, schools, and social and lifestyle venues open, 75% of the population showing probable support for a strategy that prohibited large gatherings and closed lifestyle and social venues. Latent class analysis, however revealed four preference sub-groups in the population - “risk eliminators”, “risk balancers”, “altruistic” and “risk takers”, with men twice as likely as women to belong to the risk-taking group. In this setting, public health policies which as a first phase prohibit large gatherings, as well as close social and lifestyle venues may be acceptable and adhered to by the public. In addition, policy messages that address preference heterogeneity, for example by targeting public health messages at men, could improve adherence to social distancing measures and prevent further COVID-19 transmission prior to vaccine distribution and in the event of future pandemics.Significance StatementPreferences drive behavior – DCE’s are a novel tool in public health that allow examination of preferences for a product, service or policy, identifying how the public prioritizes personal risks and cost in relation to health behaviors. Using this method to establish preferences for COVID-19 mitigation strategies, our results suggest that, firstly, a tiered approach to non-essential business closures where large gatherings are prohibited and social and lifestyle venues are closed as a first phase, would be well aligned with population preferences and may be supported by the public, while school and outdoor venue closures may require more consideration prior to a second phase of restrictions. And secondly, that important distinct preference phenotypes - that are not captured by sociodemographic (e.g., age, sex, race) characteristics - exist, and therefore that messaging should be target at such subgroups to enhance adherence to prevention efforts.

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Appliance energy labels and consumer heterogeneity: A latent class approach based on a discrete choice experiment in China

Energy Economics ◽

10.1016/j.eneco.2020.104839 ◽

2020 ◽

Vol 90 ◽

pp. 104839 ◽

Cited By ~ 1

Author(s):

Donglan Zha ◽

Guanglei Yang ◽

Wenzhong Wang ◽

Qunwei Wang ◽

Dequn Zhou

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Latent Class ◽

Consumer Heterogeneity

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What do community health workers want? Findings of a discrete choice experiment among Accredited Social Health Activists (ASHAs) in India

BMJ Global Health ◽

10.1136/bmjgh-2019-001509 ◽

2019 ◽

Vol 4 (3) ◽

pp. e001509 ◽

Cited By ~ 7

Author(s):

Marwa Abdel-All ◽

Blake Angell ◽

Stephen Jan ◽

Martin Howell ◽

Kirsten Howard ◽

...

Keyword(s):

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Latent Class ◽

Health Workers ◽

Family Health ◽

Health Check ◽

Social Health ◽

Significant Heterogeneity ◽

Group 3

IntroductionA number of factors contribute to the performance and motivation of India’s Accredited Social Health Activists (ASHAs). This study aims to identify the key motivational factors (and their relative importance) that may help retain ASHAs in service.MethodsA discrete choice experiment (DCE) survey presented ASHAs with eight unlabelled choice sets, each describing two hypothetical jobs that varied based on five attributes, specifically salary, workload, travel allowance, supervision and other job benefits. Multinomial logit and latent class (LC) models were used to estimate stated preferences for the attributes.ResultWe invited 318 ASHAs from 53 primary health centres of Guntur, a district in south India. The DCE was completed by 299 ASHAs using Android tablets. ASHAs were found to exhibit a strong preference for jobs that incorporated training leading to promotion, a fixed salary and free family healthcare. ASHAs were willing to sacrifice 2530 Indian rupee (INR) from their monthly salary, for a job offering training leading to promotion opportunity and 879 INR for a free family health-check. However, there was significant heterogeneity in preferences across the respondents. The LC model identified three distinct groups (comprising 51%, 35% and 13% of our cohort, respectively). Group 1 and 2 preferences were dominated by the training and salary attributes with group 2 having higher preference for free family health-check while group 3 preferences were dominated by workload. Relative to group 3, ASHAs in groups 1 and 2 were more likely to have a higher level of education and less likely to be the main income earners for their families.ConclusionASHAs are motivated by both non-financial and financial factors and there is significant heterogeneity between workers. Policy decisions aimed at overcoming workforce attrition should target those areas that are most valued by ASHAs to maximise the value of investments into these workers.Trial registration numberCTRI/2018/03/012425.

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Individual-level determinants of waterpipe smoking demand in four Eastern-Mediterranean countries

Health Promotion International ◽

10.1093/heapro/day084 ◽

2018 ◽

Vol 34 (6) ◽

pp. 1157-1166 ◽

Cited By ~ 5

Author(s):

Ramzi G Salloum ◽

Rima Nakkash ◽

Niveen M E Abu-Rmeileh ◽

Randah R Hamadeh ◽

Muhammad W Darawad ◽

...

Keyword(s):

Young Adult ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Eastern Mediterranean ◽

Waterpipe Smoking ◽

Individual Level ◽

Nicotine Content ◽

Mediterranean Countries ◽

Opt Out

Abstract The prevalence of waterpipe tobacco smoking in the Eastern Mediterranean Region is at alarmingly high levels, especially among young people. The objective of this research was to evaluate the preferences of young adult waterpipe smokers with respect to potential individual-level determinants of waterpipe smoking using discrete choice experiment methodology. Participants were young adult university students (18–29 years) who were ever waterpipe smokers, recruited from universities across four Eastern Mediterranean countries: Jordan, Oman, Palestine and the United Arab Emirates. The Internet-based discrete choice experiment, with 6 × 3 × 2 block design, evaluated preferences for choices of waterpipe smoking sessions, presented on hypothetical waterpipe café menus. Participants evaluated nine choice sets, each with five fruit-flavored options, a tobacco flavored option (non-flavored), and an opt-out option. Choices also varied based on nicotine content (0.0% vs. 0.05% vs. 0.5%) and price (low vs. high). Participants were randomized to receive menus with either a pictorial + text health-warning message or no message (between-subjects attribute). Multinomial logit regression models evaluated the influence of these attributes on waterpipe smoking choices. Across all four samples (n = 1859), participants preferred fruit-flavored varieties to tobacco flavor, lower nicotine content and lower prices. Exposure to the health warning did not significantly predict likelihood to opt-out. Flavor accounted for 81.4% of waterpipe smoking decisions. Limiting the use of fruit flavors in waterpipe tobacco, in addition to accurate nicotine content labeling and higher pricing may be effective at curbing the demand for waterpipe smoking among young adults.

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