scholarly journals Enhancing Public Participation in Public Health Offerings: Patient Preferences for Facilities in the Western Cape Province Using a Discrete Choice Experiment

2022 ◽  
Vol 19 (1) ◽  
pp. 590
Author(s):  
Plaxcedes Chiwire ◽  
Charlotte Beaudart ◽  
Silvia M. Evers ◽  
Hassan Mahomed ◽  
Mickaël Hiligsmann
Keyword(s):  
Public Health ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Waiting Times ◽  
Cape Town ◽  
Health Facilities ◽  
Western Cape ◽  
Western Cape Province ◽  
Public Health Facilities

Understanding patients’ preferences for health facilities could help decision makers in designing patient-centered services. Therefore, this study aims to understand how patients’ willingness to trade for certain attributes affects the choice of public health facilities in the Western Cape province of Cape Town, South Africa. A discrete choice experiment was conducted in two community day centers (CDCs). Patients repetitively chose between two hypothetical health facilities that differed in six attributes: distance to facility, treatment by doctors vs. nurses, confidentiality during treatment, availability of medication, first visit (drop-in) waiting times, and appointment waiting times. The sample consisted of 463 participants. The findings showed that availability of medication (50.5%), appointment waiting times (19.5%), and first visit waiting times (10.2%) were the most important factors for patients when choosing a health facility. In addition, respondents preferred shorter appointment and first visit waiting times (<2 h). These results identified important characteristics in choosing public health facilities in Cape Town. These public health facilities could be improved by including patient voices to inform operational and policy decisions in a low-income setting.

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

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.

scholarly journals Understanding public health providers’ preferences for interventions against informal payment in Tanzania: a discrete choice experiment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Binyaruka
Keyword(s):  
Public Health ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Private Practice ◽  
Choice Experiment ◽  
Multinomial Logit ◽  
Health Providers ◽  
Informal Payment ◽  
Survey Tool ◽  
Facility Level

Abstract Background Informal payments are regressive. They can limit the access to quality healthcare, particularly of the most vulnerable, and are potentially catastrophic. Little is known in terms of providers' preferences for interventions. Methods We conducted a cross-sectional discrete choice experiment (DCE) among 432 health providers from 42 public health facilities (hospitals and health centres) in seven districts from Pwani region and five districts from Dar es Salaam region. The DCE attributes were derived from a scoping literature review, qualitative interview from 27 key informants from three districts, and through workshop with health providers, managers and policy makers. The final DCE survey tool included 12 unlabeled choice sets, each describing two hypothetical jobs that varied across six attributes: mode of payment, supervision at facility, opportunity for private practice, awareness and monitoring, measures against informal payment, and incentive payment for lack informal payment in the past 6 months. Multinomial logit and mixed multinomial logit methods were used to estimate preferences for the attributes. Results All attribute-levels, apart from supervision at the facility level, were significantly influencing health providers' choice decisions for job type (p &lt; 0.001). The most preferred attributes were measures for awareness creation and monitoring -i.e. preferences were significantly higher for facility with noticeboard (coefficient 0.39, 95% CI 0.29 -0.48 ), followed by provision of receipts (0.34, 0.24 -0.44) and presence of hotline number for reporting corrupt practices (0.26, 0.17 -0.35). Opportunity for private practice was significantly preferred (0.38, 0.31-045) and job preference increases as salary top-up increases (0.06, 0.05-0.7). The less preferred attributes were cash payment for healthcare (-0.27, -0.35- -0.19) and disciplinary measures at the district (-0.15, -0.23 - -0.07) or facility level (-0.10, -0.17- -0.03).

scholarly journals Do Canadians Support Tailored And Targeted Public Health Programs? A Discrete Choice Experiment

2021 ◽  
Author(s):  
Kiffer G. Card ◽  
Marina Adshade ◽  
Robert S. Hogg ◽  
Jody Jollimore ◽  
Nathan J. Lachowsky
Keyword(s):  
Public Health ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Public Support ◽  
Health Conditions ◽  
Health Programs ◽  
Public Health Programs ◽  
Marginalized Communities ◽  
Generalized Linear Mixed Effects

Abstract Background. We aimed to assess public support of tailored and targeted public health interventions for various marginalized communities. Methods. We conducted a discrete choice experiment using a web-based survey advertised to Facebook and Instagram users living in Canada, aged >16. Participants were asked to choose between funding two hypothetical public health programs. Each program was described by its purpose; expected increase in life expectancy; and target group. Demographically-weighted generalized linear mixed-effects models were constructed to identify program factors associated with program selection.Results. 23,889 exercises were completed by 3,054 participants. Selected programs were less likely to focus on prevention (vs. treatment). For each 1-year increase in the marginal years of life gained, there was a 15% increase in the odds of a program being selected. Interventions tailored to marginalized communities or targeting stigmatized health conditions were less likely to be selected compared with interventions targeted to the general population or targeting chronic health conditions. Noteworthy exceptions included an increased preference for interventions aligning with the perceived needs of marginalized communities (e.g. HIV and men who have sex with men). Conclusions. Stigmatizing perceptions of health conditions and key populations likely influence public health programming preferences of Canadians. Informational campaigns highlighting disparities experienced by marginalized populations may improve support for targeted and tailored interventions.

scholarly journals Operational nurse managers’ perceptions on the competence of community service nurses in public settings in the Western Cape

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Vatiswa Makie ◽  
Karien Jooste ◽  
Tendani B. Mabuda ◽  
Theresa Bock ◽  
Guinevere M. Lourens ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Care ◽  
Community Service ◽  
Nurse Managers ◽  
Health Facilities ◽  
Theory And Practice ◽  
Western Cape ◽  
Clinical Patient ◽  
Public Health Facilities ◽  
Leadership Quality

Background: Community service nurses placed in the Western Cape Government public health facilities render essential healthcare to underserved populations. Anecdotal evidence from operational nurse managers indicated concerns that community service nurses may lack competence in basic required nursing competencies.Objectives: To investigate operational nurse managers’ perceptions of the competence of community service nurses in public health facilities in the Western Cape.Method: A quantitative survey was conducted with an all-inclusive sample of 297 operational nurse managers in the Western Cape. A self-administered questionnaire with 65 questions with a 4-point rating scale was used to rate perceived competence of community service nurses across the South African Nursing Council (SANC) competencies. Descriptive and inferential statistics were calculated per competency domain.Results: The survey (response rate: 59%) showed that the operational nurse managers perceived the community service nurses to be competent in the clinical patient care domain and mostly either developing proficiency or proficient in the SANC competencies of legal framework and ethical practice, interprofessional relationships, leadership, quality management and management competency domains.Conclusion: Community service nurses were found to be competent in the clinical patient care, possibly because of the integration of theory and practice focus of work-integrated learning in the programme. Education and practice supportive strategies for community service nurses should be developed to support the successful transition from students to community service nurses, especially around the development of research and critical thinking skills.

scholarly journals Enhancing Public Health Messaging: Discrete-Choice Experiment Evidence on the Design of HIV Testing Messages in China

2019 ◽  
Vol 39 (5) ◽  
pp. 568-582
Author(s):  
Maya Durvasula ◽  
Stephen W. Pan ◽  
Jason J. Ong ◽  
Weiming Tang ◽  
Bolin Cao ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Hiv Testing ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Underserved Populations ◽  
Social Media Platforms ◽  
Choice Tasks ◽  
Health Messaging

Introduction. While a growing literature documents the effectiveness of public health messaging on social media, our understanding of the factors that encourage individuals to engage with and share messages is limited. In the context of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in China, rising incidence and low testing rates despite decades of interventions suggest the need for effective, targeted messaging to reach underserved populations. Social media platforms and sex-seeking apps present a promising avenue, as web-based strategies can take advantage of existing trust within dense social networks. Methods. We conducted an online discrete-choice experiment in January 2017 with MSM from across China. Participants were presented with 6 choice tasks, each composed of 2 messages about HIV testing, and were asked in which scenario they were more likely to share the content. Participants were given information about the source of the HIV testing message, the social media sharing platform, and the recipients with whom they would share the message. They were given the option of sharing 1 message or neither. Multinomial and mixed logit models were used to model preferences within 4 subgroups. Results. In total, 885 MSM joined the survey, completing 4387 choice tasks. The most important attribute for 3 of the 4 subgroups was social media sharing platform. Men were more willing to share messages on sex-seeking mobile applications and less willing to share materials on generic (non-MSM) social media platforms. We found that men with more active online presences were less willing to share HIV testing messages on generic social media platforms. Conclusions. Our findings suggest that sex-seeking platforms represent a targeted, efficient method of actively engaging MSM in public health interventions.

scholarly journals What matters when managing childhood fever in the emergency department? A discrete-choice experiment comparing the preferences of parents and healthcare professionals in the UK

2020 ◽  
Vol 105 (8) ◽  
pp. 765-771
Author(s):  
Simon Leigh ◽  
Jude Robinson ◽  
Shunmay Yeung ◽  
Frans Coenen ◽  
Enitan D Carrol ◽  
...  
Keyword(s):  
Emergency Department ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Nurse Practitioners ◽  
Choice Experiment ◽  
Waiting Times ◽  
Febrile Illness ◽  
Antibiotic Prescribing ◽  
Visit Time ◽  
Management Scenarios

BackgroundFever among children is a leading cause of emergency department (ED) attendance and a diagnostic conundrum; yet robust quantitative evidence regarding the preferences of parents and healthcare providers (HCPs) for managing fever is scarce.ObjectiveTo determine parental and HCP preferences for the management of paediatric febrile illness in the ED.SettingTen children’s centres and a children’s ED in England from June 2018 to January 2019.Participants98 parents of children aged 0–11 years, and 99 HCPs took part.MethodsNine focus-groups and coin-ranking exercises were conducted with parents, and a discrete-choice experiment (DCE) was conducted with both parents and HCPs, which asked respondents to choose their preferred option of several hypothetical management scenarios for paediatric febrile illness, with differing levels of visit time, out-of-pocket costs, antibiotic prescribing, HCP grade and pain/discomfort from investigations.ResultsThe mean focus-group size was 4.4 participants (range 3–7), with a mean duration of 27.4 min (range 18–46 min). Response rates to the DCE among parents and HCPs were 94.2% and 98.2%, respectively. Avoiding pain from diagnostics, receiving a faster diagnosis and minimising wait times were major concerns for both parents and HCPs, with parents willing-to-pay £16.89 for every 1 hour reduction in waiting times. Both groups preferred treatment by consultants and nurse practitioners to treatment by doctors in postgraduate training. Parents were willing to trade-off considerable increases in waiting times (24.1 min) to be seen by consultants and to avoid additional pain from diagnostics (45.6 min). Reducing antibiotic prescribing was important to HCPs but not parents.ConclusionsBoth parents and HCPs care strongly about reducing visit time, avoiding pain from invasive investigations and receiving diagnostic insights faster when managing paediatric febrile illness. As such, overdue advances in diagnostic capabilities should improve child and carer experience and HCP satisfaction considerably in managing paediatric febrile illness.

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