What Influences Educators' Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment.
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SUBMITTER: Cunningham CE
PROVIDER: S-EPMC7021664 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
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What Influences Educators' Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment.
Cunningham Charles E CE Rimas Heather H Vaillancourt Tracy T Stewart Bailey B Deal Ken K Cunningham Lesley L Vanniyasingam Thuva T Duku Eric E Buchanan Don H DH Thabane Lehana L
School mental health 20190622 1
We used a discrete choice conjoint experiment to model the anti-bullying (AB) program preferences of 1080 junior kindergarten to Grade 8 educators. Participants chose between hypothetical AB programs that varied combinations of 12 design attributes. Multi-level latent class analysis yielded three classes: <i>All</i>-<i>in Supervisors</i> (21.5%) preferred that all teaching staff supervise playgrounds and hallways; <i>Facilitators</i> (61.6%) preferred that students take ownership of AB activitie ...[more]
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Project description:PurposeThis study aims to explore and compare Chinese university students' preferences for various physical activity motivation programs.Patients and methodsA cross-sectional study was conducted in China from February 25 to March 25, 2022. Participants anonymously completed an online questionnaire based on a DCE. A total of 1,358 university students participated in the survey. The conditional logit model (CLM), willingness to accept (WTA), and propensity score matching (PSM) were used to assess college students' preferences for different attributes and levels of physical activity incentive programs.ResultsRespondents identified the number of bonus, exercise time, and academic rewards as the three most significant attributes of the athletic incentive program. The importance of each attribute varied based on individual characteristics such as gender and BMI. In CLM, college students displayed a preference for a "¥4" bonus amount (OR: 2.04, 95% CI 1.95-2.13), "20 min" of exercise time (OR: 1.85, 95% CI 1.79-1.92), and "bonus points for comprehensive test scores" as academic rewards (OR: 1.33, 95% CI 1.28-1.37). According to the WTA results, college students were willing to accept the highest cost to obtain academic rewards tied to composite test scores.ConclusionThe number of bonus, exercise time, and academic rewards emerge as the three most crucial attributes of physical activity incentive programs. Furthermore, college students with different characteristics exhibit heterogeneity in their preferences for such programs. These findings can guide the development of programs and policies aimed at motivating college students to engage in physical activities.
| S-EPMC10646335 | biostudies-literature
Project description:IntroductionThe PROMISE study, launched in 2018, evaluates the implementation of revisions to the HIV Care Coordination Program (CCP) designed to minimize persistent disparities in HIV outcomes among high-need persons living with HIV in New York City. We conducted a discrete choice experiment (DCE) assessing the preferences of CCP clients to inform improvements to the program's design.MethodsClients chose between two hypothetical CCP options that varied across four program attributes: help with antiretroviral therapy (ART) adherence (directly observed therapy [DOT] vs. remind via phone/text vs. adherence assessment), help with primary care appointments (remind and accompany vs. remind and transport vs. remind only), help with issues other than primary care (coverage and benefits vs. housing and food vs. mental health vs. specialty medical care) and visit location (meet at home vs. via phone/video vs. program visit 30 or 60 minutes away). The latent class analysis identified different preference patterns. A choice simulation was performed to model client preferences for hypothetical CCPs as a whole.ResultsOne hundred and eighty-one CCP clients from six sites implementing the revised CCP completed the DCE January 2020-March 2021. Most clients had stable housing (68.5%), reported no problem substance use in the last 3 months (72.4%) and achieved viral suppression (78.5) with only 26.5% receiving DOT within a CCP. 77.3% of responses were obtained before the COVID-19 pandemic. Preferences clustered into three groups. Visit location and ART adherence support were the most important attributes. Group 1 (40%) endorsed telehealth for visit location; telehealth for ART adherence support; and help with securing housing/food; Group 2 (37%) endorsed telehealth for visit location; telehealth for ART adherence support; and staff reminding/arranging appointment transportation; Group 3 (23%) endorsed staff meeting clients at program location and staff working with clients for medication adherence. In the choice simulation, Basic and Medium hypothetical CCPs were endorsed more than Intensive CCPs.ConclusionsThis DCE revealed a strong preference for telehealth and a relatively low preference for intensive services, such as DOT and home visits; preferences were heterogeneous. The findings support differentiated care and remote service delivery options in the NYC CCP, and can inform improvements to CCP design.
| S-EPMC10465014 | biostudies-literature
Project description:ObjectiveTo quantify patients' preferences for physical therapy programmes after a lower extremity fracture and determine patient factors associated with preference variation.DesignDiscrete choice experiment.SettingLevel I trauma centre.ParticipantsOne hundred fifty-one adult (≥18 years old) patients with lower extremity fractures treated operatively.InterventionPatients were given hypothetical scenarios and asked to select their preferred therapy course when comparing cost, mobility, long-term pain, session duration, and treatment setting.Main outcome measuresA multinomial logit model was used to determine the relative importance and willingness to pay for each attribute.ResultsMobility was of greatest relative importance (45%, 95% CI: 40% to 49%), more than cost (23%, 95% CI: 19% to 27%), long-term pain (19%, 95% CI: 16% to 23%), therapy session duration (12%, 95% CI: 9% to 5%) or setting (1%, 95% CI: 0.2% to 2%). Patients were willing to pay US$142 more per session to return to their preinjury mobility level (95% CI: US$103 to US$182). Willingness to pay for improved mobility was higher for women, patients aged 70 years and older, those with bachelor's degrees or higher and those living in less-deprived areas. Patients were willing to pay US$72 (95% CI: US$50 to US$93) more per session to reduce pain from severe to mild. Patients were indifferent between formal and independent home therapy (willingness to pay: -US$12, 95% CI: -US$33 to US$9).ConclusionsPatients with lower extremity fractures highly value recovering mobility and are willing to pay more for postoperative physical therapy programmes that facilitate returning to their pre-injury mobility level. These patient preferences might be useful when prescribing and designing new techniques for postoperative therapy.
| S-EPMC10565336 | biostudies-literature
Project description:This study investigates individual preferences for work arrangements in a discrete choice experiment. Based on sociological and economic literature, we identified six essential job attributes-earnings, job security, training opportunities, scheduling flexibility, prestige of the company, and gender composition of the work team-and mapped these into hypothetical job offers. Out of three job offers, with different specifications in the respective job attributes, respondents had to choose the offer they considered as most attractive. In 2017, we implemented our choice experiment in two large-scale surveys conducted in two countries: Germany (N = 2,659) and the Netherlands (N = 2,678). Our analyses revealed that respondents considered all six job attributes in their decision process but had different priorities for each. Moreover, we found gendered preferences. Women preferred scheduling flexibility and a company with a good reputation, whereas men preferred jobs with high earnings and a permanent contract. Despite different national labor market regulations, different target populations, and different sampling strategies for the two surveys, job preferences for German and Dutch respondents were largely parallel.
| S-EPMC8274907 | biostudies-literature
Project description:BACKGROUND: Participation rates of lifestyle programs among type 2 diabetes mellitus (T2DM) patients are less than optimal around the globe. Whereas research shows notable delays in the development of the disease among lifestyle program participants. Very little is known about the relative importance of barriers for participation as well as the willingness of T2DM patients to pay for participation in such programs. The aim of this study was to identify the preferences of T2DM patients with regard to lifestyle programs and to calculate participants' willingness to pay (WTP) as well as to estimate the potential participation rates of lifestyle programs. METHODS: A Discrete Choice Experiment (DCE) questionnaire assessing five different lifestyle program attributes was distributed among 1250 Dutch adults aged 35-65 years with T2DM, 391 questionnaires (31%) were returned and included in the analysis. The relative importance of the program attributes (i.e., meal plan, physical activity (PA) schedule, consultation structure, expected program outcome and out-of-pocket costs) was determined using panel-mixed logit models. Based on the retrieved attribute estimates, patients' WTP and potential participation rates were determined. RESULTS: The out-of-pocket costs (? =?-0.75, P <?.001), consultation structure (? =?-0.46, P <?.001) and expected outcome (? =0.72, P <?.001) were the most important factors for respondents when deciding whether to participate in a lifestyle program. Respondents were willing to pay €128 per year for individual instead of group consultation and €97 per year for 10 kilograms anticipated weight loss. Potential participation rates for different lifestyle-program scenarios ranged between 48.5% and 62.4%. CONCLUSIONS: When deciding whether to participate in a lifestyle program, T2DM patients are mostly driven by low levels of out-of-pocket costs. Thereafter, they prefer individual consultation and high levels of anticipated outcomes with respect to weight loss.
| S-EPMC3909291 | biostudies-other
Project description:BackgroundInadequate screening and diagnostic testing in the United States throughout the first several months of the COVID-19 pandemic led to undetected cases transmitting disease in the community and an underestimation of cases. Though testing supply has increased, maintaining testing uptake remains a public health priority in the efforts to control community transmission considering the availability of vaccinations and threats from variants.ObjectiveThis study aimed to identify patterns of preferences for SARS-CoV-2 screening and diagnostic testing prior to widespread vaccine availability and uptake.MethodsWe conducted a discrete choice experiment (DCE) among participants in the national, prospective CHASING COVID (Communities, Households, and SARS-CoV-2 Epidemiology) Cohort Study from July 30 to September 8, 2020. The DCE elicited preferences for SARS-CoV-2 test type, specimen type, testing venue, and result turnaround time. We used latent class multinomial logit to identify distinct patterns of preferences related to testing as measured by attribute-level part-worth utilities and conducted a simulation based on the utility estimates to predict testing uptake if additional testing scenarios were offered.ResultsOf the 5098 invited cohort participants, 4793 (94.0%) completed the DCE. Five distinct patterns of SARS-CoV-2 testing emerged. Noninvasive home testers (n=920, 19.2% of participants) were most influenced by specimen type and favored less invasive specimen collection methods, with saliva being most preferred; this group was the least likely to opt out of testing. Fast-track testers (n=1235, 25.8%) were most influenced by result turnaround time and favored immediate and same-day turnaround time. Among dual testers (n=889, 18.5%), test type was the most important attribute, and preference was given to both antibody and viral tests. Noninvasive dual testers (n=1578, 32.9%) were most strongly influenced by specimen type and test type, preferring saliva and cheek swab specimens and both antibody and viral tests. Among hesitant home testers (n=171, 3.6%), the venue was the most important attribute; notably, this group was the most likely to opt out of testing. In addition to variability in preferences for testing features, heterogeneity was observed in the distribution of certain demographic characteristics (age, race/ethnicity, education, and employment), history of SARS-CoV-2 testing, COVID-19 diagnosis, and concern about the pandemic. Simulation models predicted that testing uptake would increase from 81.6% (with a status quo scenario of polymerase chain reaction by nasal swab in a provider's office and a turnaround time of several days) to 98.1% by offering additional scenarios using less invasive specimens, both viral and antibody tests from a single specimen, faster turnaround time, and at-home testing.ConclusionsWe identified substantial differences in preferences for SARS-CoV-2 testing and found that offering additional testing options would likely increase testing uptake in line with public health goals. Additional studies may be warranted to understand if preferences for testing have changed since the availability and widespread uptake of vaccines.
| S-EPMC8722498 | biostudies-literature
Project description:OBJECTIVES:It is desirable that public preferences are established and incorporated in emergency healthcare reforms. The aim of this study was to investigate preferences for local versus centralised provision of all emergency medical services (EMS) and explore what individuals think are important considerations for EMS delivery. DESIGN:A discrete choice experiment was conducted. The attributes used in the choice scenarios were: travel time to the hospital, waiting time to be seen, length of stay in the hospital, risks of dying, readmission and opportunity for outpatient care after emergency treatment at a local hospital. SETTING:North East England. PARTICIPANTS:Participants were a randomly sampled general population, aged 16 years or above recruited from Healthwatch Northumberland network database of lay members and from clinical contact with Northumbria Healthcare National Health Service Foundation Trust via Patient Experience Team. PRIMARY AND SECONDARY OUTCOME MEASURES:Analysis used logistic regression modelling techniques to determine the preference of each attribute. Marginal rates of substitution between attributes were estimated to understand the trade-offs individuals were willing to make. RESULTS:Responses were obtained from 148 people (62 completed a web and 86 a postal version). Respondents preferred shorter travel time to hospital, shorter waiting time, fewer number of days in hospital, low risk of death, low risk of readmission and outpatient follow-up care in their local hospital. However, individuals were willing to trade off increased travel time and waiting time for high-quality centralised care. Individuals were willing to travel 9 min more for a 1-day reduction in length of stay in the hospital, 38 min for a 1% reduction in risk of death and 112 min for having outpatient follow-up care at their local hospital. CONCLUSIONS:People value centralised EMS if it provides higher quality care and are willing to travel further and wait longer.
| S-EPMC6858184 | biostudies-literature
Project description:Choosing hypodontia treatment requires young people and parents to consider a large amount of information, identify what is important to them, and make trade-offs between options. This study aimed to examine young people and parents' preferences for hypodontia treatment using discrete choice experiment (DCE). This was a cross-sectional survey of young people (12-16 y) with hypodontia of any severity, at any stage of treatment, and their parents. Participants were recruited from NHS Hospitals in England and Wales. A bespoke DCE questionnaire was developed to measure preferences for 6 attributes of hypodontia treatment (waiting time, treatment time, problems during treatment, discomfort during treatment, bite, appearance). The questionnaire was completed 1) online by young people and parents, individually or together, and 2) by child-parent dyads under observation. Preferences were analyzed using regression models. In total, 204 participants (122 young people, 56 parents, 26 dyads) completed the online questionnaire and 15 child-parent dyads completed the questionnaire under observation. The most important attribute in hypodontia treatment was improvement in appearance, but significant heterogeneity was found in preferences. Four distinct groups of participants were found: group 1 (39%): severe discomfort and problems were most important; group 2 (31%): most concerned about improvement in appearance of teeth and improvement in bite; group 3 (22%): appearance 3 times more important than any other attribute; and group 4 (9%): preferences difficult to interpret. There was variation in how child-parent dyads approached decision-making, with some negotiating joint preferences, while for others, one individual dominated. Making trade-offs in DCE tasks helped some people think about treatment and identify their preferences. Appearance is an important outcome from hypodontia treatment, but preferences vary and potential risks and functional outcome are also important to some people. There is a notable level of uncertainty in decision-making, which suggests further shared decision support would be valuable.
| S-EPMC9693901 | biostudies-literature
Project description:BackgroundRisk stratification has been proposed to improve the efficiency of population-level cancer screening. We aimed to describe and quantify the relative importance of different attributes of potential screening programs among the public, focusing on stratifying eligibility.MethodsWe conducted a discrete choice experiment in which respondents selected between 2 hypothetical screening programs in a series of 9 questions. We presented the risk factors used to determine eligibility (age, sex, or lifestyle or genetic risk scores) and anticipated outcomes based on eligibility criteria with different sensitivity and specificity levels. We performed conditional logit regression models and used the results to estimate preferences for different approaches. We also analyzed free-text comments on respondents' views on the programs.ResultsA total of 1,172 respondents completed the survey. Sensitivity was the most important attribute (7 and 11 times more important than specificity and risk factors, respectively). Eligibility criteria based on age and sex or genetics were preferred over age alone and lifestyle risk scores. Phenotypic and polygenic risk prediction models would be more acceptable than screening everyone aged 55 to 70 y if they had high discrimination (area under the receiver-operating characteristic curve ≥0.75 and 0.80, respectively).LimitationsAlthough our sample was representative with respect to age, sex, and ethnicity, it may not be representative of the UK population regarding other important characteristics. Also, some respondents may have not understood all the information provided to inform decision making.ConclusionsThe public prioritized lives saved from cancer over reductions in numbers screened or experiencing unnecessary follow-up. Incorporating personal-level risk factors into screening eligibility criteria is acceptable to the public if it increases sensitivity; therefore, maximizing sensitivity in model development and communication could increase uptake.HighlightsThe public prioritized lives saved when considering changing from age-based eligibility criteria to risk-stratified cancer screening over reductions in numbers of people being screened or experiencing unnecessary follow-up.The risk stratification strategy used to do this was the least important component, although age plus sex or genetics were relatively preferable to using age alone and lifestyle risk scores.Communication strategies that emphasize improvements in the numbers of cancers detected or not missed across the population are more likely to be salient than reductions in unnecessary investigations or follow-up among some groups.Future research should focus on developing implementation strategies that maximize gains in sensitivity within the context of resource constraints and how to present attributes relating to specificity to facilitate understanding and informed decision making.
| S-EPMC10021112 | biostudies-literature
Project description:UNLABELLED: Active case finding for osteoporosis is used to identify patients at high fracture risk who may benefit from preventive drug treatment. We investigated the relative weight that women place on various aspects of preventive drugs in a discrete choice experiment. Our patients said they were prepared to take preventive drugs even if side effects were expected. INTRODUCTION: Active case finding for osteoporosis is used to identify patients who may benefit from preventive drugs. We aimed to elicit the relative weight that patients place on various aspects of preventive drug treatment for osteoporosis. METHODS: We designed a discrete choice experiment, in which women had to choose between drug profiles that differed in five treatment attributes: effectiveness, side effects (nausea), total treatment duration, route of drug administration, and out-of-pocket costs. We included 120 women aged 60 years and older, identified by osteoporosis case finding in 34 general practices in the Netherlands. A conditional logit regression model was used to analyse the relative importance of treatment attributes, the trade-offs that women were willing to make between attributes, and their willingness to pay. RESULTS: All treatment attributes proved to be important for women's choices. A reduction of the relative 10-year risk of hip fracture by 40% or more by the drug was considered to compensate for nausea as a side effect. Women were prepared to pay an out-of-pocket contribution for the currently available drug treatment (bisphosphonate) if the fracture risk reduction was at least 12%. CONCLUSIONS: Women identified by active osteoporosis case finding stated to be prepared to take preventive drugs, even if side effects were expected and some out-of-pocket contribution was required.
| S-EPMC2440927 | biostudies-other