Preferences for COVID-19 epidemic control measures among French adults: a discrete choice experiment.
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ABSTRACT:
SUBMITTER: Sicsic J
PROVIDER: S-EPMC8934018 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objectives: While several authors have suggested using a multi-criteria approach for orphan drug assessment and proposed lists of determinants of orphan drug value, studies on social preferences regarding these determinants remain limited. The current study aimed to identify preferences of the French general population regarding attributes characterizing the value of orphan drugs in a discrete choice experiment. Methods: The list of attributes was formed based on a literature search and was refined through expert interviews, a focus group, and a pilot study. The final list included nine attributes: disease-associated disability, disease-associated mortality, number of patients, availability of alternative treatments, treatment impact on disease disability, treatment impact on mortality, treatment safety, uncertainty around therapeutic effect, and annual treatment cost per patient. Members of the General Public were presented with 12 choice sets containing two drug profiles described according to the attributes and an option to fund neither of these treatments. The questionnaire was disseminated online. A conditional logit model with random effects was used to estimate the weight of each attribute. Results: A total of 958 persons participated in the study (48.7% male, mean age: 47.5 years). All attributes except for disease-associated disability had a statistically significant influence on the choices made by participants. The attribute with the highest weight was treatment impact on mortality (p < 0.0001), followed by uncertainty around therapeutic effect (p < 0.0001). The direction of results was generally consistent with intuition: patients preferred a drug with a larger impact on mortality, a larger impact on disability, with mild or no adverse events, with less uncertainty. Although patients appeared to prefer drugs with a lower budget impact, the relationship between patient preferences and costs was more complex. Conclusions: Preferences of the general public between orphan drugs are mostly driven by the impact on mortality and the degree of certainty regarding the available evidence.
| S-EPMC7379418 | 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: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:ObjectivesWe aimed to elicit preferences of the French-speaking Quebec population regarding a COVID-19 vaccination program and to characterize individuals with respect to their vaccination behaviors.MethodsA discrete choice experiment was conducted in Autumn 2020 via a web-based survey. Its design included seven attributes: vaccine origin, vaccine effectiveness, side effects, protection duration, priority population, waiting time to get vaccinated, and recommender of the vaccine. Utilities were estimated using a mixed-logit model and a latent class logit model.ResultsOur sample included 1599 individuals. From this total, 119 always chose the opt-out option (7.4%). According to the mixed-logit model, the relative weights of attributes were as follows: effectiveness (28.48%), side effects (23.68%), protection duration (17.41%), vaccine origin (12.75%), recommender (11.96%), waiting time to get vaccinated (3.62%), and priority population (2.11%). Five classes were derived from the latent class logit model. Class 1 (9.13%) wanted to get vaccinated as fast as possible and was composed of uncertain and more vulnerable individuals. Class 5 (25.14%) was similar to the full sample, mostly favoring vaccination. Classes 2 (7.69%) and 4 (15.82%) included "vaccine hesitant and demanding" individuals but were different in their sociodemographic profiles. Finally, "anti-vaccine" and other "vaccine hesitant" individuals were in class 3 (42.21%).ConclusionsThis study showed the vaccine characteristics that are likely to improve vaccine uptake, which may more easily lead to herd immunity. Different profiles of respondents also showed various levels of acceptance toward a COVID-19 vaccination program, which may help to better understand vaccine hesitancy behaviors.
| S-EPMC8769946 | biostudies-literature
Project description:COVID-19 is a continuing threat to global public health security. For elderly people, timely and effective vaccination reduces infection rates in this group and safeguards their health. This paper adopted an offline Discrete Choice Experiment (DCE) to research the preference for COVID-19 vaccination amongst Chinese adults aged 50 years and above. Through multinomial logistic regression analysis, our DCE leverages five attributes-the risk of adverse reactions, protective duration, injection doses, injection period, and effectiveness-each of which is split into three to four levels. The risk of adverse reaction and the protective duration were demonstrated to be determinants of vaccination preference. Moreover, it was found that socio demographic factors like region, self-health assessment and the number of vaccinated household members can strengthen or weaken the effects of vaccine attributes. In conclusion, the preferences of the elderly population should be considered when developing COVID-19 vaccination programs for this population in China. Accordingly, the results may provide useful information for policymakers to develop tailored, effectively vaccination strategies.
| S-EPMC10063931 | biostudies-literature
Project description:BackgroundLow vaccine uptake has the potential to seriously undermine COVID-19 vaccination programs, as very high coverage levels are likely to be needed for virus suppression to return life to normal. We aimed to determine the influence of vaccine attributes (including access costs) on COVID-19 vaccination preferences among the Malaysian public to improve national uptake.MethodsAn online Discrete Choice Experiment (DCE) was conducted on a representative sample of 2028 Malaysians. Respondents were asked to make vaccination decisions in a series of hypothetical scenarios. A nested, mixed logit model was used to estimate the preferences for vaccination over vaccine refusal and for how those preferences varied between different sub-populations. The attributes were the risk of developing severe side effects of the vaccine, vaccine effectiveness, vaccine content, vaccination schedule, and distance from home to vaccination centre.FindingsReported public uptake of COVID-19 vaccination was primarily influenced by the risk of developing severe side effects (b = -1·747, 95% CI = -2·269, -1·225), vaccine effectiveness (b = 3·061, 95% CI = 2·628, 3·494) and its Halal status (b = 3·722, 95% CI = 3·152, 4·292). Other factors such as appointment timing and travel distance to the vaccination centre also had an effect on vaccine uptake. There was substantial heterogeneity in preferences between different populations, particularly for age groups, ethnicity, regions, and underlying health conditions.InterpretationPerceived effectiveness and side effects are likely to affect COVID-19 vaccine uptake in Malaysia. Halal content is critical to Malays' vaccination choices. Reducing the physical distance to vaccination centres, particularly in rural areas where uptake is lower, is likely to improve uptake.FundingMinistry of Health Research Grant from the Malaysian government [NIH/800-3/2/1 Jld.7(46), grant reference no: 57377 and warrant no: 91000776].
| S-EPMC9359905 | biostudies-literature
Project description:ObjectiveTo promote public health and resume university activities, COVID-19 vaccination has been mandated from an increasing number of universities worldwide. The objective of the study is to understand the factors that impact preference and willingness to take the vaccine among university students in Hong Kong universities utilizing an online questionnaire. The findings will be imperative for health education and the success of the vaccination program.ResultsWe conducted a discrete choice experiment survey among university students in Hong Kong and applied conditional logit regression to estimate their vaccine preference and the weight of each attribute. Regression results showed adverse reactions, efficacy, origin of the vaccine, required number of doses and out-of-pocket price are significant determinants for the choice of vaccine, ranked from the most to least important. Similar preference weighting results were observed after adjusting age, sex, monthly household income, studying medical-related subjects and recent influenza vaccination. Safety, efficacy and origin of the vaccine are key drivers for vaccination decisions among young adults in Hong Kong. Health education and communication focused on these factors are urgently needed to overcome vaccine hesitancy and improve the vaccine uptake.
| S-EPMC8607213 | 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
Project description:BACKGROUND: Guidelines underline the role of individual preferences in the selection of a screening test, as insufficient evidence is available to recommend one screening test over another. We conducted a study to determine the preferences of individuals and to predict uptake for colorectal cancer (CRC) screening programmes using various screening tests. METHODS: A discrete choice experiment (DCE) questionnaire was distributed among naive subjects, yet to be screened, and previously screened subjects, aged 50-75 years. Subjects were asked to choose between scenarios on the basis of faecal occult blood test (FOBT), flexible sigmoidoscopy (FS), total colonoscopy (TC) with various test-specific screening intervals and mortality reductions, and no screening (opt-out). RESULTS: In total, 489 out of 1498 (33%) screening-naïve subjects (52% male; mean age+/-s.d. 61+/-7 years) and 545 out of 769 (71%) previously screened subjects (52% male; mean age+/-s.d. 61+/-6 years) returned the questionnaire. The type of screening test, screening interval, and risk reduction of CRC-related mortality influenced subjects' preferences (all P<0.05). Screening-naive and previously screened subjects equally preferred 5-yearly FS and 10-yearly TC (P=0.24; P=0.11), but favoured both strategies to annual FOBT screening (all P-values <0.001) if, based on the literature, realistic risk reduction of CRC-related mortality was applied. Screening-naive and previously screened subjects were willing to undergo a 10-yearly TC instead of a 5-yearly FS to obtain an additional risk reduction of CRC-related mortality of 45% (P<0.001). CONCLUSION: These data provide insight into the extent by which interval and risk reduction of CRC-related mortality affect preferences for CRC screening tests. Assuming realistic test characteristics, subjects in the target population preferred endoscopic screening over FOBT screening, partly, due to the more favourable risk reduction of CRC-related mortality by endoscopy screening. Increasing the knowledge of potential screenees regarding risk reduction by different screening strategies is, therefore, warranted to prevent unrealistic expectations and to optimise informed choice.
| S-EPMC2844026 | biostudies-other