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Distinguishing protest responses in contingent valuation: A conceptualization of motivations and attitudes behind them.

ABSTRACT: The percentage of protesters in contingent valuation surveys is substantial-about 20% across many studies. This paper seeks to clarify the motivations behind protest responses. In addition, the question whether the estimation of willingness to pay (WTP) is more biased by the exclusion or inclusion of protest bids is yet undecided. Methodological improvements are difficult for three reasons: motivations behind protest responses are largely unclear, definitions of protest differ between studies and often only participants who state a zero WTP are asked for their reasons. Our survey on farm animal welfare (n = 1335) provides detailed motivations, two definitions and includes debriefing of all participants for their WTP. We find that protest bids are not a refusal to answer, they are neither irrational nor driven by lack of understanding. Quite the contrary, a large part of participants is directly motivated by moral reasons. Furthermore, protest responses are not coupled to a zero WTP. In our sample, only 8% out of 32% protesting participants had a zero WTP. Only a small fraction of zero bids (0.4%) are true WTP-statements, i.e. respondents were satisfied with the status quo. This finding has important implications for existing WTP-estimates which might be biased. Finally, we provide detailed estimates of the WTP for animal welfare issues by including and excluding different types of protesters and outliers.

SUBMITTER: Frey UJ

PROVIDER: S-EPMC6324805 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Distinguishing protest responses in contingent valuation: A conceptualization of motivations and attitudes behind them.

Frey Ulrich J UJ Pirscher Frauke F

PloS one 20190108 1

The percentage of protesters in contingent valuation surveys is substantial-about 20% across many studies. This paper seeks to clarify the motivations behind protest responses. In addition, the question whether the estimation of willingness to pay (WTP) is more biased by the exclusion or inclusion of protest bids is yet undecided. Methodological improvements are difficult for three reasons: motivations behind protest responses are largely unclear, definitions of protest differ between studies an ...[more]

PMID: 30620731

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Project description:BackgroundA greater emphasis on providing high-value orthopaedic interventions has resulted in increased health economic reporting. The contingent-valuation method (CVM) is used to determine consumer valuation of the benefits provided by healthcare interventions. CVM is an important value-based health economic tool that is underutilized in orthopaedic surgery.Questions/purposesThe purpose of this study was to (1) identify previously published CVM studies in the orthopaedic literature, (2) assess the methodologies used for CVM research, and (3) understand how CVM has been used in the orthopaedic cost-benefit analysis framework.MethodsA systematic review of the literature using the MEDLINE database was performed to compile CVM studies. Search terms incorporated the phrase willingness to pay (WTP) or willingness to accept (WTA) in combination with orthopaedic clinical key terms. Study methodology was appraised using previously defined empirical and conceptual criteria for CVM studies.ResultsOf the 160 studies retrieved, 22 (13.8%) met our inclusion criteria. The economics of joint arthroplasty (n?=?6, 27.3%) and non-operative osteoarthritis care (n?=?4, 18.2%) were the most common topics. Most studies used CVM for pricing and/or demand forecasting (n?=?16, 72.7%); very few studies used CVM for program evaluation (n?=?6). WTP was used in all included studies, and one study used both WTP and WTA. Otherwise, there was little consistency among included studies in terms of CVM methodology. Open-ended questioning was used by only ten studies (45.5%), a significant number of studies did not perform a sensitivity analysis (n?=?9, 40.9%), and none of the studies accounted for the risk preference of subjects. Only two of the included studies applied CVM within a cost-benefit analysis framework.ConclusionCVM is not commonly reported in orthopaedic surgery and is seldom used in the context of cost-benefit analysis. There is wide variability in the methods used to perform CVM. We propose that CVM is an appropriate and underappreciated method for understanding the value of orthopaedic interventions. Increased attention should be paid to consumer valuations for orthopaedic interventions.

Project description:BackgroundChanging population demographics and technology developments have resulted in growing interest in the potential of consumer-facing digital health. In the United Kingdom, a £37 million (US $49 million) national digital health program delivering assisted living lifestyles at scale (dallas) aimed to deploy such technologies at scale. However, little is known about how consumers value such digital health opportunities.ObjectiveThis study explored consumers' perspectives on the potential value of digital health technologies, particularly mobile health (mHealth), to promote well-being by examining their willingness-to-pay (WTP) for such health solutions.MethodsA contingent valuation study involving a UK-wide survey that asked participants to report open-ended absolute and marginal WTP or willingness-to-accept for the gain or loss of a hypothetical mHealth app, Healthy Connections.ResultsA UK-representative cohort (n=1697) and a dallas-like (representative of dallas intervention communities) cohort (n=305) were surveyed. Positive absolute and marginal WTP valuations of the app were identified across both cohorts (absolute WTP: UK-representative cohort £196 or US $258 and dallas-like cohort £162 or US $214; marginal WTP: UK-representative cohort £160 or US $211 and dallas-like cohort £151 or US $199). Among both cohorts, there was a high prevalence of zeros for both the absolute WTP (UK-representative cohort: 467/1697, 27.52% and dallas-like cohort: 95/305, 31.15%) and marginal WTP (UK-representative cohort: 487/1697, 28.70% and dallas-like cohort: 99/305, 32.5%). In both cohorts, better general health, previous amount spent on health apps (UK-representative cohort 0.64, 95% CI 0.27 to 1.01; dallas-like cohort: 1.27, 95% CI 0.32 to 2.23), and age had a significant (P>.00) association with WTP (UK-representative cohort: -0.1, 95% CI -0.02 to -0.01; dallas-like cohort: -0.02, 95% CI -0.03 to -0.01), with younger participants willing to pay more for the app. In the UK-representative cohort, as expected, higher WTP was positively associated with income up to £30,000 or US $39,642 (0.21, 95% CI 0.14 to 0.4) and increased spending on existing phone and internet services (0.52, 95% CI 0.30 to 0.74). The amount spent on existing health apps was shown to be a positive indicator of WTP across cohorts, although the effect was marginal (UK-representative cohort 0.01, 95% CI 0.01 to 0.01; dallas-like cohort 0.01, 95% CI 0.01 to 0.02).ConclusionsThis study demonstrates that consumers value mHealth solutions that promote well-being, social connectivity, and health care control, but it is not universally embraced. For mHealth to achieve its potential, apps need to be tailored to user accessibility and health needs, and more understanding of what hinders frequent users of digital technologies and those with long-term conditions is required. This novel application of WTP in a digital health context demonstrates an economic argument for investing in upskilling the population to promote access and expedite uptake and utilization of such digital health and well-being apps.

Dataset Information

Distinguishing protest responses in contingent valuation: A conceptualization of motivations and attitudes behind them.

Publications

Distinguishing protest responses in contingent valuation: A conceptualization of motivations and attitudes behind them.

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