1
|
Maculaitis MC, Hauber B, Beusterien KM, Will O, Kopenhafer L, Law AW, Vietri JT, Cappelleri JC, Coulter JR, Pugh S, Shea KM. A latent class analysis of factors influencing preferences for infant respiratory syncytial virus (RSV) preventives among pregnant people in the United States. Hum Vaccin Immunother 2024; 20:2358566. [PMID: 38847198 PMCID: PMC11164215 DOI: 10.1080/21645515.2024.2358566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/19/2024] [Indexed: 06/12/2024] Open
Abstract
A maternal vaccine and long-acting monoclonal antibody (mAb) were recently approved to protect infants against respiratory syncytial virus (RSV). We identified subgroups of pregnant people with different preferences for RSV preventives and respondent characteristics associated with subgroup membership. An online survey, including a discrete choice experiment (DCE), was conducted among US pregnant people. RSV preventive attributes included effectiveness, duration of protection during RSV season, injection recipient/timing, preventive type (vaccine or mAb), and type of visit required to receive injection. In DCE choice tasks, pregnant people selected between two hypothetical preventive profiles with varying attribute-levels and a no-preventive option. Logistic regression, including latent class analysis (LCA), was used to analyze the data. Of 992 pregnant people (mean age: 30.0 years), 60.3% were expecting their second/later birth. LCA identified three preference subgroups: 'Effectiveness' (preventive choice mostly driven by increases in effectiveness; 51.4% class membership probability), 'Season' (preventive choice mostly driven by improvement in duration of protection during the RSV season; 39.2% class membership probability), and 'No Preventive' (frequently chose no-preventive option; 9.4% class membership probability). 'Effectiveness' and 'Season' preferred maternal vaccine over mAb; mAb was preferred by 'No Preventive.' Perceiving RSV as serious for infants, higher health literacy, and lower household income were associated with 'Effectiveness.' Perceiving RSV as serious for pregnant people was associated with 'Season.' Perceiving RSV to not be serious for pregnant people and not being employed were associated with 'No Preventive.' Subgroups of pregnant people vary in preferences for RSV preventives. Most pregnant people preferred a maternal vaccine, although some may be more willing to accept alternative preventive options.
Collapse
Affiliation(s)
| | - Brett Hauber
- Worldwide Medical and Safety, Pfizer Inc, New York, NY, USA
| | | | - Oliver Will
- Real World Data & Analytics, Oracle Life Sciences, Austin, TX, USA
| | - Lewis Kopenhafer
- Real World Data & Analytics, Oracle Life Sciences, Austin, TX, USA
| | - Amy W. Law
- Global Access & Value Pfizer Inc, New York, NY, USA
| | | | | | | | - Sarah Pugh
- US Vaccines Medical & Scientific Affairs, Pfizer Inc, New York, NY, USA
| | | |
Collapse
|
2
|
Wright DR, Chen T, Chalmers KD, Shah SK, Yi-Frazier JP, LeBlanc JL, Garvey K, Senturia KD, Pihoker C, Malik FS. Adolescent-Preferred financial incentives to promote type 1 diabetes Self-Care: A discrete choice experiment. Diabetes Res Clin Pract 2024; 215:111798. [PMID: 39096938 DOI: 10.1016/j.diabres.2024.111798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/12/2024] [Accepted: 07/28/2024] [Indexed: 08/05/2024]
Abstract
AIMS This study aimed to quantify preferences for the characteristics of a financial incentives program that would motivate adolescent engagement in type 1 diabetes (T1D) self-care. METHOD We performed a discrete choice experiment with 12-18 year-olds with T1D from two pediatric hospital endocrinology clinics (n = 317). We identified key attributes of incentives: (1) monthly value of the reward, (2) payment structure, and (3) difficulty of incentivized behaviors. In twelve choice questions, adolescents chose the incentive option from a pair of profiles that was more likely to motivate them to increase adherence to recommended self-care. Options presented were tailored to adolescents' T1D technology use and perceived difficulty of completing each behavior. We analyzed data using a conditional logit model. RESULTS The value of the reward accounted for 60.8% of preferences. Adolescents were willing to accept lower value rewards when incentive payments used positive vs. negative reinforcement (-$10.88 (95% CI: -$12.60, -9.24)) and preferred higher incentives for performing hard vs. easier behaviors (+$14.92 (95% CI: +$12.66, +$17.28)). CONCLUSIONS Stated preferences can inform intervention design. Future research will evaluate the external validity of the discrete choice experiment-informed intervention design by assessing adolescent health and behavioral outcomes in a randomized controlled trial.
Collapse
Affiliation(s)
- Davene R Wright
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Tom Chen
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Seema K Shah
- Department of Pediatrics, Northwestern University School of Medicine, Chicago, IL, USA; Smith Child Health Outreach, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Lurie Children's Hospital, Chicago, IL, USA
| | - Joyce P Yi-Frazier
- Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA USA
| | - Jessica L LeBlanc
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Katharine Garvey
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - Kirsten D Senturia
- Seattle Children's Research Institute, Seattle, WA, USA; University of Washington, Seattle, WA, USA
| | - Catherine Pihoker
- Seattle Children's Research Institute, Seattle, WA, USA; University of Washington, Seattle, WA, USA
| | - Faisal S Malik
- Seattle Children's Research Institute, Seattle, WA, USA; University of Washington, Seattle, WA, USA
| |
Collapse
|
3
|
Forcada-Segarra JA, Cuesta-Esteve I, García Pérez A, Sancho Martínez R, Rey Biel P, Carrera-Barnet G, Cuadra-Grande ADL, Casado MÁ, Drago G, Gómez-Barrera M, López-Belmonte JL. Nurses' preferences regarding MenACWY conjugate vaccines attributes: a discrete choice experiment in Spain. Public Health 2024; 230:163-171. [PMID: 38555685 DOI: 10.1016/j.puhe.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Immunisation against preventable diseases as meningitis is crucial from a public health perspective to face challenges posed by these infections. Nurses hold a great responsibility for these programs, which highlights the importance of understanding their preferences and needs to improve the success of campaigns. This study aimed to investigate nurses' preferences regarding Meningococcus A, C, W, and Y (MenACWY) conjugate vaccines commercialised in Spain. STUDY DESIGN A national-level discrete choice experiment (DCE) was conducted. METHODS A literature review and a focus group informed the DCE design. Six attributes were included: pharmaceutical form, coadministration evidence, shelf-life, package contents, single-doses per package, and package volume. Conditional logit models quantified preferences and relative importance (RI). RESULTS Thirty experienced primary care nurses participated in this study. Evidence of coadministration with other vaccines was the most important attribute (RI = 43.78%), followed by package size (RI = 22.17%), pharmaceutical form (RI = 19.07%), and package content (RI = 11.80%). There was a preference for evidence of coadministration with routine vaccines (odds ratio [OR] = 2.579, 95% confidence interval [95%CI] = 2.210-3.002), smaller volumes (OR = 1.494, 95%CI = 1.264-1.767), liquid formulations (OR = 1.283, 95%CI = 1.108-1.486) and package contents including only vial/s (OR = 1.283, 95%CI = 1.108-1.486). No statistical evidence was found for the remaining attributes. CONCLUSIONS Evidence of coadministration with routine vaccines, easy-to-store packages, and fully liquid formulations were drivers of nurses' preferences regarding MenACWY conjugate vaccines. These findings provide valuable insights for decision-makers to optimize current campaigns.
Collapse
Affiliation(s)
- J A Forcada-Segarra
- Asociación Nacional de Enfermería y Vacunas (ANENVAC), Valencia, Spain; Public Health Nurse, Valencia, Spain
| | - I Cuesta-Esteve
- Asociación Nacional de Enfermería y Vacunas (ANENVAC), Valencia, Spain; Nurse and Matron, Zaragoza, Spain
| | - A García Pérez
- Asociación Nacional de Enfermería y Vacunas (ANENVAC), Valencia, Spain; Primary Care Nurse, Cáceres, Spain
| | - R Sancho Martínez
- Asociación Nacional de Enfermería y Vacunas (ANENVAC), Valencia, Spain; Vaccinology, Public Health, Basque Government, San Sebastian, Spain
| | - P Rey Biel
- ESADE Business School, Universitat Ramón Llull, Spain
| | | | - A de la Cuadra-Grande
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 e Letter I, Pozuelo de Alarcón, 28224, Madrid, Spain.
| | - M Á Casado
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 e Letter I, Pozuelo de Alarcón, 28224, Madrid, Spain
| | - G Drago
- Medical Advisor Vaccines, Sanofi, Barcelona, Spain
| | - M Gómez-Barrera
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 e Letter I, Pozuelo de Alarcón, 28224, Madrid, Spain
| | | |
Collapse
|
4
|
Zhang L, Chen J, Cao Z, Zhang M, Ma R, Zhang P, Yao G, Li X. Patient versus physician preferences for lipid-lowering drug therapy: A discrete choice experiment. Health Expect 2024; 27:e14043. [PMID: 38590082 PMCID: PMC11002318 DOI: 10.1111/hex.14043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The emergence of proprotein convertase subtilisin/kexin type 9 inhibitors offered dyslipidemia patients an alternative to statins for lipid-lowering treatment. Understanding patient and physician preferences for lipid-lowering drugs may promote shared decision-making and improve treatment outcomes. METHODS This study utilized an online discrete choice experiment (DCE) to assess the relative importance (RI) of six attributes related to lipid-lowering drugs, including frequency of administration, mode of administration, reduction of low-density lipoprotein cholesterol (LDL-C) level, risk of myopathy, risk of liver damage, and out-of-pocket monthly cost. Respondents were recruited from dyslipidemia patients and cardiovascular physicians in China. A mixed logit model and latent class analysis were employed to estimate the preference coefficient, marginal willingness to pay (mWTP), and RI of attributes. Ethical approval has been obtained for this study. RESULTS A total of 708 patients and 507 physicians participated in the survey. Patients prioritized the 'risk of liver damage' (RI = 23.6%) with 'mode of administration' (RI = 19.2%) and 'frequency of administration' (RI = 18.8%) following closely. Contrarily, physicians prioritized the 'reduction of LDL-C level' (RI = 33.5%), followed by 'risk of liver damage' (RI = 26.0%) and 'risk of myopathy' (RI = 16.1%). Patients placed a higher value on 'frequency of administration' (p < .001) and 'mode of administration' (p < .001) compared to physicians, while physicians valued 'reduction of LDL-C level' (p < .001) and 'risk of myopathy' (p = .012) more than patients. Physicians exhibited higher mWTP than patients for all attributes except frequency and mode of administration. The LCA revealed three distinct patient classes: focus on oral administration, focus on hepatic safety and frequency and focus on hepatic safety and cost. Likewise, three physician classes were identified: frequency-insensitive, efficacy-focused and safety-focused. CONCLUSIONS The preferences for lipid-lowering drug therapy differed between patients and physicians in China. Physicians should take into account patients' preferences and provide personalized treatment when they formulate lipid-lowering treatment plans. PATIENT OR PUBLIC CONTRIBUTION Patients participated in the questionnaire design process. They engaged in a focus group discussion to determine attributes and levels and also participated in a pilot survey to assess the comprehensibility of the questionnaires. Additionally, patients were involved in the DCE survey to express their preferences. The findings of patient preference for lipid-lowering drug therapy will promote shared decision-making and optimize the treatment regimen.
Collapse
Affiliation(s)
- Lingli Zhang
- Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of PharmacyNanjing Medical UniversityNanjingChina
| | - Jiali Chen
- Department of Health Policy, School of Health Policy and ManagementNanjing Medical UniversityNanjingChina
| | - Zhaoliu Cao
- Department of PharmacyNanjing City Qixia District HospitalNanjingChina
| | - Mengdie Zhang
- Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of PharmacyNanjing Medical UniversityNanjingChina
| | - Rui Ma
- Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of PharmacyNanjing Medical UniversityNanjingChina
| | - Pei Zhang
- Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of PharmacyNanjing Medical UniversityNanjingChina
| | - Guiqing Yao
- Department of Cardiovascular Sciences and Leicester Clinical Trial Unit, College of Life SciencesUniversity of LeicesterLeicesterUK
| | - Xin Li
- Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of PharmacyNanjing Medical UniversityNanjingChina
- Department of Health Policy, School of Health Policy and ManagementNanjing Medical UniversityNanjingChina
- Center for Global Health, School of Public HealthNanjing Medical UniversityNanjingChina
| |
Collapse
|
5
|
Chan AHY, Tao M, Marsh S, Petousis-Harris H. Vaccine decision making in New Zealand: a discrete choice experiment. BMC Public Health 2024; 24:447. [PMID: 38347498 PMCID: PMC10863187 DOI: 10.1186/s12889-024-17865-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a significant threat to global health. A key part of addressing hesitancy is to ensure that public health messaging prioritises information that is considered important to the public. This study aimed to examine how different vaccine characteristics affect public preferences for vaccines in New Zealand, what trade-offs they are willing to make between different vaccine characteristics, and how their preferences are affected by their vaccine-related conspiracy beliefs and COVID-19 vaccination status. METHODS An online discrete choice experiment (DCE) was designed to elicit individual preferences about vaccines using the 1000minds platform. Members of the general population of New Zealand aged ≥ 18 years were invited to complete the DCE. Participants were asked to indicate their preference between two options showing different combinations of vaccine characteristics. Data on sociodemographic characteristics were collected. Beliefs were measured using the vaccine conspiracy beliefs scale (VCBS) with scores ≥ 19 indicating strong vaccine-related conspiracy beliefs. The DCE was analysed using the PAPRIKA method (Potentially All Pairwise RanKings of all possible Alternatives) and preferences compared between respondents with high versus low VCBS scores and vaccinated versus unvaccinated respondents for COVID-19. RESULTS A total of 611 respondents from 15 regions completed the DCE. Mean (SD) age was 45.9 (14.7) years with most having had 2 or more doses of the coronavirus vaccine (86%). Mean (SD) VCBS score was 18.5 (12.4) indicating moderate vaccine-related conspiracy beliefs. Risk of severe adverse effects was the most highly valued vaccine characteristic, followed by vaccine effectiveness and duration of protection. Vaccine origin and route of administration were ranked least important. Respondents scoring high on the VCBS placed less value on the effectiveness of vaccines but greater value on development time and total number of doses (p < 0.001). COVID-19 unvaccinated respondents ranked development time and total number of doses more highly than those vaccinated respondents (p < 0.001). CONCLUSIONS Risk of severe adverse effects, vaccine effectiveness and duration of protection were rated by the New Zealand public as the top three most important vaccine characteristics. This information is important for informing public health messaging to promote vaccine uptake and inform vaccine decision-making.
Collapse
Affiliation(s)
- Amy Hai Yan Chan
- School of Pharmacy, University of Auckland, Level 3, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand.
| | - Marvin Tao
- School of Medicine, University of Auckland, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Samantha Marsh
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Helen Petousis-Harris
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| |
Collapse
|
6
|
Ma W, Zhang L, Ren D, Meng X, Yin J, Sun Q. Parental preferences for rotavirus vaccination for their children under 5 years old in China: A discrete choice experiment. Hum Vaccin Immunother 2023; 19:2179222. [PMID: 36794417 PMCID: PMC10026903 DOI: 10.1080/21645515.2023.2179222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Rotavirus vaccination is the most effective means to prevent rotavirus gastroenteritis, but its coverage in China is not ideal. We aimed to explore parental preferences for rotavirus vaccination for their children under 5years old to improve vaccination coverage. A Discrete Choice Experiment was conducted online on 415 parents with at least one child under 5years old in 3 cities. Five attributes including vaccine effectiveness, protection duration, risk of mild side-effects, out-of-pocket costs, and time required for vaccination were identified. Each attribute was set at three levels. Mixed-logit models were used to measure parental preferences and the relative importance of vaccine attributes. The optimal vaccination strategy was also explored. 359 samples were included in the analysis. The impacts of the vaccine attribute levels on vaccine choice were all statistically significant (p < .01), except for 1-hour vaccination time. The risk of mild side-effects was the most important factor influencing vaccination. The time required for vaccination was the least important attribute. The largest increase in vaccination uptake (74.45%) occurred with decreased the vaccine risk of mild side-effects from 1/10 to 1/50. The predicted vaccination uptake of the optimal vaccination scenario was 91.79%. When deciding about vaccination, parents preferred the rotavirus vaccination with lower risk of mild side-effects, higher effectiveness, longer protection duration, 2-hour vaccination time and lower cost. The authorities should support enterprises to develop vaccines with lower side-effects, higher effectiveness and longer protection duration in the future. We call for appropriate government subsidies for the rotavirus vaccine.
Collapse
Affiliation(s)
- Wenwen Ma
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Liujin Zhang
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Deyu Ren
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaoqing Meng
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jia Yin
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Qiang Sun
- Centre for Health Management and Policy Research, School of Public Health,Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| |
Collapse
|
7
|
Du J, Ji W, Zhao H, McIver DJ, Zhao Y, Chang J, Fang Y. Preferences of pregnant women toward a future maternal Group B Streptococcus vaccine in China: A cross-sectional survey with a discrete choice experiment. Hum Vaccin Immunother 2023; 19:2281713. [PMID: 38175949 PMCID: PMC10760376 DOI: 10.1080/21645515.2023.2281713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/03/2023] [Indexed: 01/06/2024] Open
Abstract
Group B streptococcus (GBS) is a major cause of neonatal death worldwide. A GBS vaccine for pregnant women is under development and is expected to be available in the near future. The perceptions and preferences of pregnant women in China of GBS vaccines has not been investigated, and this study aimed to investigate pregnant women's awareness of GBS and their potential preferences for the GBS vaccine. A discrete choice experiment was conducted among pregnant women in hospitals from Shaanxi, Hunan, and Zhejiang provinces located in Western, Central, and Eastern China, respectively. A conditional logit model was used to analyze the data and calculate willingness to pay values and choice probabilities of different GBS vaccine programs. A total of 354 pregnant women were included in the final analysis, 45.8% of whom were willing to receive a GBS vaccine if it were licensed. Vaccine safety was the most important attribute of a future vaccine, while cost was the least important attribute. Compared with no vaccination, pregnant women had a strong preference for future GBS vaccination (ASC = 1.267, p < .001). Pregnant women's decisions were highly influenced by those of other pregnant women. Improving the safety, efficacy, and vaccination rate of the GBS vaccine in China is of great significance for future GBS vaccine development and vaccination. Compared to other variable options, the cost of a GBS vaccine was of the least importance among pregnant women in mainland China. These findings can inform public health policy decisions related to GBS vaccination in China.
Collapse
Affiliation(s)
- Jiaxi Du
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Hang Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - David J. McIver
- Institute for Global Health Sciences, University of California, San Fransisco, CA, USA
| | - Yifei Zhao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China’s Western Technological Innovation Harbor, Xi’an, China
| |
Collapse
|
8
|
Bonner KE, Chyderiotis S, Sicsic J, Mueller JE, Ulrich AK, Toomey T, Horvath KJ, Neaton JD, Basta NE. What motivates adults to accept influenza vaccine? An assessment of incentives, ease of access, messaging, and sources of information using a discrete choice experiment. SSM Popul Health 2023; 22:101384. [PMID: 37008807 PMCID: PMC10060740 DOI: 10.1016/j.ssmph.2023.101384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/15/2023] Open
Abstract
Seasonal influenza vaccination rates remain low, and contribute to preventable influenza cases, hospitalizations, and deaths in the US. While numerous interventions have been implemented to increase vaccine uptake, there is a need to determine which interventions contribute most to vaccine willingness, particularly among age groups with vaccination rates that have plateaued at suboptimal levels. This study aimed to quantify the relative effect of multiple interventions on vaccine willingness to receive influenza vaccine in three age groups using a series of hypothetical situations with different behavioral interventions. We assessed the relative impact of four categories of interventions: source of vaccine messages, type of vaccination messages, vaccination incentives, and ease of vaccine access using a discrete choice experiment. Within each category, we investigated the role of four different attributes to measure their relative contribution to willingness to be vaccinated by removing one option from each of the intervention categories. Among the 1,763 Minnesota residents who volunteered for our study, participants expressed vaccine willingness in over 80% of the scenarios presented. Easy access to drop-in vaccination sites had the greatest impact on vaccine willingness in all age groups. Among the younger age group, small financial incentives also contributed to high vaccine willingness. Our results suggest that public health programs and vaccination campaigns may improve their chances of successfully increasing vaccine willingness if they offer interventions preferred by adults, including facilitating convenient access to vaccination and offering small monetary incentives, particularly for young adults.
Collapse
|
9
|
Tagbor S, Ohene LA, Adjei CA, Kyei J. Perceptions and Cues to Action as Predictors of Nurses' Vaccination Intentions at Two Primary Health Care Facilities in Ghana. Am J Trop Med Hyg 2023; 108:433-440. [PMID: 36535250 PMCID: PMC9896321 DOI: 10.4269/ajtmh.21-1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/13/2022] [Indexed: 12/23/2022] Open
Abstract
Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses' hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r = 0.14, P < 0.05; r = 0.17, P < 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r = -0.13, P < 0.05; r = -0.24, P < 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (β = -0.22, t = -2.48, P = 0.01). Nurses' vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses' vaccination uptake.
Collapse
Affiliation(s)
- Solomon Tagbor
- Department of Nursing, Nursing and Midwifery Training College, Kete-Krachi, Ghana
| | - Lillian Akorfa Ohene
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Charles Ampong Adjei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Josephine Kyei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| |
Collapse
|
10
|
Martinón-Torres F, de Miguel ÁG, Ruiz-Contreras J, Vallejo-Aparicio LA, García A, Gonzalez-Inchausti MC, de Gomensoro E, Kocaata Z, Gabás-Rivera C, Comellas M, Prades M, Lizán L. Societal Preferences for Meningococcal B Vaccination in Children: A Discrete Choice Experiment in Spain. Infect Dis Ther 2023; 12:157-175. [PMID: 36367677 PMCID: PMC9868201 DOI: 10.1007/s40121-022-00708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Immunization is the most effective strategy for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroup B (MenB); however, parents need to weigh the risk-benefit and financial impact of immunizing their children against MenB in the absence of a national immunization program (NIP). This study aimed to explore societal preferences (of parents and pediatricians) regarding the attributes of a MenB vaccine in Spain. METHODS A discrete choice experiment (DCE) based on cross-sectional surveys was carried out to determine preferences. A literature review and scientific committee determined the six attributes related to the MenB vaccine included in the DCE: vaccination age, cost, duration, percentage of protection, adverse events probability, and expert/authority recommendation. Data were analyzed using a mixed logit model. Relative importance (RI) of attributes was calculated and compared between parents and pediatricians. RESULTS A total of 278 parents [55.8% female, mean age 40.4 (standard deviation, SD 7.3) years] and 200 pediatricians [73.0% female, mean age 45.8 (SD 12.9) years] answered the DCE. For parents, the highest RI was attributed to vaccine cost, expert/authority recommendation, and percentage of protection (26.4%, 26.1%, and 22.9%, respectively), while for pediatricians the highest RI was assigned to percentage of protection, expert/authority recommendation, and vaccination age (27.2%, 23.7%, and 22.6%, respectively). Significant differences between parents and pediatricians were found in the RI assigned to all attributes (p < 0.001), except for vaccine recommendation. CONCLUSION In the decision regarding MenB vaccination, cost was a driver in parental decision-making but had a low RI for pediatricians and, conversely, vaccination age was highly valued by pediatricians but was the attribute with least importance for parents. Despite these differences, expert/authority recommendation and percentage of protection were essential criteria for both groups. These results provide relevant information about MenB vaccination, highlighting the importance of considering societal preferences for NIP inclusion.
Collapse
Affiliation(s)
- Federico Martinón-Torres
- grid.411048.80000 0000 8816 6945Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain ,grid.11794.3a0000000109410645Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Ángel Gil de Miguel
- grid.28479.300000 0001 2206 5938Department of Preventive Medicine and Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | - Jesús Ruiz-Contreras
- grid.144756.50000 0001 1945 5329Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Pediatrics, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | | | - Zeki Kocaata
- grid.425090.a0000 0004 0468 9597GSK, Wavre, Belgium
| | | | | | | | - Luis Lizán
- Outcomes’10, Castellón, Spain ,Department of Medicine, Universidad Jaime I, Castellón, Spain
| |
Collapse
|
11
|
Panchalingam T, Shi Y. Parental refusal and hesitancy of vaccinating children against COVID-19: Findings from a nationally representative sample of parents in the U.S. Prev Med 2022; 164:107288. [PMID: 36228873 PMCID: PMC9549707 DOI: 10.1016/j.ypmed.2022.107288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 12/04/2022]
Abstract
The uptake rate of COVID-19 vaccines among children remains low in the U.S. This study aims to 1) identify sociodemographic and behavioral factors influencing parental refusal of vaccinating children, and 2) quantify the relative importance of vaccine characteristics in parental hesitancy of vaccinating children. An online survey was conducted from October to November 2021 among a probability-based, representative sample of 1456 parents with children under age 18. The survey included a discrete choice experiment asking parents to choose between two hypothetical COVID-19 vaccine alternatives with varying levels of characteristics in 10 hypothetical scenarios. Logistic regressions were used to estimate parental refusal (refused to choose any vaccine alternatives in all hypothetical scenarios) and random parameter logit regressions were used to estimate parental hesitancy (choice of vaccine alternatives depended on vaccine characteristics) of vaccinating children. About 20% parents refused to vaccinate children. The refusal is predicted by parents' sociodemographic characteristics, political orientation, vaccination status, and parents' and children's previous exposure with COVID-19. Among parents who were willing to consider vaccinating children, the most important vaccine characteristics are risk of severe side effects (31.2% relative importance) and effectiveness (30.7%), followed by protection duration (22.6%), local coverage (9.4%), and hospitalization rate of unvaccinated children (6.1%). Our findings imply that policymakers and public health professionals could develop outreach programs at community level to encourage specific subgroups and focus on vaccination depoliticization. Effectively communicating the low risk of severe side effects and high effectiveness of the vaccines may relieve some of the parental hesitancy.
Collapse
Affiliation(s)
- Thadchaigeni Panchalingam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA.
| |
Collapse
|
12
|
Poulos C, Boeri M, Coulter J, Huang L, Schley K, Pugh SJ. Travelers' preferences for tick-borne encephalitis vaccination. Expert Rev Vaccines 2022; 21:1495-1504. [PMID: 36154795 DOI: 10.1080/14760584.2022.2108798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aimed to quantify preferences and risk tolerance for a tick-borne encephalitis (TBE) vaccination. RESEARCH DESIGN AND METHODS A stated-preference survey instrument was administered to international travelers living in the United States to elicit preferences for a no-cost TBE vaccine when planning an international trip, conditional upon four different qualitative levels of endemic TBE risk. RESULTS The likelihood of choosing the vaccine increased with a destination's level of endemic risk. Most respondents (94%) would choose to receive the vaccine at the highest risk level presented in the survey (i.e. when multiple TBE cases among humans are reported year after year); 6% of the sample would choose not to receive the vaccine at any risk level. Respondents who engage in outdoor activities were twice as likely as the average respondent to choose vaccination rather than opting out of vaccination, and were one-third more likely than the average respondent to choose to receive the vaccine at the lowest risk level. CONCLUSIONS Respondents were highly interested in a TBE vaccine, assuming no cost, and most were willing to be vaccinated at all qualitative TBE risk levels. Respondents who participated in outdoor activities were more likely than the average respondent to choose the vaccine.
Collapse
Affiliation(s)
| | - Marco Boeri
- RTI Health Solutions, Belfast, Northern Ireland
| | | | | | | | | |
Collapse
|
13
|
Darrudi A, Daroudi R, Yunesian M, Akbari Sari A. Public Preferences and Willingness to Pay for a COVID-19 Vaccine in Iran: A Discrete Choice Experiment. PHARMACOECONOMICS - OPEN 2022; 6:669-679. [PMID: 35997900 PMCID: PMC9397161 DOI: 10.1007/s41669-022-00359-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic is a major international threat and vaccination is the most robust strategy to terminate this crisis. It is helpful for policymakers to be aware of community preferences about vaccines. The present study aims to investigate the public's preferences and willingness to pay for the COVID-19 vaccine in Iran. METHODS This research is a cross-sectional study performed using a discrete choice experiment for a sample of the public population of several provinces of Iran in 2021. The samples were divided into two groups: one group expressed their preferences regarding the vaccine's attributes, and another group expressed their preferences regarding prioritizing individuals to get the vaccine. The discrete choice experiment design included five attributes including effectiveness, risk of severe complications, price, location of vaccine production, and duration of protection related to preferences for vaccine selection and six attributes including age, underlying diseases, employment in the healthcare sector, the rate of virus spread, the necessary job, and cost to the community related to preferences for prioritizing individuals to get the vaccine. A total of 715 individuals completed the questionnaire. The conditional logit regression model was used to analyze the discrete choice experiment data. Willingness to pay for each attribute was also calculated. RESULTS The willingness to pay for the COVID-19 vaccine with 90% (70%) efficacy, the risk of severe complications for 1 (5) person per one million people, imported (domestic) vaccine, and 24-month (12-month) duration of protection attributes was about US$71 (US$37). The preference for vaccination for respondents was enhanced by increasing the efficacy and the duration of vaccine protection and decreasing complications and costs. The likelihood of prioritizing individuals to get a vaccination was increased for a person with an underlying disease, employment in the healthcare sector, the necessary job for the community, the high potential for virus spread in the community, and the high cost of death to the community. The age variable was not statistically significant for prioritizing individuals to get the vaccine. CONCLUSIONS In the setting of the COVID-19 vaccination program, the public's preferences identified in this study should be considered. The obtained results provide useful information for policymakers to identify individual and social values for an appropriate vaccination strategy.
Collapse
Affiliation(s)
- Alireza Darrudi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., 1417613191, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., 1417613191, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., 1417613191, Tehran, Iran.
| |
Collapse
|
14
|
Speckemeier C. Preferences for attributes of long-term care in dementia: a scoping review of multi-criteria decision analyses. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01743-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Abstract
Aim
Long-term care considerations for persons with dementia are complex. Multi-criteria decision analysis (MCDA) methods are increasingly used to support healthcare decisions. The objective of this scoping review was to identify and analyze published MCDAs in which preferences for living and care concepts for persons with dementia are determined.
Subject and methods
A literature search was conducted in PubMed, EMBASE, Web of Science, and Google Scholar in October 2021. Searches were limited to peer-reviewed articles published up to October 14, 2021. The included publications aimed at eliciting care preferences for persons with dementia from patients, relatives, healthcare practitioners or the broader public by means of MCDA.
Results
Ten studies were included of whom seven were published in 2017 or afterwards. In nine studies, a discrete choice experiment (DCE) was conducted. The majority of studies surveyed the general population or caregivers of persons with dementia. Five studies assessed preferences for attributes of home care and two for long-term care facilities. Willingness to pay was addressed in eight studies. Choice task structure and experimental design varied widely. Despite different objectives, strong preferences for continuous care by the same person, organizational aspects, and caregiver expertise were found across studies.
Conclusion
This review shows that MCDA methods have successfully been applied to analyze preferences for living and care arrangements for persons with dementia. The majority of publications report on DCEs, and a variety of different study objectives and methodological approaches have been observed. Further research is needed to inform the design of innovative concepts which are a valuable alternative to existing care options.
Collapse
|
15
|
Li S, Gong T, Chen G, Liu P, Lai X, Rong H, Ma X, Hou Z, Fang H. Parental preference for influenza vaccine for children in China: a discrete choice experiment. BMJ Open 2022; 12:e055725. [PMID: 35680275 PMCID: PMC9185483 DOI: 10.1136/bmjopen-2021-055725] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate what factors affect parents' influenza vaccination preference for their children and whether there exists preference heterogeneity among respondents in China. DESIGN Cross-sectional study. A discrete choice experiment was conducted. Five attributes were identified based on literature review and qualitative interviews, including protection rate, duration of vaccine-induced protection, risk of serious side effects, location of manufacturer and out-of-pocket cost. SETTING Multistage sampling design was used. According to geographical location and the level of economic development, 10 provinces in China were selected, and the survey was conducted at community healthcare centres or stations. PARTICIPANTS Parents with at least one child aged between 6 months and 5 years old were recruited and the survey was conducted via a face-to-face interview in 2019. In total, 600 parents completed the survey, and 449 who passed the internal consistency test were included in the main analysis. MAIN OUTCOMES AND MEASURES A mixed logit model was used to estimate factors affecting parents' preference to vaccinate their children. In addition, sociodemographic characteristics were included to explore the preference heterogeneity. RESULTS In general, respondents preferred to vaccinate their children. All attributes were statistically significant and among them, the risk of severe side effects was the most important attribute, followed by the protection rate and duration of vaccine-induced protection. Contrary to our initial expectation, respondents have a stronger preference for the domestic than the imported vaccine. Some preference heterogeneity among parents was also found and in particular, parents who were older, or highly educated placed a higher weight on a higher protection rate. CONCLUSION Vaccination safety and vaccine effectiveness are the two most important characteristics that influenced parents' decision to vaccinate against influenza for their children in China. Results from this study will facilitate future policy implementations to improve vaccination uptake rates.
Collapse
Affiliation(s)
- Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Tiantian Gong
- Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Clayton, Victoria, Australia
| | - Ping Liu
- Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing, China
| | - Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing, China
- Institute for Excellence in Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China
- Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University, Beijing, China
| |
Collapse
|
16
|
Luyten J, Beutels P, Vandermeulen C, Kessels R. Social preferences for adopting new vaccines in the national immunization program: A discrete choice experiment. Soc Sci Med 2022; 303:114991. [PMID: 35594739 DOI: 10.1016/j.socscimed.2022.114991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 04/17/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
Abstract
Governments regularly have to decide whether new vaccines should be adopted in their national immunization program. These choices imply complex trade-offs of epidemiological, medical and socio-economic criteria. We investigated how the population in Flanders (Belgium) wants their government to set vaccine-funding priorities. In December 2019, we executed a discrete choice experiment in a sample of the Flemish population (N = 1636). In total, we analysed 16 360 choices between vaccines competing for funding, described in terms of eight characteristics. Using a panel mixed logit model, we quantified the relative importance of each characteristic and investigated differences in preferences across respondent groups. The observed vaccine priorities were different from those that would be identified through cost-effectiveness analysis. People valued the health impact from infectious diseases differently than their weight expressed in QALYs would suggest. Mortality and frequently occurring mild illness were valued higher, whereas lasting morbidity received lower weight. Contribution of the vaccine to disease eradication and uncertainty in vaccine effectiveness were both highly influential factors. Health equity impact was also important whereas the economic impact of the disease did not matter at all. Our results can be used to incorporate public values into vaccine decision-making.
Collapse
Affiliation(s)
- Jeroen Luyten
- KU Leuven, Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, Kapucijnenvoer 35, 3000, Leuven, Belgium.
| | - Philippe Beutels
- University of Antwerp, Centre for Health Economics Research & Modelling Infectious Diseases, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Corinne Vandermeulen
- KU Leuven, Environment and Health, Department of Public Health and Primary Care, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Roselinde Kessels
- Maastricht University, Department of Data Analytics and Digitalization, PO Box 616, 6200 MD, Maastricht, The Netherlands; University of Antwerp, Department of Economics, City Campus, Prinsstraat 13, 2000, Antwerp, Belgium
| |
Collapse
|
17
|
Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042145. [PMID: 35206343 PMCID: PMC8871809 DOI: 10.3390/ijerph19042145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 12/22/2022]
Abstract
The influenza vaccination coverage among children is low in China. We aimed to conduct a nationwide survey to quantify parental preferences and willingness to pay (WTP) for influenza vaccination for their children. Parents with children aged six months to 18 years from six provinces in China were investigated by a discrete choice experiment regarding six influenza vaccination attributes. Mixed logit models were used to estimate the relative importance of vaccine attributes and parents’ WTP. Interaction analysis and subgroup analysis were conducted to explore preference heterogeneity. A total of 1206 parents were included in the analysis. Parents reported vaccine effectiveness as the most important vaccine attribute. The mode of vaccine administration had no significant impact on parents’ preferences. Parents aged over 30 years with higher education or income levels were more likely to prefer no influenza vaccination for their children. The largest marginal WTP (CNY 802.57) for vaccination and the largest increase in vaccine uptake (41.85%) occurred with improved vaccine effectiveness from 30% to 80%. Parents from central regions or mid-latitude areas had a relatively lower WTP than those from other regions. No significant difference in the relative importance of vaccine attributes were observed among parents from various regions of China.
Collapse
|
18
|
Vásquez WF, Trudeau JM, Alicea‐Planas J. Immediate and informative feedback during a pandemic: Using stated preference analysis to predict vaccine uptake rates. HEALTH ECONOMICS 2021; 30:3123-3137. [PMID: 34561932 PMCID: PMC8646631 DOI: 10.1002/hec.4432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 05/17/2023]
Abstract
In response to an emerging pandemic, there is urgent need for information regarding individual evaluation of risk and preferences toward mitigation strategies such as vaccinations. However, with social distancing policies and financial stress during an outbreak, traditional robust survey methodologies of face-to-face, probabilistic sampling, may not be feasible to deploy quickly, especially in developing countries. We recommend a protocol that calls for a sensitive survey design, acceptance of a web-based approach and adjustments for uncertainty of respondents, to deliver urgently needed information to policymakers as the public health crisis unfolds, rather than in its aftermath. This information is critical to tailor comprehensive vaccination campaigns that reach critical immunity thresholds. We apply our recommendations in a regional study of 16 Latin American countries in the month following index cases of COVID-19. We use a split-sample, contingent valuation approach to evaluate the effects of cost, duration of immunity and effectiveness of the vaccine. Our results show that cost and duration of immunity are significant factors in the decision to vaccinate, while the degree of effectiveness is insignificant, unless the vaccine is 100% effective. Income as well as perceived risk and severity of the virus are important determinants also.
Collapse
Affiliation(s)
| | - Jennifer M. Trudeau
- Department of Business EconomicsSacred Heart UniversityFairfieldConnecticutUSA
| | - Jessica Alicea‐Planas
- Egan School of Nursing and Health SciencesFairfield UniversityFairfieldConnecticutUSA
| |
Collapse
|
19
|
Diks ME, Hiligsmann M, van der Putten IM. Vaccine preferences driving vaccine-decision making of different target groups: a systematic review of choice-based experiments. BMC Infect Dis 2021; 21:879. [PMID: 34454441 PMCID: PMC8397865 DOI: 10.1186/s12879-021-06398-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 07/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Choice-based experiments have been increasingly used to elicit preferences for vaccines and vaccination programs. This study aims to systematically identify and examine choice-based experiments assessing (differences in) vaccine preferences of vaccinees, representatives and health advisors. METHODS Five electronic databases were searched on choice-based conjoint analysis studies or discrete choice experiments capturing vaccine preferences of children, adolescents, parents, adults and healthcare professionals for attributes of vaccines or vaccine settings up to September 2020. Data was extracted using a standardized form covering all important aspects of choice experiments. A quality assessment was used to assess the validity of studies. Attributes were categorized into outcome, process, cost and other. The importance of attributes was assessed by the frequency of reporting and statistical significance. Results were compared between high-quality studies and lower-quality studies. RESULTS A total of 42 studies were included, with the majority conducted in high-income countries after 2010 (resp. n = 34 and n = 37). Preferences of representatives were studied in nearly half of the studies (47.6%), followed by vaccinees (35.7%) and health advisors (9.5%). Sixteen high-quality studies passed the quality assessment. Outcome- and cost- related attributes such as vaccine effectiveness, vaccine risk, cost and protection duration were most often statistically significant across both target groups, with vaccine effectiveness being the most important. Risks associated with vaccination, such as side effects, were more often statistically significant in studies targeting vaccinees, while cost-related attributes were more often statistically significant in studies of representatives. Process-related attributes such as vaccine accessibility and time were least important across both target groups. CONCLUSION To our knowledge, this is the first systematic review in which vaccine preferences of different target groups were assessed and compared. The same attributes were most important for vaccine decisions of vaccinees and representatives, with only minor differences in level of evidence for vaccine risk and cost. Future research on vaccine preferences of health advisors and/or among target groups in low-resource settings would give insight into the generalizability of current findings.
Collapse
Affiliation(s)
- Marilyn Emma Diks
- Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229, Maastricht, Netherlands
| | - Mickael Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229, Maastricht, Netherlands
| | - Ingeborg Maria van der Putten
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229, Maastricht, Netherlands.
| |
Collapse
|
20
|
Methods for Conducting Stated Preference Research with Children and Adolescents in Health: A Scoping Review of the Application of Discrete Choice Experiments. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 14:741-758. [PMID: 34008164 DOI: 10.1007/s40271-021-00519-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Discrete choice experiments (DCEs) are a common method used to describe and quantitatively assess preferences in health applications. Increasingly, DCEs have been used to elicit preferences from children and adolescents and generate evidence to inform policies affecting this population. OBJECTIVES The aim of this review was to summarize and describe the application of DCEs conducted with children and adolescents and describe author-reported age-specific considerations in design, implementation, and analysis. METHODS A scoping review was conducted using a 'pearl-growing' technique whereby the reference lists of existing systematic reviews of DCEs were used to identify potential studies conducted with children or adolescents as respondents published between 1990 and 2017. This list was supplemented with an updated electronic search using the same strategy as the initial reviews to identify studies from 2017 to 2020. RESULTS Of 480 studies identified, 19 were included; topics included vaccines (32%), drugs/medical devices (26%), treatment or health promotion interventions/programs (21%), warning labels on cigarettes/nicotine products (10%), and preferences for physical activity and healthy food choices (10%). The youngest reported age for independent DCE completion was 8 years. Approaches to assessing validity and reliability of choices were consistent with best practices for the conduct of DCEs. Reported age-specific considerations included use of visual aids, age-appropriate language, reducing task complexity and cognitive burden, and exploration of interpretation of willingness-to-pay. CONCLUSION The number of DCEs conducted with children and adolescents has increased in recent years. Detailed explanation of why reported age-specific considerations were necessary, how they could be used to interpret results, or to understand the appropriateness of this methodology for different age groups was limited. Despite a recognition of the need for special consideration when conducting DCEs in this population, the unique issues in the context of age-specific considerations are largely unexplored, and further research is required. Moving forward, stated preference research conducted with children and adolescents should report in more detail methods of recruitment, results of validity assessments, and provide specific reflection on the extent to which modeled results are consistent with expectations and underlying theory.
Collapse
|
21
|
Leng A, Maitland E, Wang S, Nicholas S, Liu R, Wang J. Individual preferences for COVID-19 vaccination in China. Vaccine 2020; 39:247-254. [PMID: 33328140 PMCID: PMC7719001 DOI: 10.1016/j.vaccine.2020.12.009] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Vaccinations are an effective choice to stop disease outbreaks, including COVID-19. There is little research on individuals' COVID-19 vaccination decision-making. OBJECTIVE We aimed to determine individual preferences for COVID-19 vaccinations in China, and to assess the factors influencing vaccination decision-making to facilitate vaccination coverage. METHODS A D-efficient discrete choice experiment was conducted across six Chinese provinces selected by the stratified random sampling method. Vaccine choice sets were constructed using seven attributes: vaccine effectiveness, side-effects, accessibility, number of doses, vaccination sites, duration of vaccine protection, and proportion of acquaintances vaccinated. Conditional logit and latent class models were used to identify preferences. RESULTS Although all seven attributes were proved to significantly influence respondents' vaccination decision, vaccine effectiveness, side-effects and proportion of acquaintances vaccinated were the most important. We also found a higher probability of vaccinating when the vaccine was more effective; risks of serious side effects were small; vaccinations were free and voluntary; the fewer the number of doses; the longer the protection duration; and the higher the proportion of acquaintances vaccinated. Higher local vaccine coverage created altruistic herd incentives to vaccinate rather than free-rider problems. The predicted vaccination uptake of the optimal vaccination scenario in our study was 84.77%. Preference heterogeneity was substantial. Individuals who were older, had a lower education level, lower income, higher trust in the vaccine and higher perceived risk of infection, displayed a higher probability to vaccinate. CONCLUSIONS Preference heterogeneity among individuals should lead health authorities to address the diversity of expectations about COVID-19 vaccinations. To maximize COVID-19 vaccine uptake, health authorities should promote vaccine effectiveness; pro-actively communicate the absence or presence of vaccine side effects; and ensure rapid and wide media communication about local vaccine coverage.
Collapse
Affiliation(s)
- Anli Leng
- School of Political Science and Public Administration, Institute of Governance, Shandong University, 72 Binhai Rd, Qingdao, Shandong 266237, China.
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Chatham Building, Chatham Street, Liverpool L697ZH, England, United Kingdom.
| | - Siyuan Wang
- University of Melbourne, 369 Abbotsford Street, North Melbourne, VIC 3051, Australia.
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, 1 Central Avenue Australian Technology Park, Eveleigh Sydney, NSW 2015, Australia; Newcastle Business School, University of Newcastle, University Drive, Newcastle, NSW 2308, Australia.
| | - Rugang Liu
- School of Health Policy & Management, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing 211166, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, 54 Dongsi Lishi Hutong, Beijing 100010, China; Center for Health Economics and Management at School of Economics and Management, Wuhan University, Wuhan, Hubei Province 430072, China.
| |
Collapse
|
22
|
Gong T, Chen G, Liu P, Lai X, Rong H, Ma X, Hou Z, Fang H, Li S. Parental Vaccine Preferences for Their Children in China: A Discrete Choice Experiment. Vaccines (Basel) 2020; 8:vaccines8040687. [PMID: 33207667 PMCID: PMC7712304 DOI: 10.3390/vaccines8040687] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 11/24/2022] Open
Abstract
Vaccination is one of the most cost-effective health investments to prevent and control communicable diseases. Improving the vaccination rate of children is important for all nations, and for China in particular since the advent of the two-child policy. This study aims to elicit the stated preference of parents for vaccination following recent vaccine-related incidents in China. Potential preference heterogeneity was also explored among respondents. Methods: A discrete choice experiment was developed to elicit parental preferences regarding the key features of vaccines in 2019. The study recruited a national sample of parents from 10 provinces who had at least one child aged between 6 months and 5 years old. A conditional logit model and a mixed logit model were used to estimate parental preference. Results: A total of 598 parents completed the questionnaire; among them, 428 respondents who passed the rational tests were analyzed. All attributes except for the severity of diseases prevented by vaccines were statistically significant. The risk of severe side effects and protection rates were the two most important factors explaining parents’ decisions about vaccination. The results of the mixed logit model with interactions indicate that fathers or rural parents were more likely to vaccinate their children, and children whose health was not good were also more likely to be vaccinated. In addition, parents who were not more than 30 years old had a stronger preference for efficiency, and well-educated parents preferred imported vaccines with the lowest risk of severe side effects. Conclusion: When deciding about vaccinations for their children, parents in China are mostly driven by vaccination safety and vaccine effectiveness and were not affected by the severity of diseases. These findings will be useful for increasing the acceptability of vaccination in China.
Collapse
Affiliation(s)
- Tiantian Gong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (T.G.); (P.L.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne 3145, Australia;
| | - Ping Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (T.G.); (P.L.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China;
| | - Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai 200032, China;
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China
- Key Laboratory of Reproductive Health National Health Commission of the People’s Republic of China, Beijing 100083, China
- Correspondence: (H.F.); (S.L.)
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (T.G.); (P.L.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Correspondence: (H.F.); (S.L.)
| |
Collapse
|
23
|
A Hierarchical Bayes Approach to Modeling Heterogeneity in Discrete Choice Experiments: An Application to Public Preferences for Prenatal Screening. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 13:211-223. [DOI: 10.1007/s40271-019-00402-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
24
|
Ledent E, Gabutti G, de Bekker-Grob EW, Alcázar Zambrano JL, Campins Martí M, Del Hierro Gurruchaga MT, Fernández Cruz MJ, Ferrera G, Fortunato F, Torchio P, Zoppi G, Agboton C, Kandeil W, Marchetti F. Attributes influencing parental decision-making to receive the Tdap vaccine to reduce the risk of pertussis transmission to their newborn - outcome of a cross-sectional conjoint experiment in Spain and Italy. Hum Vaccin Immunother 2019; 15:1080-1091. [PMID: 30735474 PMCID: PMC6605846 DOI: 10.1080/21645515.2019.1571890] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Pertussis vaccination of parents and household contacts (‘cocooning’) to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was ‘reduction in source of infection’ in Spain (23.1%) and ‘vaccination location’ in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89–98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7–20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.
Collapse
Affiliation(s)
- Edouard Ledent
- a Statistical Solutions & Innovations , GSK , Rixensart , Belgium
| | - Giovanni Gabutti
- b Department of Medical Sciences , University of Ferrara , Ferrara , Italy
| | - Esther W de Bekker-Grob
- c Section Health Technology Assessment and Erasmus Choice Modelling Centre , Erasmus School of Health Policy & Management, Erasmus University Rotterdam , Rotterdam , The Netherlands
| | | | - Magda Campins Martí
- e Servicio de Medicina Preventiva y Epidemiología , Hospital Universitario Vall d'Hebron , Barcelona , Spain
| | | | | | - Giuseppe Ferrera
- i Dipartimento Medico di Prevenzione-Servizio Epidemiologia , ASP Ragusa, Centro Servizi , Ragusa , Italy
| | - Francesca Fortunato
- j Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | | | - Giorgio Zoppi
- l Dipartimento di Prevenzione , Struttura Complessa Igiene e Sanità Pubblica , Chiavari , Regione Liguria , Italy
| | | | | | | |
Collapse
|
25
|
Soekhai V, de Bekker-Grob EW, Ellis AR, Vass CM. Discrete Choice Experiments in Health Economics: Past, Present and Future. PHARMACOECONOMICS 2019; 37:201-226. [PMID: 30392040 PMCID: PMC6386055 DOI: 10.1007/s40273-018-0734-2] [Citation(s) in RCA: 393] [Impact Index Per Article: 78.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state of the science of health-related DCEs. The aim of this paper was to update prior reviews (1990-2012), to identify all health-related DCEs and to provide a description of trends, current practice and future challenges. METHODS A systematic literature review was conducted to identify health-related empirical DCEs published between 2013 and 2017. The search strategy and data extraction replicated prior reviews to allow the reporting of trends, although additional extraction fields were incorporated. RESULTS Of the 7877 abstracts generated, 301 studies met the inclusion criteria and underwent data extraction. In general, the total number of DCEs per year continued to increase, with broader areas of application and increased geographic scope. Studies reported using more sophisticated designs (e.g. D-efficient) with associated software (e.g. Ngene). The trend towards using more sophisticated econometric models also continued. However, many studies presented sophisticated methods with insufficient detail. Qualitative research methods continued to be a popular approach for identifying attributes and levels. CONCLUSIONS The use of empirical DCEs in health economics continues to grow. However, inadequate reporting of methodological details inhibits quality assessment. This may reduce decision-makers' confidence in results and their ability to act on the findings. How and when to integrate health-related DCE outcomes into decision-making remains an important area for future research.
Collapse
Affiliation(s)
- Vikas Soekhai
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA The Netherlands
| | - Esther W. de Bekker-Grob
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
| | - Alan R. Ellis
- Department of Social Work, North Carolina State University, Raleigh, NC USA
| | - Caroline M. Vass
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| |
Collapse
|
26
|
Lasseter G, Al-Janabi H, Trotter CL, Carroll FE, Christensen H. The views of the general public on prioritising vaccination programmes against childhood diseases: A qualitative study. PLoS One 2018; 13:e0197374. [PMID: 29897894 PMCID: PMC5999095 DOI: 10.1371/journal.pone.0197374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/01/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Decisions regarding which vaccines are funded in the United Kingdom (UK) are increasingly informed by cost-effectiveness analyses. Such analyses use Quality Adjusted Life Years (QALYs) as a measure of effectiveness and assume that QALYs are equal regardless of where and in whom they occur in the population. However, there is increasing debate about whether this QALY approach is appropriate and whether societal preferences for childhood vaccinations should be used to help inform childhood immunisation policy. OBJECTIVE To gauge the general public's preferences for prioritising certain characteristics of childhood vaccination, to help inform future policy making decisions in the UK. DESIGN Qualitative design using individual face-to-face interviews, with data analysed using an inductive thematic framework approach. SETTING Two counties in England, UK. POPULATION Adult members of the general public were recruited using the Bristol and South Gloucestershire open electoral registers, using gender and deprivation quotas for each area. PARTICIPANTS 21 members of the public participated in qualitative interviews. RESULTS The qualitative research identified three major themes and several key attributes that influences participant's opinions about priority setting for childhood vaccinations: (1) population segment (i.e. age group, carer impact and social group), (2) vaccine preventable diseases preferences (i.e. disease severity, disease incidence and declining infection) and (3) risks and benefits associated with childhood vaccinations (i.e. vaccine associated side-effects, herd protection and peace of mind). CONCLUSION Evidence from this qualitative study suggests that some members of the UK general public have more nuanced views than the health-maximisation approach when considering how childhood vaccines should be prioritised. This is not necessarily captured by the current economic approaches for assessing the benefits from childhood vaccinations in the UK, but is an important area for future research to ensure appropriate decision making.
Collapse
Affiliation(s)
- Gemma Lasseter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Hareth Al-Janabi
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Caroline L. Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Fran E. Carroll
- Royal College of Obstetricians and Gynaecologists, London, United Kingdom
| | - Hannah Christensen
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
27
|
Boeri M, McMichael AJ, Kane JPM, O'Neill FA, Kee F. Physician-Specific Maximum Acceptable Risk in Personalized Medicine: Implications for Medical Decision Making. Med Decis Making 2018; 38:593-600. [PMID: 29611459 DOI: 10.1177/0272989x18758279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In discrete-choice experiments (DCEs), respondents are presented with a series of scenarios and asked to select their preferred choice. In clinical decision making, DCEs allow one to calculate the maximum acceptable risk (MAR) that a respondent is willing to accept for a one-unit increase in treatment efficacy. Most published studies report the average MAR for the whole sample, without conveying any information about heterogeneity. For a sample of psychiatrists prescribing drugs for a series of hypothetical patients with schizophrenia, this article demonstrates how heterogeneity accounted for in the DCE modeling can be incorporated in the derivation of the MAR. METHODS Psychiatrists were given information about a group of patients' responses to treatment on the Positive and Negative Syndrome Scale (PANSS) and the weight gain associated with the treatment observed in a series of 26 vignettes. We estimated a random parameters logit (RPL) model with treatment choice as the dependent variable. RESULTS Results from the RPL were used to compute the MAR for the overall sample. This was found to be equal to 4%, implying that, overall, psychiatrists were willing to accept a 4% increase in the risk of an adverse event to obtain a one-unit improvement of symptoms - measured on the PANSS. Heterogeneity was then incorporated in the MAR calculation, finding that MARs ranged between 0.5 and 9.5 across the sample of psychiatrists. LIMITATIONS We provided psychiatrists with hypothetical scenarios, and their MAR may change when making decisions for actual patients. CONCLUSIONS This analysis aimed to show how it is possible to calculate physician-specific MARs and to discuss how MAR heterogeneity could have implications for medical practice.
Collapse
Affiliation(s)
- Marco Boeri
- Health Preference Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Alan J McMichael
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, Antrim, UK
| | - Joseph P M Kane
- Institute of Neuroscience, Newcastle University, Campus of Ageing and Vitality, Newcastle Upon Tyne, England, UK
| | - Francis A O'Neill
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, Antrim, UK
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, Antrim, UK
| |
Collapse
|