Eliciting Women's Preferences for a Training Program in Breast Self-Examination: A Conjoint Ranking Experiment

Abstract

Objectives Although the clinical grounds for recommending breast self-examination (BSE) have been extensively debated in the literature, there has been no investigation into women's preferences for BSE training. The aim of this study was to test the conjoint ranking method using data on women's preferences for different BSE training programs. Different econometric specifications were tested and sample subgroup differences were investigated. Methods Postal data were collected from 1258 women with and without previous participation in a BSE training program. The women ranked eight hypothetical training programs that were defined in terms of three attributes. Inclusion of a payment attribute enabled the calculation of marginal willingness-to-pay (WTP) estimates. Results The marginal WTP for individual training in comparison to group training with 18 to 20 participants was estimated to be 225 Danish Kroner (DKK) to 462 DKK. The marginal WTP for training in groups of eight to 10 participants was 180 DKK to 270 DKK. The respondents also preferred to receive instruction using their own breasts, although this was valued lower than a small group size. The results were similar regardless of whether or not the women had previously participated in BSE training. Around 20% of respondents violated a basic assumption of economic theory, in which the cheaper of two otherwise identical goods should be preferred. Conclusions Conjoint ranking can provide comprehensive information about benefit assessment. The approach is cognitively demanding, however, and may cause some respondents to violate the axiom of nonsatiation.