Abstract
BackgroundDiscrete choice experiment (DCE) is a quantitative technique which helps determine preferences from a definite set of choices. DCEs have been widely used to inform health services in high-income country settings and is gradually being used in low and middle-income countries (LMICs). There are challenges in deploying this method in LMIC settings due to the contextual, cultural and language related barriers. Most DCEs are conducted using paper-based tools. With mobile technology readily accessible across LMICs, we developed an Android-based platform to conduct a DCE among community health workers (CHWs) in rural India.MethodsThis paper describes the development of a DCE for low-literacy community health workers (CHWs) in low-resourced setting on an Android platform. We illustrate the process of identifying realistic and locally relevant attributes, finalising the tool and cognitively testing it among respondents with an average of 10 years of education using ‘think aloud’ and ‘verbal probing’ techniques. The Android application was tested in two rounds, first by the research team and second, by the CHWs. The ‘think aloud’ and ‘verbal probing’ techniques were essential in assessing the comprehension of the CHWs to the DCE choices.ResultsThe CHWs did not take much time to familiarize themselves with the Android application. Compared to the paper based DCE, the time required for data collection using the Android application was reduced by 50%. We found the Android-based app to be more efficient and time saving as it reduced errors in data collection, eliminated the process of data entry and presented the data for analysis in real time.ConclusionElectronic administration of DCE on Android computer tablets to CHWs with basic education is more efficient, time-saving than paper-based survey designs once the application is provided. It is feasible to use technology to develop and implement DCEs among participants with basic education in resource poor settings.
Highlights
Discrete choice experiment (DCE) is a quantitative technique which helps determine preferences from a definite set of choices
We describe the development of an Android platform for the administration of a DCE among community health workers (CHWs) in rural India
Methodological developments We developed an Android-based application to display a DCE in order to quantify the relative importance of different factors, which improve job-satisfaction and motivate Accredited Social Health Activist (ASHA) in a state in rural India
Summary
Discrete choice experiment (DCE) is a quantitative technique which helps determine preferences from a definite set of choices. Discrete choice experiment (DCE) is a quantitative research method used to assess the preferences and priorities of individuals. DCEs analyse the trade-offs individuals make when choosing between sets of hypothetical choices with different attributes. It is regarded as a more useful tool than ranking techniques in policy. Abdel-All et al Archives of Public Health (2019) 77:20 This is critical for successful design and implementation of interventions; and to minimise the gap between policy and evidence-based practices [2]. DCEs are used to inform policies to reduce health disparities in resource poor settings [4]. Research indicates that DCEs may be cognitively challenging for individuals with low literacy levels, and have recommended pre-testing the tool during the development stage to ensure that the DCE captures the true preferences of respondents [5]
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