Drivers Of Choice Research Articles

Real-world biomarker testing patterns, first line treatment and drivers of treatment choice in patients with advanced/metastatic gastric/gastroesophageal junction adenocarcinoma in the United States and Europe.

353 Background: For first line (1L) treatment (tx) in HER2- gastric/gastroesophageal junction (G/GEJ) adenocarcinoma (AC), clinical guidelines recommended platinum-fluoropyrimidine (PF) chemotherapy (CT) in patients (pts) with a PD-L1 combined positive score (CPS) <5 and PF CT in combination with immunotherapy (IO) for CPS ≥5. There is little contemporary evidence into IO tx uptake in the real world. This real world study examined biomarker testing, 1L tx characteristics, and reasons for 1L tx choice in pts with HER2- G/GEJ AC to identify unmet needs and opportunities for optimal clinical practice. Methods: Data were derived from the Adelphi G/GEJ Cancer Disease Specific Programme: a systematic approach involving multi-national, multi-faceted data sources including cross-sectional surveys capturing data from physicians and their consulting pts. Physicians reported pt demographics, clinical characteristics, tx received and reasons for tx decisions, via chart review. Data were collected across US and Europe (EU: France, Germany, Spain, the UK) between Oct 2022 to Apr 2023. All pts were alive at data collection and analyses were descriptive. Results: Overall, 243 treating physicians (US n=60/EU n=183) provided data on 642 HER2- pts (US n=83/EU n=559) receiving 1L tx at data collection. For pts from US/EU, median age was 66/67 years, 84%/79% had an ECOG of 0-1 and 52%/75% had metastatic disease at data collection. In the US/EU, 87%/80% of pts were tested for PD-L1 status respectively, of which 63%/69% had a known CPS. For US/EU, 67%/45% of pts (n=30/n=139) had a CPS ≥5. Differences in biomarker testing rates were observed in US v EU pts respectively for MSI/dMMR (66% v 58%), NTRK-gene fusion (31% v 4%) and FGFR2 (27% v 3%). Of US/EU physicians, 70%/85% (n=60/n=183), reported the main reason for conducting biomarker testing was ‘to inform tx decisions’. Cost related concern (50%/39%) and time constraints (23%/15%) were the main perceived barriers to testing. Among pts with PD-L1 CPS <5, 27% of US pts and 2% of EU pts received IO + CT; in pts with CPS ≥5, 63% of US pts and 76% of EU pts received IO + CT. Whilst progression free survival/overall survival benefit were the most common reasons selected by physicians for 1L tx choice across the US/EU (75%/74% and 60%/61%), differences across regions were reported for tx choice based on maintaining and improving pt’s QoL (4%/28%) and pt’s performance status (2%/24%). Conclusions: PD-L1 testing was not performed by 19% of physicians and approximately one third of pts with CPS ≥5 across the US/EU were not receiving IO + CT in 1L. As informing 1L tx choice was a key driver for biomarker testing, there may be scope for improvement in 1L tx by increasing testing rates. Further studies are needed to address barriers to biomarker testing and uptake of IO in pts who can benefit from 1L IO tx.

N12 Patient perspectives of switch in route of administration among patients established on long term intravenous Infliximab therapy

Abstract Background An increasing number of patients are switching from intravenous (IV) to subcutaneous (SC) formulations of biologic agents for inflammatory bowel disease (IBD). Research is needed to inform discussions about therapy choices for individual patients switching to SC route from established long term on IV therapy. This study investigates patient preferences, willingness to switch from IV to SC, and factors associated with acceptability of switch. Methods We administered a 6-item questionnaire ranked on Likert’s scale to patients undergoing planned switch from IV to SC Infliximab at our IBD centre. The questionnaire measured patient perspectives in the use of both formulations as well as the acceptability of the process of switching between them. In addition, the overall acceptability rating of the route of administration was measured on a visual analogue scale. Baseline characteristics and disease behaviour was recorded from electronic records. Eligibility to switch was deemed as being clinically stable based on clinicians’ assessment and on maintenance Infliximab therapy for ≥12. Results Eighty eight patients (M: F =1.2:1, UC=35, Crohn’s=53) of the 115 patients (76.5%) who were switched from intravenous to subcutaneous infliximab completed pre and post switch survey. Median age at switch was 32 years (range 17- 76) and median duration of intravenous therapy prior to switch was 156 weeks (IQR 81). Median follow up post switch was 25 weeks (IQR 38). The proportion of patients strongly satisfied with their route of administration increased from 30% to 68% following SC switch. Negative impact on activities of daily living improved from 26% to 1% post switch.11% of patients reported negative financial consequences with IV route while post switch 98% reported no financial consequences. 9% and 8% were not in favour of or neutral to IV route pre-switch. Following switch 98% favoured SC route and 2% were neutral to the route of administration. Mean acceptability score post SC switch (9.5, range 8-10) was better than prior to switch (8, range 5-10) with 86/88 (97.7%) patients reporting equal or higher scores post switch. Conclusion Patients with IBD tend to be more likely to choose SC administration than IV infusion, but preferences and drivers of choice may vary according among individuals. These findings may assist discussions around appropriate treatment choices for each patient.

The Icelandic presidential election of 2024: strategic voting in a second order election?

Icelandic presidential elections are under-studied in the field of political science. We examine the determinants of vote choice in the 2024 Icelandic presidential election and, in particular, whether the election can be characterised as a second- order election, where voters’ views about parliamentary politics are more important than their views on the presidency. We rely on data from four surveys focusing on various aspects of the 2024 election to investigate which factors were the most important drivers of vote choice, whether voters voted strategically against the candidate most associated with the incumbent government, and whether the election results might have been different under alternative voting systems. Our findings suggest that attitudes towards the national government were the strongest determinants of vote choice in the election and that strategic voting appears to have played an important role in shaping the outcome. However, views about the role of the president also played a role and the eventual winner, Halla Tómasdóttir, would likely have won under any of the voting systems considered. We conclude with a discussion of how our results affect interpretations of the Icelandic presidency and the presidential mandate.

Longitudinal analysis of lifestyle risk factors, nutrition status, and drivers of food choice among urban migrants in Ulaanbaatar, Mongolia and Almaty, Kazakhstan: a formative study.

To quantify and compare concurrent within-person trends in lifestyle risks, nutrition status, and drivers of food choice among urban migrants in Central Asia. We collected panel data on household structure, drivers of food choice, nutrition knowledge, and diverse measures of nutrition status and lifestyle risk from urban migrants at 0, 3, 6, and 9 months using harmonized methodology in two cities. Trends were analyzed using mixed-effects models and qualitatively compared within and between cities. Ulaanbaatar, Mongolia and Almaty, Kazakhstan. 200 adults (22-55 years) who migrated to these cities within the past 2 years. Adjusting for age and sex, each month since migration was positively associated with fasting triglycerides in Almaty (0.55 mg/dL; 95%CI: 0.13-0.94) and BMI (0.04 kg/m2; 95%CI: 0.01-0.07), body-fat (0.14%; 95%CI: 0.01-0.26), and fasting glucose (0.04 mmol/L; 95%CI: 0.02-0.05) and lipids in Ulaanbaatar (p<0.05). In Almaty, nutrition knowledge (measured using an objective 20-point scale) declined despite improvements in diet quality (measured by Prime Diet Quality Score). Influence of food availability, price, and taste on food choice increased in Almaty (p<0.05). Upon multivariable-adjustment, nutrition knowledge was positively associated with diet quality in Almaty and adherence to "Acculturated" diet patterns in both cities (p<0.05). Different trends in smoking, sleep quality, and generalized anxiety were observed between cities. Findings indicate heterogenous shifts in nutrition, lifestyles, and drivers of food choice among urban migrants in Central Asia and provide an evidence base for focused research and advocacy to promote healthy diets and enable nutrition-sensitive food environments.

An exploration of the impact of cultural tourism as a major driver of destination choice: Perspectives from Mberengwa East district of Zimbabwe

An exploration of the impact of cultural tourism as a major driver of destination choice: Perspectives from Mberengwa East district of Zimbabwe

Association between Socio-Demographic Characteristics and Drivers of Food Choice among Women of Reproductive Age

Food choices are influenced by a variety of factors, including sociodemographic characteristics and play a critical role in shaping dietary patterns. Among women of reproductive age, these decisions have significant implications for both individual health and public health outcomes. This study examined the association between socio-demographic factors and drivers of food choice among women aged 18-59 years in Kiambu County, Kenya. Understanding this relationship is crucial for informing nutrition policies and interventions aimed at improving dietary diversity and health outcomes in this population. A cross-sectional analytical design was employed, with a sample size of 383. Data was collected using questionnaires and a focus group discussion (FDG), assessing drivers of food choice such as health, convenience, sensory appeal, price, mood, religion, and ethical concerns. Socio-demographic variables, including age, marital status, education level, and income, were also collected to assess their influence on food choices. Data analysis was conducted using SPSS version 23.0 and data was presented using means and frequencies. Chi-square tests were used to determine associations between the variables, and a significance level was set at p&lt;0.05. The results indicated that convenience and sensory appeal were the most influential drivers of food choice. Significant associations were observed between marital status and convenience (p=0.000), as well as income and access to food (p=0.031). Age also influenced ethical concerns, particularly regarding food packaging, with older women showing a greater preference for environmentally friendly packaging. Religion played a notable role in mood and health-related food choices, while women in lower-income brackets prioritized affordability over nutritional quality. The study highlights the need for targeted nutrition education and policy interventions tailored to the socio-demographic diversity of women in Kiambu County. Specifically, there is a need for programs focusing on promoting the affordability of healthy foods among younger and lower-income women

Psychological value theory: predicting health-seeking behavior from symptom perception.

We recruit Psychological Value Theory (PVT) to understand how symptom value influences health-seeking decisions. Estimates of the Psychological Value of relief from a particular symptom were previously collected and used to predict the speed of participants' decision and the choice they make in three discrete choice experiments. Experiment 1 presented participants with a scenario and asked them to identify which of two symptoms they would seek healthcare services to treat. For each participant on every trial, two randomly chosen symptoms were inserted into the scenario. Experiment 2 addressed how the Psychological Value of a group of symptoms is predicted from the individual symptoms. Experiment 2 replicated Experiment 1 using groups of two symptoms, and predicted choice based on three grouping functions. Experiment 3 replicated Experiment 2 using a yes/no task, whereby participants were asked if they would pursue a health care visit for a single set of symptoms. The results showed that PVT accurately predicted speed and choice in all three experiments. The Psychological Value of relief from a symptom was the primary driver of choice along with a response bias in favor of avoiding symptoms labeled "severe."Health-seeking decisions are well modeled by a general-purpose, value-based computational model (PVT), with the Psychological Value of relief from health symptoms as a primary driver of health-seeking behavior.

What makes patients tick? Vaccine preferences against tick-borne encephalitis in four European countries

BackgroundWe explored vaccine motivation and preferences for tick-borne encephalitis (TBE) vaccine attributes among participants in TBE-endemic countries in Europe.MethodsAn online survey was conducted among the general public in Austria, Germany, Switzerland, and Sweden. Participants were ≥ 18 years old, open to receiving vaccines, and living in, or regularly traveling to, TBE-endemic regions in the aforementioned countries. Participants were asked about their general vaccine knowledge and motivations for vaccination, before rating the importance of TBE vaccine attributes, such as efficacy, safety, dosing schedule, and booster interval. Thereafter, participants were shown three hypothetical TBE vaccine profiles with different combinations of attributes. Assuming equal efficacy and safety, participants were asked to select their preferred profile from 12 screens as part of a discrete-choice conjoint analysis. Utility scores were calculated to show the importance of each attribute. Data are presented for the overall survey group and by age and gender, using t-tests to compare means.ResultsFor 73% of participants (n = 1003/1379), self-protection was among the top three reasons to get vaccinated. Disease severity, protection of children or family, and advice or recommendation from a doctor/healthcare professional (HCP) were top three reasons for over half of participants. The majority (58–69%) agreed or strongly agreed that they trust their doctor/HCP on the subject of vaccines, they rely on their doctor/HCP’s vaccine knowledge, and they prefer their doctor/HCP to make recommendations on which vaccines they or their families should take. Efficacy and safety were the most important standalone TBE vaccine attributes; however, among TBE vaccine profiles including 3-, 5- and 10-year booster intervals, the 10-year booster interval was the most influential attribute level when choosing a preferred vaccine profile (utility score: 0.58 [standard error: 0.01]). Differences in motivators and preferences were observed between age and gender subgroups.ConclusionThe high level of doctor/HCP reliance highlights the key role doctors/HCPs play in influencing vaccine decision-making. Booster interval was the biggest driver of choice when selecting a hypothetical TBE vaccine profile, with the strongest preference for a 10-year booster interval. These findings could be used to inform TBE vaccination recommendations and in the further development of TBE vaccines.

EP.12B.05 Drivers of Treatment Choice in ALK-Positive Metastatic Non-Small Cell Lung Cancer from Patients' and Caregivers' Perspectives

EP.12B.05 Drivers of Treatment Choice in ALK-Positive Metastatic Non-Small Cell Lung Cancer from Patients' and Caregivers' Perspectives

Criteria for Personalised Choice of a Continuous Glucose Monitoring System: An Expert Opinion.

Despite the growing evidence supporting the outpatient use of continuous glucose monitoring (CGM) for improving glycaemic control and reducing hypoglycaemia, there is a need for a detailed understanding of the specific features of CGM devices that best meet individual patient needs. This expert opinion, based on a comprehensive literature review and the personal perspectives of clinicians, aims to provide thehealthcare professionals (HCPs) with a comprehensive framework for selecting CGM devices. It evaluates the current state of CGM technology, categorizing features into essential features, major drivers of choice, and additional/useful features. Moreover, the practical model presented outlines a patient's journey with CGM, emphasising the importance of aligning device features with patient needs. This includes understanding the patient's lifestyle, clinical conditions, and personal preferences to optimize CGM use and improve diabetes management outcomes.

Taxes, Leverage, and Profit Shifting in Banks

The goal of this research is to investigate whether taxation affects the leverage decisions of banks and if the response of leverage to tax increases depends on profit-shifting opportunities available to individual banks. This topic remains controversial since it is often believed that banking regulation is such an essential driver of leverage choices that little room is left for other considerations studied in the corporate finance literature. Using a difference-in-differences setup encompassing the period from 2006 to 2017, we exploit two exogenous income tax rate increases applicable to 225 Brazilian banks, employing novel identification strategies based on the intricacies of local taxation rules and on the distinctions between individual banks and financial conglomerates. We find stark differences in the behavior of banks around the two events, with a substantial increase in leverage following the first tax hike but no leverage response following the second. In addition, we find no evidence of heterogeneous effects based on the amount of profit-shifting opportunities available to individual banks. Regulatory concerns possibly became more relevant for leverage decisions during the period around the second tax hike because it coincided with the implementation of stricter capital requirements associated with the Basel III framework. Taken together, our results suggest that financial institutions balance considerations regarding the tax-shield benefits of debt against regulatory concerns specific to the banking industry when making capital structure choices.

Physician-reported patient involvement and treatment decisions in first-line ovarian cancer in the USA and Europe

ObjectivesReal-world data evaluating how approvals of novel treatment regimens for ovarian cancer have impacted the treatment paradigm, including first-line maintenance, are lacking. This analysis aimed to describe treatment patterns for...

Food Shopping Strategies Among a Diverse Sample of East Harlem Residents: A Qualitative Study.

To inform food retail interventions, this study explored food shopping strategies employed by people constrained by limited budgets but residing in an urban environment offering numerous retail options. Qualitative study incorporating semi-structured interviews and shop-alongs. East Harlem, New York City. 37 East Harlem residents participated in interviews, of whom 15 participated in shop-alongs. Interviews and shop-alongs were conducted in English, Spanish, and Mandarin Chinese. Interview transcripts were analyzed using a grounded theory approach. Data from shop-alongs were used to supplement interview findings. Participants shopped 1-2 times at an average of 4 retail locations per week. Two key themes emerged: (1) planning trips and choosing venues; and (2) shopping experiences and perceptions of stores. Price was the primary driver of store choice, followed by product quality and variety. Substantial time was invested in shopping. Most English- and Spanish-speaking participants shopped in East Harlem. Chinese American participants shopped in Chinatown due to language concordance, availability of culturally-preferred foods, and proximity to other services. East Harlem residents invested substantial planning, time and effort in food shopping to acquire sufficient food for their households on limited budgets. These findings offer insight into how residents interact with food environments and key drivers of decision-making about food shopping that affect decisions about where to shop and what to purchase.

Benefits of Biosimilars in the Management of Patients with Inflammatory Bowel Disease: An International Survey.

Background/Objectives: The development of biosimilar drugs has revolutionized the management of patients with inflammatory bowel diseases (IBD), significantly reducing healthcare costs. However, the impact of biosimilar availability on patient care is unknown. We conducted a survey to investigate the benefits of using biosimilars in patients with IBD. Methods: Physicians involved in the IBD care were invited to participate in an anonymous online survey. The questionnaire consisted of 42 questions addressing availability, cost, recommendations, and positioning regarding the use of biosimilars. Results: A total of 233 physicians (88.4% gastroenterologists) from 63 countries worldwide participated in the survey. Most respondents had >10 years of practice (202/233, 85.9%). Biosimilars were available in almost all cases (221, 94.8%), and over two-thirds of respondents had more than one biosimilar of adalimumab or infliximab on hospital formulary. In most cases, adalimumab and infliximab biosimilars had a reduced cost of at least 30% compared to the originators. The savings resulting from the use of biosimilars allowed physicians to improve patient care (3/233, 1.3%) or to improve research (2/233, 0.8%) in only a few cases. Interestingly, for about 50% of respondents, the cost of biologics was a limitation for patient access to therapy. For the majority of participants, the availability of biosimilars did not influence treatment decisions in Crohn's disease (70/165, 42.4%) and ulcerative colitis (83/165, 50.3%). Conclusions: The reduced cost of biosimilars compared to reference products is the main driver of choice in IBD. The impact of biosimilars of ustekinumab and vedolizumab in improving access to therapies and changing the treatment algorithm remains to be defined.

Main consumer choice drivers for fi lm products in the Russian market

Film distribution market is a highly competitive one, which only emphasizes the need to optimize costs for the production and promotion of domestic films while increasing box office potential. The purpose of this research is to identify the primary choice drivers for movies in the movie theater in current market conditions as a required prerequisite for effective promotion. The results of a content analysis of open data tracker Cinema Viewer in 2021 allow us to identify several drivers defining the choice of moviegoers. They can be divided into two main categories: content elements and promotional elements. Among content elements, the most important are film's genre, plot, and cast. The most important promotional element is the trailer. Furthermore, two findings stand out among the results of this study, which require detailed research in the further works on the subject, as they can significantly influence the promotional strategies for film products in the Russian market. Firstly, the study showed that information itself, rather than its source, is more important for the viewer, which means that further optimization of marketing budgets is possible by reducing spending on most expensive platforms (primarily TV). Secondly, recommendations play just as important a role in the choice of film as advertising, which also makes it possible to optimize the marketing budget through social media marketing.

Exploring food and beverage pairing from a cross-cultural projective mapping

Culture is a well-known driver of food choices, and therefore, it could also impact food pairing preferences. Food pairing has been studied from different approaches; however, little cross-cultural research has been done. This work explored food and beverage pairing using projective mapping (PM) to create maps of food-beverage combinations. Four countries (Mexico, Argentina, France, and Norway), thirty foods, and six beverages were selected. PM was carried out through an online study in each country. Participants were asked to map foods together with beverages following the instruction that foods and beverages closer together represented a good combination. The coordinates of each product were analyzed through Multiple Factorial Analyses (MFA) by countries. The first four factors of each MFA were used to perform RV coefficients to test similarities in food-beverage pairings between the countries. Finally, a k-means clustering was performed on the beverage coordinates of each MFA. PM provided maps representing food and beverage pairings for each country in which the proximity between food-beverages represented a good combination according to consumers. RV coefficients between countries were low, showing that food-beverage pairings were not similar across countries, evidencing the cultural effect in food-drink combinations. Results from the k-means clustering showed some similarities and differences between countries. In general, the food-beverage pairing was effectively explored with PM, from which several differences and similarities were found within cultures.

Cropping decisions under water stress: Evidence from Cauvery Delta Region, India

AbstractCropping decisions under resource constraints such as water stress have a significant influence on the livelihoods of farm households. Using survey data from 152 farm households in three villages of the paddy producing zone in the Cauvery Delta Region in India, we examine the factors that determine selection of paddy varieties and cotton. Our findings show that the marketability of specific paddy varieties, given inadequate public procurement, and groundwater use, driven by reduced surface water flows, influence crop choice. Farmers have modified their sowing practices and cropping patterns as a response to water stress and market signals. We conclude that to develop effective interventions to improve farm‐based livelihoods, it is important to look not just at climatic drivers of crop choice and farm level adjustments but the multiple stressors at different scales.

Examining the nutrition and packaging of foods promoted as ‘Back to School’ products for children’s school lunchboxes

The local food environment plays an important role in food purchasing behaviours, and it is important to understand the how this context shapes the highly complex drivers of food choice for children and families. In Australia, children consume more than one-third of their total energy intake whilst at school(1), thus making the content of school lunchboxes an important target for nutrition promotion efforts. Supermarkets invest heavily in promoting food for inclusion in school lunchboxes, particularly in the ‘Back to School’ period, but little is known about the nutrition content or the packaging of the foods included in these promotions. This study aimed to examine the types and packaging of foods that are promoted by supermarkets as school lunchbox foods. Catalogues for six supermarket chains in Adelaide, South Australia were collected during the four weeks of January 2023, the window often described as the ‘Back to School’ period. An audit of the contents was conducted and items promoted specifically as ‘Back to School’ items were coded according to the type of food (fruits, vegetables, dairy, grains/cereals, protein or drinks), whether the items was packaged or unpackaged and the processing classification according to the NOVA criteria(2). Descriptive statistics were calculated. In the ‘Back to School’ period, each of the six supermarket chains produced 4 catalogues and items relating specifically to foods promoted for inclusion in school lunchboxes appeared in 18 of the 24 catalogues. A total of 151 food or drink items appeared in the ‘Back to School’ promotions in these catalogues, and 100% of these items were packaged; 29% were packaged in single-use plastic packaging, 25% were packaged in recyclable packaging and 46% were packaged in a combination of single-use plastic and recyclable packaging. In terms of foods, snack foods, including sweet (n = 32, 21%) and savoury (n = 21, 14%) snacks were highly represented (35% overall). Dairy products (n = 23, 15%), grains/cereal products (n = 23, 15%) and drinks (n = 20, 13%) were also featured, and spreads (e.g. vegemite, Nutella) appeared in 13% of catalogues (n = 12). Fruits (n = 8, 5%), vegetables (n = 3, 2%) and proteins (n = 5, 3%) did not appear in many catalogues. Seventeen (11%) foods were unprocessed, with 111 (74%) classified as ultra-processed foods. Supermarket catalogues promote ‘Back to School’ lunchbox foods that are overwhelmingly packaged and ultra-processed. Working with supermarkets to adapt the promotion of foods that are less packaged and less processed is an important step to improving the local food environment.

Nutrition-Related Knowledge, Attitudes, Practices, and Anemia Status of Lactating Mothers in Bukavu, Democratic Republic of the Congo-A Cross-Sectional Analysis.

Maternal nutrition is impacted by personal and environmental factors including dietary intake, knowledge, food availability, and affordability. This cross-sectional analysis aimed to evaluate nutrition-related knowledge, attitudes, practices, and associations with hemoglobin concentration among lactating mothers in the Bukavu region, Democratic Republic of the Congo. In 444 lactating mothers, nutrition-related knowledge and practice were assessed by questionnaires and translated into knowledge and practice scores ranging from 0 to 1, attitudes and drivers of food choice were assessed, the Dietary Diversity Score (DDS) was assessed with 24 h dietary recalls in a potential range from 0 to 10, and hemoglobin (Hb) was measured in mothers and their infants. Anemia prevalence was 28.2% among mothers and 74.3% among infants aged 3-8 months. Nutritional knowledge and practice were limited (the median total knowledge score was 0.39, median DDS was 3.0). While there were slight positive correlations between knowledge and maternal Hb, DDS did not significantly correlate with either knowledge or Hb. Although half of the mothers stated a perception about their own susceptibility to anemia or vitamin A deficiency (56.4%, 47.4%), less than half of those could justify their estimation (40.9%, 44.2%). Taste (68.1%), appearance (42.5%), availability (29.0%), and health effects (25.6%) were important drivers of food choice. In conclusion, interventions on the different influencing factors including nutrition education strategies are needed.

Heterogeneous university research and firm R&D location decisions: research orientation, academic quality, and investment type

Universities play an important role in regional development and innovation and engage with the industry through various channels. In this paper, we examine the role of heterogeneous characteristics of university research, in particular universities’ orientation towards basic or applied research and the quality of this research, in attracting firms’ R&D investment. We analyze the location decisions in the United States by foreign multinational firms at the level of metropolitan areas. We contrast research and development projects and explore whether they are driven by different factors. We find that the drivers of location choice differ importantly as a consequence of the type of the focal R&D investment of the firm. Universities with an orientation towards applied scientific research and exhibiting higher academic quality of applied research attract more R&D investment focusing on development activities. In contrast, firms’ investments in research activities are attracted by the academic quality of basic scientific research of local universities. Hence, increased university emphasis on academic engagement and applied research may have negative consequences for industrial research in the region.