Higher Willingness Research Articles

Designing price-service menus in a product-service system

We study contract menu design by a vendor leasing production equipment to its clients who serve customers. The equipment can fail which can cause delays to clients' customers. The equipment vendor can offer its clients three types of lease-and-repair contracts: equipment lease with an immediate replacement upon failure, repair with a redundant unit on client premises (parallel layout), and repair without a backup unit on the premises. The vendor does not have full information about each client but knows that clients fall into two types. ‘High’ (vs. ‘Low’) type clients have a higher (vs. lower) willingness to pay but have customers who are more (vs. less) delay-sensitive. Modeling the interaction between the vendor and its clients as a leader-follower game and using queueing theory, we show that a monopolistic vendor can increase its expected profit through second-degree price discrimination by offering a menu of contracts to its clients. We find that when the distribution of customers with low and high willingness to pay is not skewed (one-sided) and either the cost of repair or cost of equipment is low the vendor can increase its profit by inducing price discrimination through offering the menus proposed in the paper.

COVID-19 Vaccination Personas in Yemen: Insights from Three Rounds of a Cross-Sectional Survey.

We used three rounds of a repeated cross-sectional survey on COVID-19 vaccination conducted throughout the entire territory of Yemen to: (i) describe the demographic and socio-economic characteristics associated with willingness to be vaccinated; (ii) analyse the link between beliefs associated with COVID-19 vaccines and willingness to be vaccinated; and (iii) analyse the potential platforms that could be used to target vaccine hesitancy and improve vaccine coverage in Yemen. Over two-thirds of respondents were either unwilling or unsure about vaccination across the three rounds. We found that gender, age, and educational attainment were significant correlates of vaccination status. Respondents with better knowledge about the virus and with greater confidence in the capacity of the authorities (and their own) to deal with the virus were more likely to be willing to be vaccinated. Consistent with the health belief model, practising one (or more) COVID-19 preventative measures was associated with a higher willingness to get a COVID-19 vaccination. Respondents with more positive views towards COVID-19 vaccines were also more likely to be willing to be vaccinated. By contrast, respondents who believed that vaccines are associated with significant side effects were more likely to refuse vaccination. Finally, those who relied on community leaders/healthcare workers as a trusted channel for obtaining COVID-19-related information were more likely to be willing to be vaccinated. Strengthening the information about the COVID-19 vaccination (safety, effectiveness, side effects) and communicating it through community leaders/healthcare workers could help increase the COVID-19 vaccine coverage in Yemen.

Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study.

The fulfillment of contractual obligations by rural-oriented tuition-waived medical students (RTMSs) to work in rural medical institutions after graduation directly impacts the improvement of rural health quality. This study aimed to not only quantitatively measure the direct impact of honesty-credit, specialty identity, and career identity on willingness to fulfill the contract of RTMSs but also to quantify the intermediary role of specialty identity and career identity between honesty-credit and willingness to fulfill the contract. The research results provided recommendations for the rural-oriented tuition-waived medical education (RTME) program to achieve its goal of training rural primary healthcare personnel. From March to May 2022, 1162 RTMSs were selected as the research objects. The honesty-credit, specialty identity, career identity, and willingness to fulfill the contract were quantitated using a self-completed questionnaire. Pearson's correlation analysis and structural equation modeling were used for statistical analysis and mediating effect evaluation. A total of 455 (42.3%) RTMSs had high willingness to fulfill the contract, and honesty-credit had a significant direct positive effect on willingness (β = 0.198, P < 0.001), specialty identity (β = 0.653, P < 0.001), and career identity (β = 0.180, P < 0.001). In the intermediary path between honesty-credit and willingness, career identity [95% confidence interval (CI): 0.007-0.051] had significant mediating effects. Career identity (95% CI: 0.030-0.149) also had significant mediating effects between specialty identity and willingness, and specialty identity (95% CI: 0.465-0.760) had significant mediating effects between honesty-credit and career identity. These results strongly confirmed that honesty-credit, specialty identity, and career identity are early and powerful predictors of the willingness to fulfill the contract of RTMSs. The honesty-credit of RTMSs can predict their willingness to fulfill the contract early, significantly and positively. For the students who fail to pass the credit assessment for many times and have a strong tendency to default, their training qualifications should be canceled in time, so that students who are truly willing to serve rural areas can enter the project, and finally achieve the policy goal of "strengthening the rural primary medical and health system".

Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities.

The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America. We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis. A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables. We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001). Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.

Community pharmacists’ readiness to take action to improve working conditions

ObjectiveThe objective of this study was to assess pharmacists’ readiness to take actions resulting in change at the individual level or systemic level. Design/Setting and Participants/Outcome measuresAn online survey was distributed via pharmacy-related social media pages and several state pharmacy association newsletters and e-mail listservs. Fifteen items assessed participants’ readiness to pursue change using a 5-point scale based on the transtheoretical model of behavior change (1 = Do not plan on doing, 2 = Plan to take in the next 6 months, 3 = Plan to take in the next month, 4 = Took in the past 6 months, 5 = Took more than 6 months ago). Categorical principal components analysis (CATPCA) was used as a data reduction technique to identify underlying components of the 15 items assessing readiness to improve working conditions. Component scores for each component were calculated and used as dependent variables in multivariable linear regression models to test associations between the components and sociodemographic and work-related predictors. ResultsCATPCA revealed a 12-item scale with 2 components accounting for 39.97% of the total variance. Pharmacists working in independent pharmacies had a significantly higher willingness than chain pharmacists to pursue actions with potential to result in systemic-level changes, such as contacting or joining an organization to attempt to improve their current working conditions (regression coefficient = 0.623, P < 0.001). Pharmacists working in independent pharmacies had a significantly lower willingness than chain pharmacists to pursue actions resulting in individual-level changes, such as changing their current job or quitting (regression coefficient = −0.485, P < 0.001). ConclusionPharmacists working in national chains may be less willing than independent pharmacists to pursue systemic-level changes owing to fear of discipline from employers. Future research should examine the effect of interventions intended to increase pharmacists’ motivation and readiness to pursue changes to improve working conditions.

Comparing Elicitation Methods of Risk Preferences in Personal Financial Planning: A Field Experiment among Working Adults in Malaysia

Risk preference is an important input in designing investment types or port-folios in personal finance. Although there are many reported risk elicitation methods, the risk preference measure obtained from these methods has not been associated with any behavioural or psychological reasons underlying the choices made. This association is important in providing the underlying theoretical understanding of risk preferences and establishing the robustness of a measure. The present paper attempted to test the consistency of risk preferences between two widely used elicitation methods: Grable and Lytton (1999, 2003) risk tolerance score and probability weighting function in prospect theory (Kahneman &amp; Tversky, 1979; Tversky &amp; Kahneman, 1992). The risk score captures the self-reported willingness to engage in risky investment, and the probability weighting function shows overweighting or underweighting of the probability. We conducted a series of field experiments involving working adults of three main ethnic groups in Malaysia. The results showed consistency in risk preferences between the two methods: high willingness to engage in risk was complemented by optimistic probability weighting, and respondents with low willingness to engage in risky investment evaluated high probability more favourably. The study is useful to financial professionals when implementing the questionnaire to measure risk preferences.

Parent's Attitudes toward Their Children's Oral Health Care during the COVID-19 Pandemic: A Cross-Sectional Study.

The COVID-19 pandemic has significantly impacted global health and presented challenges to maintaining oral health in children. Efficient management and prevention of oral diseases are therefore crucial in this population. This cross-sectional study aimed to assess parents' self-reported oral and dental hygiene habits for their children during the COVID-19 pandemic. A total of 256 parents of primary school children in Qazvin completed an online questionnaire containing demographic, general, and cardinal questions. The collected data were analyzed using SPSS 22 software, and accurate analytical tests were run to reach the results. The study found that 69.1% of parents and 87.1% of children brushed their teeth regularly during the pandemic. Additionally, 80.5% of parents monitored their children while brushing. While some parents expressed concerns about COVID-19 infection, parents from lower socioeconomic status reported a higher willingness to attend dental centers than those from more prosperous areas. These findings suggest that parents' supervision and attitude toward oral health care significantly affect children's oral hygiene habits during the pandemic, possibly due to increased time spent together during lockdowns.

Loving-kindness and walking meditation with a robot: Countering negative mood by stimulating creativity

Young adults undergoing psychological changes are particularly vulnerable. Recent social isolation impedes interpersonal help while stress from family, school, work, and society has brought negative effects on mental health, even in otherwise healthy young adults. Recent research has shown that daily creativity contributes to well-being. To circumvent issues of contamination, we tried a NAO robot guiding a Loving-kindness Meditation (LKM) and Walking Meditation (WM). By improving mental states (i.e. positive valence and state openness), we stimulated creative behavior to reduce negative mood. Participants (N = 142) were healthy individuals, aged between 18 and 34, joining a one-time laboratory experiment. They responded to two rounds of questionnaires, with a 10 min intervention guided by audio or a NAO robot in between each round. A control group with participants with no treatment (i.e. taking a 10 min rest) was added for comparison. Both audio-guided LKM and WM successfully evoked state openness, with the former also exerting a positive effect on valence. Valence and state openness were positively correlated, and both were associated with a higher willingness to create. With positive valence, young adults likely perform better on convergent thinking. The result may potentially lead to negative mood reduction. The discussion emphasizes the importance of designing specific characteristics of social robots in accordance with the task's context.

Atribucije kontrole i namjera pružanja pomoći među studentima

Previous studies have shown that individual and social factors can moderate the relationship between attributions of controllability, emotions, and helping. The aim of this study was to test the attribution-emotion-helping relationship in the Croatian academic context and to investigate the moderating effects of some student variables, i.e., the helper’s academic field, personal absence from class, and the habit of taking notes in class. We conducted a survey experiment with vignettes describing a student who wants to borrow lecture notes. Participants also estimated how often they take lecture notes and how often they had skipped class in the previous semester. The data were collected from 298 students from three faculties of the University of Zagreb. Although Croatian students generally showed a high willingness to help a classmate in need and the effect of controllability on helping intentions was weak, the results supported the attribution-emotion model. However, the results suggest that some student characteristics may attenuate the relationship between controllability, emotions, and helping. The indirect effect of controllability on helping intentions through sympathy was weaker for participants who frequently skipped classes and rarely had their own lecture notes.

Artificial intelligence in pharmacy practice: Attitude and willingness of the community pharmacists and the barriers for its implementation

BackgroundArtificial intelligence (AI) is the capacity of machines to perform tasks that ordinarily require human intelligence. AI can be utilized in various pharmaceutical applications with less time and cost. ObjectivesTo evaluate community pharmacists’ willingness and attitudes towards the adoption of AI technology at pharmacy settings, and the barriers that hinder AI implementation. MethodsThis cross-sectional study was conducted among community pharmacists in Jordan using an online-based questionnaire. In addition to socio-demographics, the survey assessed pharmacists’ willingness, attitudes, and barriers to AI adoption in pharmacy. Binary logistic regression was conducted to find the variables that are independently associated with willingness and attitude towards AI implementation. ResultsThe present study enrolled 401 pharmacist participants. The median age was 30 (29–33) years. Most of the pharmacists were females (66.6%), had bachelor’s degree of pharmacy (56.1%), had low-income (54.6%), and had one to five years of experience (35.9%). The pharmacists showed good willingness and attitude towards AI implementation at pharmacy (n = 401). The most common barriers to AI were lack of AI-related software and hardware (79.2%), the need for human supervision (76.4%), and the high running cost of AI (74.6%). Longer weekly working hours (attitude: OR = 1.072, 95% C.I (1.040–1.104), P < 0.001, willingness: OR = 1.069, 95% Cl. 1.039–1.009, P-value = 0.011), and higher knowledge of AI applications (attitude: OR = 1.697, 95%Cl (1.327–2.170), willingness: OR = 1.790, 95%Cl. (1.396–2.297), P-value < 0.001 for both) were significantly associated with better willingness and attitude towards AI, whereas greater years of experience (OR = 20.859, 95% Cl (5.241–83.017), P-value < 0.001) were associated with higher willingness. In contrast, pharmacists with high income (OR = 0.382, 95% Cl. (0.183–0.795), P-value = 0.010), and those with<10 visitors (OR = 0.172, 95% Cl. (0.035–0.838), P-value = 0.029) or 31–50 visitors daily (OR = 0.392, 95% Cl. (0.162–0.944), P-value = 0.037) had less willingness to adopt AI. ConclusionsDespite the pharmacists' positive willingness and attitudes toward AI, several barriers were identified, highlighting the importance of providing educational and training programs to improve pharmacists' knowledge of AI, as well as ensuring adequate funding support to overcome the issue of AI high operating costs.

Revealing the complexity of users’ intention to adopt healthcare chatbots: A mixed-method analysis of antecedent condition configurations

Healthcare chatbots provide a professional, immediate, and low-cost tool for advising people on health information. Unlike previous studies on chatbot adoption that focus on the one-way net effect of components, this study reveals the complex antecedent configurations behind online healthcare chatbot adoption through an asymmetric approach. This study attempts to explain the causal configuration of user adoption in terms of three dimensions: functional, social, and user motivation features. A sequential mixed-method approach was chosen and a two-stage study, fuzzy set comparison analysis (fsQCA), and semi-structured interviews were conducted to deepen users' understanding, perceptions, and attitudes toward online healthcare chatbots, expressing more fine-grained insights into variable relationships. Five configurations were found to explain the high willingness of users to adopt healthcare chatbots. Perceived social presence was a core condition for each configuration. However, the social features of chatbots can only lead to high levels of trust and satisfaction when combined with functionality. The findings of this paper's mixed-method design and complexity study contribute to the adoption and theoretical literature on intelligent health services and chatbots. It guides tailoring chatbot functionality to individual user needs and provides practical guidance for the development of chatbots for health services through diverse combinations of machine chatbot features and user-motivated features.

Cheating amongst youth offenders: How peers and their social status influence cheating

AbstractWe conducted an experiment with 204 youth inmates to study how the intrinsic psychological cost of cheating that was shaped by peers changed inmates' cheating behavior. We find that innately dishonest inmates who naively revealed their higher willingness to cheat indeed cheated more in the actual game. When given the chance to observe an imperfect signal of whether a peer cheated, only innately dishonest inmates followed this signal and cheated more. This positive treatment effect increases with the saliency of the signal, and becomes more pronounced when the cheating signal is from an influential peer.

A discrete choice experiment to examine the factors influencing consumers' willingness to purchase health apps.

The benefits of health apps can only be realized when consumers purchase them for use. Thus, it is important to understand what factors influence consumers' willingness to purchase health apps. Therefore, this study aimed to examine the influence of health app attributes and sociodemographic characteristics on consumers' willingness to purchase health apps, and how the value of the health app attributes varies for individuals with different sociodemographic characteristics. A questionnaire-based discrete choice experiment (DCE) was conducted with a random sample of 561 adults. A standard logit regression was applied to assess the influence of health app attributes and sociodemographic characteristics on consumers' willingness to purchase health apps, and marginal willingness to pay (MWTP) was calculated for each factor using regression coefficients. Interaction effects were also examined to determine how the value of health app attributes varies by sociodemographic characteristics. Usefulness, ease of use, security and privacy, and attitudes of healthcare professionals toward consumers' use of health apps were the attributes of health apps that positively influenced consumers' willingness to purchase them. Conversely, smartphone storage consumption, mobile Internet data consumption, and app price negatively influenced consumers' willingness to purchase the apps. For sociodemographic characteristics, being male, having a household size greater than three, having a monthly household income of HK$30,000 or more, having a lower education level (below diploma), having previously used health apps, and having previously purchased health apps were associated with a higher willingness to purchase health apps. Health app attributes that influenced consumers' willingness to purchase the apps and populations that were less willing to purchase health apps were identified. Efforts should be made to improve health app attributes and enhance the promotion of health apps among these underserved populations.

Scale effects in ridesplitting: A case study of the City of Chicago

Ridesplitting -- a type of ride-hailing in which riders share vehicles with other riders -- has become a common travel mode in some major cities. This type of shared ride option is currently provided by transportation network companies (TNCs) such as Uber, Lyft, and Via and has attracted increasing numbers of users, particularly before the COVID-19 pandemic. Previous findings have suggested ridesplitting can lower travel costs and even lessen congestion by reducing the number of vehicles needed to move people. Recent studies have also posited that ridesplitting should experience positive feedback mechanisms in which the quality of the service would improve with the number of users. Specifically, these systems should benefit from economies of scale and increasing returns to scale. This paper demonstrates evidence of their existence using trip data reported by TNCs to the City of Chicago between January and September 2019. Specifically, it shows that increases in the number of riders requesting or authorizing shared trips during a given time period is associated with shorter trip detours, higher rates of riders being matched together, lower costs relative to non-shared trips, and higher willingness for riders to share trips.

Caraterização do perfil de Doenças Profissionais notificadas num Hospital terciário Português entre 2012 e 2021

Introduction An occupational disease is a bodily injury, functional disturbance or pathology that is a necessary and direct consequence of exposure to occupational hazards and working conditions and does not result from the normal wear and tear of the body. The incidence of work-related diseases increases with age, being more frequent in females. Musculoskeletal injuries and paralysis, such as carpal tunnel syndrome, are the types of injuries most often recognized as occupational illnesses. Concerning the most predominant sector, the incidence is higher in industry, followed by construction and in the health area. Health professionals, given their exposure to ergonomic, physical, biological and chemical risks, have a high willingness to suffer from work-related illnesses. Objectives Characterize the profile of occupational diseases reported in a portuguese tertiary hospital, assessing their temporal distribution, the most affected professional category, as well as the type of injury and predominant body region. Methods An observational, cross-sectional and analytical study was realized using the analysis of occupational diseases reported in a portuguese tertiary hospital from January 2012 to December 2021, by consulting the Occupational Health Service databases. Results During the period considered, 610 occupational diseases were reported, of which 78.0% were female. The most affected professional category was nurses (40.8%), followed by operational assistants (28.5%). The year with the most notifications was 2021 (53.9%). SARS-CoV-2 infection was the most prevalent, with 431 cases, followed by musculoskeletal injuries, with 153 cases. Epicondylitis and tendinopathies of the shoulder joint were the most frequently notified musculoskeletal diseases with 39.7% and 24.0% of the participations, respectively. Conclusion Musculoskeletal injuries stand out as the most frequently reported type of injury, if we exclude the impact of SARS-CoV-2 infection, which is easily explained by exposure to the risks inherent in professions in the health sector. Its diagnosis and recognition are of great importance as they allow identifying problems and generate the need to provide a targeted response based on disease prevention and health promotion, among workers and employers. Keywords: Health Professionals, Occupational Diseases, Musculoskeletal Injury, Occupational Medicine, Occupational Hazards

Mpox Incidence and Vaccine Uptake in Men Who Have Sex with Men and Are Living with HIV in Denmark.

(1) Background: Here, we investigate the incidence of mpox and factors associated with vaccine uptake in mainly well-treated men who have sex with men and are living with HIV (MSMWH). (2) Methods: This study included 727 MSMWH from the Copenhagen co-morbidity in HIV infection (COCOMO) study from 1 May to 31 October 2022. Mpox infection and vaccination status were obtained from the Danish Microbiology Database and The Danish Vaccination Register. Vaccination willingness was assessed through an online survey. (3) Results: At a median follow-up of 180 days, 13 (1.8%) participants had laboratory-confirmed mpox infections. Furthermore, 238 (32.7%) had received the mpox vaccine. A sexually transmitted disease (STD) in the preceding two years was associated with a higher risk of mpox infection (hazard ratio 7.1; 95% confidence interval (CI) [1.9-26.9]) and with higher odds of vaccination (adjusted odds ratio 3.1; 95% CI [2.2-4.6]). 401 (55.2%) participants responded to the survey. 228 (57.0%) reported very high vaccination willingness. The self-perceived risk of infection was associated with vaccine uptake. (4) Conclusions: The incidence of mpox was low. A prior STD was associated with both a higher risk of mpox infection and higher odds of vaccination. Despite high-risk sexual behavior and high vaccination willingness, a sizable fraction of participants had not been vaccinated.

Residents’ valuation of ecosystem services in a Mediterranean coastal dune ecosystem: The case of the Ritoque dunes in central Chile

Coastal dunes provide a variety of cultural and ecological ecosystem services to local communities. However, most of these ecosystems are globally threatened by anthropic factors. Chile is home to important dune ecosystems such as the emblematic Ritoque coastal dunes located in the hotspot for biodiversity conservation in central Chile where there is a delicate relationship between conservation and human development interests, among local communities and authorities. Here, we performed a choice experiment study to determined willingness to implement conservation measures in the Ritoque dunes. In particular, we assessed residents’ preferences for improvements of the current state of local ecosystem services such as scenic beauty, biodiversity and archaeological sites. Residents showed preferences for improvements in Ritoque coastal dunes’ ecosystem services, and a high willingness to pay for protecting biodiversity and archeological sites, rather than for recreational infrastructure. Our study highlights the importance of place-based research that specifically addresses residents and stakeholders’ conservation priorities, which could be used to design and implement effective conservation management strategies for coastal ecosystems and coastal cities near them.

Patient preferences and shared decision making for the traditional Chinese medicine treatment of lung cancer: A discrete choice experiment study

BackgroundTraditional Chinese Medicine (TCM), integrating patient preferences into decision-making process, has been widely used in the multimodality therapy of lung cancer. This study aimed to estimate patient preferences for treatment and shared decision-making (SDM) modes concerning inpatient TCM treatment of lung cancer in Shanghai in order to provide a basis for clinical decision-making process on TCM therapy for lung cancer. MethodsThis study was conducted among patients (n = 347) from nine tertiary hospitals in Shanghai by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-patient version (SDM-Q-9) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of patients were performed using mixed logit models. Additionally, subgroup analysis was conducted. ResultsIn total, 347 respondents completed the questionnaire. All attributes’ coefficients were statistically significant for patients’ preferences. Patients showed strong preferences for increasing disease control rate, relieving nausea and vomiting, reducing the risk of side effects, and were concerned about monthly out-of-pocket costs. Subgroup analysis indicated that patients with a lower SDM-Q-9 score and those who were satisfied with medical services emphasized more importance of higher disease control rate. Furthermore, most of the patients (90.20%) self-reported a high willingness to use SDM during the decision-making process. ConclusionIn Shanghai, patients mainly preferred SDM and considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The study findings could underscore the importance of considering patients’ preferences and promote SDM.

How to inspire users in virtual travel communities: The effect of activity novelty on users’ willingness to co-create

Virtual travel community managers tend to incorporate a degree of novelty within activity design to foster interaction between users. Little is known of how users respond to these novel activities. Based on customer inspiration theory, this research investigated the mechanisms of activity novelty on users' willingness to co-create and the moderating effect of user regulatory focus and activity goal attainability. Results of three scenario-based experiments revealed that activity novelty positively influenced users’ willingness to co-create via user inspiration. Promotion-focused users were more inspired by novel activities and in turn had a higher willingness to co-create than those were prevention-focused. When activity goal attainability was high (vs. low), the positive effect of activity novelty on inspiration was attenuated. We present the theoretical and practical implications of activity design within virtual travel communities.

Is it more important to increase carbon sequestration, biodiversity, or jobs? A case study of citizens' preferences for forest policy in Finland

Forest management plays an important role in mitigating the most serious threats to the well-being of current and future generations: climate change and biodiversity loss. We examine citizens' preferences for alternative forest management policy goals, including the provision of carbon sinks, biodiversity, and forest sector jobs, using a discrete choice experiment in Finland. We explore preference heterogeneity using latent class multinomial logit models finding the highest willingness to pay for biodiversity-oriented forest policy. Comparing three forest policy scenarios, focusing on “Biodiversity,” “Climate,” or “Bioeconomy,” citizens preferred the overall environmental goals over economic ones. We observe considerable heterogeneity in respondents' preferences identifying five latent preference classes. The results provide valuable background information on citizens' values and preferences on tradeoffs built into future revisions of forest policy.