Preferences For Different Attributes Research Articles

A discrete choice experiment to understand public preferences and priorities for risk-stratified bowel cancer screening programmes in the UK

ObjectivePublic acceptability of bowel cancer screening programmes must be maintained, including if risk stratification is introduced. We aimed to describe and quantify preferences for different attributes of risk-stratified screening programmes amongst the UK population, focussing on who to invite for bowel screening. MethodsWe conducted a discrete choice experiment (DCE) including the following attributes: risk factors used to estimate bowel cancer risk (age plus/minus sex, lifestyle factors and genetics); personalisation of risk feedback; risk stratification strategy plus resource implications; default screening in the case of no risk information; number of deaths prevented by screening; and number experiencing physical harm from screening. We used the results of conditional logit regression models to estimate the importance of each attribute, willingness to trade-off between the attributes, and preferences for different programmes using contemporary risk scores and models. Results1196 respondents completed the survey, generating 21,528 DCE observations. Deaths prevented was the most influential attribute on respondents' decision-making (contributing to 58.8% of the choice), followed by harms experienced (15.9%). For every three additional deaths prevented, respondents were willing to accept an additional screening harm per 100,000 people. Risk factors and risk stratification strategy contributed to just 11.1% and 3.6% of the choice, respectively. Although the influence on decision-making was small, respondents favoured more personalised feedback. ConclusionsBowel cancer screening programmes that improve cancer outcomes, particularly by preventing more deaths amongst those screened, are most preferred by the public. Optimising risk prediction models, developing public communication, and readying infrastructure should be prioritised for implementation.

Chinese university students' preferences for physical activity incentive programs: a discrete choice experiment.

This study aims to explore and compare Chinese university students' preferences for various physical activity motivation programs. A cross-sectional study was conducted in China from February 25 to March 25, 2022. Participants anonymously completed an online questionnaire based on a DCE. A total of 1,358 university students participated in the survey. The conditional logit model (CLM), willingness to accept (WTA), and propensity score matching (PSM) were used to assess college students' preferences for different attributes and levels of physical activity incentive programs. Respondents identified the number of bonus, exercise time, and academic rewards as the three most significant attributes of the athletic incentive program. The importance of each attribute varied based on individual characteristics such as gender and BMI. In CLM, college students displayed a preference for a "¥4" bonus amount (OR: 2.04, 95% CI 1.95-2.13), "20 min" of exercise time (OR: 1.85, 95% CI 1.79-1.92), and "bonus points for comprehensive test scores" as academic rewards (OR: 1.33, 95% CI 1.28-1.37). According to the WTA results, college students were willing to accept the highest cost to obtain academic rewards tied to composite test scores. The number of bonus, exercise time, and academic rewards emerge as the three most crucial attributes of physical activity incentive programs. Furthermore, college students with different characteristics exhibit heterogeneity in their preferences for such programs. These findings can guide the development of programs and policies aimed at motivating college students to engage in physical activities.

Preferences, educational messaging, and demand creation channels for multipurpose-prevention technologies (MPTs) among women in South Africa

BackgroundSouth African women, including female sex workers (FSWs), are disproportionately affected by HIV, experience a high unmet need for contraception and high rates of sexually transmitted infections (STIs). Products that address the interlinked risk between HIV, unplanned pregnancy, and other STIs are needed. There are several multipurpose-prevention technologies (MPTs) in development, aimed at preventing both HIV and pregnancy. This study aimed to explore educational messaging and demand creation channels to improve the potential uptake of a hypothetical MPT implant, using participatory action research. It also aimed to look at product and service provision attributes preferred by potential end users.MethodsBetween July and August 2022, 303 PrEP-eligible adolescent girls and young women (AGYW) (18–24 years), women > 24 years, and FSW’s (≥ 18 years) participated in 4-hour workshops, where they were asked about their ideal messaging and demand creation channels and their preferences for different attributes of an MPT implant. Quantitative descriptive analysis was conducted to determine the frequency and ranking for each demand creation message, channel, and each product and service provision attribute, by population group. A chi-square test was used to assess MPT implant characteristics associated with age. Qualitative data were analysed using deductive and thematic analysis.ResultsA total of 104 AGYW, 157 women > 24 years, and 42 FSWs participated in the PAR workshops. Participants preferred demand creation messages that were empowering, motivational and encouraged body autonomy. The use of slang was popular. Community radio stations and newspapers, social media, and information at hospitals and clinics were participants’ preferred MPT demand creation channels because they were easily accessible. Providing long-term and dual HIV and pregnancy protection, receiving implant services at the local clinic, manageable side effects, discreet and private implant, and numbing the area before insertion and removal, were the most preferred product and service provision attributes.ConclusionEarly considerations for women’s product preferences are key to product development. Educational messaging around the MPT implant should be empowering and in local languages, this may motivate women to learn more about it and use it. Multiple demand creation channels should be used to engage both young and older populations, which may ensure better reach.

Choice preference and willingness to pay for COVID-19 vaccination in Namibia

BackgroundNamibia has not been spared from the coronavirus (COVID-19) pandemic, and as intervention the Namibian government has rolled out vaccination programmes. This study was conducted before the roll out of these vaccines to assess the preference for COVID-19 vaccinations. Stated preference studies provide information about social demand, access, willingness-to-pay and financing for future COVID-19 vaccination. MethodsA stated choice experiment (SCE) survey was administered to a sample of 506 participants from Namibia's general population between October 2020 and December 2020. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of a vaccine. A latent class model was used to analyse the SCE data. The study also assessed anti-vaccination behaviour, past vaccination behaviour, impacts of COVID-19 on mental and physical health and Willingness-To-Pay (WTP) measures. The WTP measures were captured as out-of-pocket and further calculated using the marginal rate of substitution method in SCE. ResultsData from 269 participants was included in the analysis. Vaccine side effects (40.065), population coverage (4.688), payment fee to receive vaccine immediately (3.733) were the top three influential attributes for vaccine preferences. Accordingly, increases in mild and severe side effects of vaccine options had negative impacts on utility; with an average WTP of N$728.26 to reduce serious side effects. The average WTP to receive a high-quality vaccine with 90% efficient was found to be N$233.11 (US$15.14). Across classes, there was a strong preference for vaccines with high effectiveness over longer durations of time. ConclusionsThe results provide useful information for the Namibian government to improve the current strategies for vaccine rollout interventions.

A discrete choice experiment on oral and injection treatment preferences among moderate-to-severe psoriasis patients inJapan.

Long-term psoriasis (PsO) management remains challenging. With growing variation in treatment efficacy, cost, and modes of administration, patient preferences for different treatment characteristics are not well understood. A discrete choice experiment (DCE), informed by qualitative patient interviews, was conducted to assess patient preferences for different attributes of PsO treatments; 222 adult patients with moderate-to-severe PsO receiving systemic therapy participated in the DCE web survey. Better long-term efficacy and lower cost were preferred (preference weights p < 0.05). Long-term efficacy had the highest relative importance (RI) and mode of administration was as important as the outcome attributes (efficacy and safety). Patients also preferred oral to injectable administration. In subgroup analyses by disease severity, residence, psoriatic arthritis as a comorbidity, and gender, the trends for each subgroup were the same as the overall population although the extent of RI for administration mode varied. Mode of administration was more important for patients with moderate versus severe disease, or rural versus urban residence. This DCE utilized attributes related to both oral and injectable treatment as well as a broad study population of systemic treatment users. Preferences were further stratified by patient characteristics to explore trends in different subgroups. Understanding the RI of treatment attributes and the attribute trade-offs acceptable to patients helps inform moderate-to-severe PsO systemic treatments decisions.

A Discrete Choice Analysis Comparing COVID-19 Vaccination Decisions for Children and Adults

COVID-19 vaccination rates in the US remain below optimal levels. Patient preferences for different attributes of vaccine products and the vaccination experience can be important in determining vaccine uptake decisions. To assess preferences for attributes of adult and pediatric COVID-19 vaccination among US adults. An online survey of a national panel of 1040 US adults was conducted in May and June 2021. A discrete choice analysis was used to measure the relative value of each attribute in the decision to choose a COVID-19 vaccination option for adults or children. Six attributes were used to described hypothetical vaccination options: vaccine effectiveness, mild side effects, rare adverse events, number of doses, time required for vaccination, and regulatory approval. Respondents chose between hypothetical vaccination profiles or no vaccination. Additional survey questions asked about vaccination beliefs, COVID-19 illness experience, COVID-19 risk factors, vaccination status, and opinions about the risk of COVID-19. Respondents chose which vaccine profile they would prefer to receive for themselves (or no vaccination). Respondents then considered an identical set of profiles for a hypothetical child aged 0 to 17 years. Relative value of vaccination-related attributes were estimated using Bayesian logit regression. Preference profiles for subgroups were estimated using latent class analyses. A total of 1040 adults (610 [59%] female; 379 participants [36%] with an age of 55 years and older years) responded to the survey. When asked about vaccination choices for themselves, participants indicated that vaccine effectiveness (95% vs 60%) was a significant attribute (β, 9.59 [95% CrI, 9.20-10.00] vs β, 0.41 [95% CrI, 0-0.80]). Respondents also preferred fewer rare adverse events (β, 6.35 [95% CrI, 5.74-6.86), fewer mild side effects (β, 5.49; 95% CrI, 5.12-5.87), 1 dose (β, 5.41; 95% CrI, 5.04-5.78), FDA approval (β, 6.01; 95% CrI, 5.64-6.41), and shorter waiting times (β, 5.67; 95% CrI, 4.87-6.48). Results were very similar when framing the question as adult or child vaccination, with slightly stronger preference for fewer rare adverse events for children. Latent class analysis revealed 4 groups of respondents: (1) individuals sensitive to safety and regulatory status, (2) individuals sensitive to convenience, (3) individuals who carefully considered all attributes in making their choices, and (4) individuals who rejected the vaccine. In this survey study of US adults, the identification of 4 distinct preference groups provides new information to guide communications to support vaccine decision making. In particular, the group that prioritize convenience (less time required for vaccination and fewer doses) may present an opportunity to create actionable strategies to increase vaccination uptake for both adult and pediatric populations.

Farmers' preferences for sustainable intensification attributes in sorghum-based cropping systems: evidence from Mali

AbstractSorghum plays a crucial role in the rural economy and nutrition of rural households in Mali. Yet the productivity of this crop is constrained by limited adoption of agricultural intensification technologies, which could be partly because technology development does not properly consider farmers' preferences. This study with smallholder farmers in southern Mali aimed to assess farmers' preferences for different attributes of sorghum technologies through the lens of sustainable intensification. The study used a discrete choice experiment, a method which involves asking individuals to state their preference over hypothetical alternative scenarios, goods or services. We considered six attributes corresponding to different domains of sustainable intensification: grain yield, risk of yield loss, soil fertility, nutrition, labor requirement and fodder yield. We analyzed the data using the mixed logit model, while considering the multinomial logit model as a robustness check. The findings revealed that smallholder farmers are strongly interested in transitioning from their existing sorghum-based cropping systems to those that closely align with these domains of sustainable intensification. However, there were diverse preferences among all the smallholder farmers studied, and between distinct sub-groups of smallholder farmers characterized by their social networks and agroecological zones, which yield relevant policy implications. Overall, these results support the growing research and development prioritization and policy interests toward scaling sustainable intensification among farmers, with a particular focus on human nutrition.

Public Valuation of Direct Restorations: A Discrete Choice Experiment

Direct posterior dental restorations are commonly provided following management of dental caries. Amalgam use has been phased down and the feasibility of a phase-out by 2030 is being explored. Alternative direct restorative materials differ in their outcomes and provision. This research aimed to elicit the UK population’s preferences for different attributes of restorations and their willingness to pay (WTP) for restorative services and outcomes. A discrete choice experiment (DCE) was designed with patient and public involvement and distributed to a representative sample of the UK general population using an online survey. Respondents answered 17 choice tasks between pairs of scenarios that varied in levels of 7 attributes (wait for filling, clinician type, filling color, length of procedure, likely discomfort after filling, average life span of filling, and cost). An opt-out (no treatment) was included. Mixed logit models were used for data analysis. Marginal WTP for attribute levels and relative attribute importance were calculated. In total, 1,002 respondents completed the DCE. Overall, respondents were willing to pay £39.52 to reduce a 6-wk wait for treatment to 2 wk, £13.55 to have treatment by a dentist rather than a therapist, £41.66 to change filling color from silvery/gray to white, £0.27 per minute of reduced treatment time, £116.52 to move from persistent to no postoperative pain, and £5.44 per year of increased restoration longevity. Ability to pay affected willingness to pay, with low-income respondents more likely to opt out of treatment and value restoration color (white) and increased longevity significantly lower than those with higher income. Clinicians should understand potential drivers of restoration choice, so they can be discussed with individual patients to obtain consent. It is important that policy makers consider general population preferences for restorative outcomes and services, with an awareness of how income affects these, when considering the potential phase-out of amalgam restorations.

Preferences for Biologic Treatment in Patients With Psoriatic Arthritis: A Discrete Choice Experiment.

We aimed to assess patient preferences for the characteristics and outcomes of biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARDs) to manage psoriatic arthritis. We conducted a discrete choice experiment in patients with psoriatic arthritis from 3 rheumatology centers in Sydney, Australia. We assessed preferences for different attributes of biologic medications. The route and frequency of medications had a range of 5 levels, and the following 7 attributes had a range of 3 levels: the ability to attend to normal activities, improvements in joint pain, enthesitis and skin disease, chance of disease remission, risk of infection, and risk of severe adverse events. Multinomial logit models including a latent class model were used to calculate preferences. Of the 150 participants, 58.3% were female, with a median age of 53.5 years. The attributes in order of preference using the β coefficient in absolute values (95% confidence interval [95% CI]) were as follows: oral route compared to subcutaneous and intravenous routes (β coefficient 1.00 [fixed parameter]), avoiding severe side effects (β coefficient 0.72 [95% CI 0.50, 0.95]), increasing ability to attend to normal activities (β coefficient 0.66 [95% CI 0.36, 0.96]), avoiding infections (β coefficient 0.38 [95% CI 0.23, 0.53]), improvement in enthesitis pain (β coefficient 0.28 [95% CI 0.20, 0.36]), improvement in psoriasis (β coefficient 0.28 [95% CI 0.20, 0.36]), increasing chance of remission (β coefficient 0.27 [95% CI 0.19, 0.36]), and improvement in joint pain (β coefficient 0.26 [95% CI 0.00, 0.52]). When choosing biologic medications, patients with psoriatic arthritis preferred oral medications. Patients prioritized avoiding severe complications, maintaining the ability to attend to work and normal activities, and avoiding infection over clinical measures of efficacy.

A discrete choice experiment to identify patient preferences for the provision of NHS medicines helpline services

Abstract Introduction Medicines helplines for patients discharged from NHS hospitals can prevent medicines-related harm (1). They are an underused service, which is partly attributed to under-resourcing and consequent inability to meet NHS standards (2). There is no evidence to inform which elements of these standards should be prioritised to increase patient access. Aim To measure patient preferences for different attributes of the provision of medicines helpline services using a discrete choice experiment (DCE). Methods The International Society for Pharmacoeconomics and Outcomes Research good research practices were used to conduct a DCE. Adult members of the NHS ‘Research for the Future’ database who regularly take ≥1 prescribed medicine (or care for someone for does) completed an online survey. The survey presented ten pairs of helplines, each helpline described by seven attributes. Participants chose which helpline from each pair they would prefer to contact with a query following discharge. The attributes of each helpline were defined using standard descriptors (levels) selected with a D-efficient experimental design from two to four options. Twenty helpline pairs were blocked into two survey variants. Participants’ overall preferences for each attribute level were obtained using conditional logit regression and expressed as willingness for the NHS to pay (WTP). Results 460 participants completed a survey (53% female, aged 20-91 years, mean number of regular medicines: 6.0). All attributes significantly affected patient preferences (p&amp;lt;0.001). Participants’ WTP for key characteristics are shown in the table. Conclusion Hospitals providing a medicines helpline should prioritise seven-day opening for extended hours with queries answered on the same day, as these attributes are valued most by potential patients. Other attributes, such as alternative means of contact or a locally based helpline are also valued, but to a lesser extent. Further analysis is required to determine the influence of participant characteristics on their preferences. Use of a DCE with experimental design and a large sample size has enabled patient preferences to be quantified with reasonable precision. However, findings are limited by the method of recruitment, as all participants had internet access and certain groups were over-represented in the sample (e.g. white ethnicity, university educated, higher income). References (1) Williams M, Jordan A, Scott J, Jones MD. A systematic review examining the effectiveness of medicines information services for patients and the general public. Int J Pharm Pract. 2020; 28(1): 26-40. (2) Williams M, Jordan A, Scott J, Jones MD. Operating a patient medicines helpline: A survey study exploring current practice in England using the RE-AIM evaluation framework. BMC Health Serv Res. 2018; 18:868.

Consumer Preference for Yogurt Packaging Design Using Conjoint Analysis

With the growing consumption market of yogurt products, the continuous innovation of packaging design has become the major means of enterprise marketing for fast-moving consumer goods. Because different combinations of packaging design elements affect the consumers in different ways, the contradiction between the product packaging design and consumer demand has impacted the further development of these products’ marketing. To explore the relationship between the constituent elements of yogurt packaging design and consumer preferences, four kinds of factors to the purchased products’ attributes were selected from the packaging design, including the graphics, packaging colors, packaging shapes and label texts. The consumers’ preferences for different attributes of yogurt packaging design were quantitatively evaluated by the Conjoint Analysis Method (CAM). Consumers showed the strongest preference for yogurt packaging shapes (39.017%), and were the most satisfied with the concrete graphics of cool colors (31.330%); the level combination of attributes most preferred by consumers is that of concrete graphics, cool colors, gable-top boxes and simple labels. The packaging design satisfying consumer preferences gave rise to positive purchase attitudes. Such research results facilitated the understanding of the consumption market and provided the theoretical support necessary for the development of yogurt packaging design to match the consumers’ preferences.

Developing a patient-centered community-based model for management of multi-drug resistant tuberculosis in Uganda: a discrete choice experiment

BackgroundThe advent of all-oral regimens for the management of multi-drug resistant tuberculosis (MDR-TB) makes the implementation of community-based directly observed therapy (CB-DOT) a possibility for this group of patients. We set out to determine patient preferences for different attributes of a community-based model for the management of MDR-TB in Uganda.MethodsThe study was conducted at five tertiary referral hospitals. We used a parallel convergent mixed methods study design. To collect quantitative data, we conducted a discrete choice experiment (DCE) with three different attributes of community-based care (DOT provider, location of care, and type of support) combined into eight choice sets, each with two options and an opt-out. We elicited patient reasons for selection of each choice set using qualitative methods. We fitted a mixed logit choice model to determine patient preferences for different attributes of community-based care and estimated the relative importance of each attribute using the range method. and used deductive thematic analysis to understand the reasons for the choices made.ResultsFrom December 2019 to January 2020, we interviewed 103 patients with MDR-TB. We found that all the three attributes considered were important predicators of choice. The relative importance of each attribute was as follows; the type of additional support (relative importance 36.2%), the location of treatment delivery (33.5%), and the type of DOT provider (30.3%). Participants significantly valued treatment delivered by community health workers (CHWs) or expert clients over that delivered by a family member, treatment delivered at home over that delivered at the workplace, and monthly travel vouchers as the form of additional support over phone call or SMS reminders. Subgroup analyses showed significant differences in preference across HIV status, age groups and duration on MDR-TB treatment, but not across gender.The preferred model consisted of a CHW giving DOT at home and travel vouchers to enable attendance of monthly clinic follow-up visits to tertiary referral hospitals for treatment monitoring. Qualitative interviews revealed that patients perceived CHWs as knowledgeable and able to offer psychosocial support. Patients also preferred to take medication at home to save both time and money and lower the risk of facing TB stigma.ConclusionPeople with MDR-TB prefer to be supported to take their medicine at home by a member of their community. The effectiveness of this model of care is being further evaluated.

Preferences or expectations: understanding the gender gap in major choice

Abstract How do students decide what major to study and what explains the low enrolment of women in science and economics? Using data on the subjective expectations of undergraduate students who are in the process of selecting a major, we model major choice as a function of major-specific and job-specific attributes. We identify significant gender differences in the preferences for different attributes as well as in the expectations of future outcomes, especially of grades. Women are willing to pay twice as much as men for course enjoyment and higher grades, even as they expect lower grades in science and economics. This suggests that in addition to gender differences in preferences being shaped by pervasive norms about which subjects are considered more suitable for women, women also suffer from a relative confidence gap in their major-specific abilities.

Speaking from experience: Preferences for cooking with biogas in rural India

Biogas has the potential to satisfy the clean energy needs of millions of households in under-served and energy-poor rural areas, while reducing both private and social costs linked to (i) fuels for household cooking, (ii) fertilizers, (iii) pressure on forests, and (iv) emissions (e.g., PM2.5 and methane) that damage both household health and global climate. While the literature has focused on identifying these costs, less attention has been paid to household preferences for biogas systems — specifically what attributes are popular with which types of households. We conduct a discrete choice experiment with 503 households in rural Odisha, India, to better characterize preferences for different attributes (smoke reduction, fuel efficiency, and maintenance) and for different cooking technologies (biogas and an improved biomass cookstove). We find that on average households value smoke reduction and fuel efficiency. Willingness to pay (WTP) a premium for the improved biomass cookstove is low, while willingness to pay a premium for biogas is high. Nonetheless, WTP varies by the type of previous experience with biogas (e.g., good or bad experience) and with time and risk preferences of households. While risk-averse and impatient respondents have lower WTP for the improved cookstoves, previous experience with biogas attenuates this gap. These findings suggest that biogas uptake and diffusion could be improved by complementing existing subsidies with technology trials, good quality products, maintenance, and customer services to reduce uncertainty.

Heterogeneity in preferences for renewable home heating systems among Irish households

This paper aims to understand heterogeneity in preferences for renewable home heating systems such as heat pump systems, using a combination of psychological construct statements and a discrete choice experiment. We employ a latent class analysis for a nationally representative sample of Irish households to identify and characterize distinct respondent classes based on their responses to statements on attitude, subjective norms, perceived behavioral control, and intention to install a heat pump that are constructed based on the theory of planned behavior. This allows us to identify four types of people with different viewpoints towards heat pumps. Furthermore, we conducted a discrete choice experiment with a subsample of randomly selected respondents to estimate preferences for different attributes of a new home heating system and the corresponding marginal willingness to pay. Our estimated results show that, in addition to upfront cost and bill savings, non-monetary attributes such as installation hassle, environmental sustainability, and an increase in home comfort of use are important determinants of the uptake of new home heating systems, including heat pumps. The findings of this study should provide useful information to policymakers and companies on end-user profiles, heterogeneity in preferences, and willingness to pay estimates for new home heating alternatives.

Eliciting Preferences for Adult Orthodontic Treatment: A Discrete Choice Experiment.

There has been little research to explore how adults financially value private orthodontic treatment and whether they have preferences for different attributes of treatment. This study used a discrete choice experiment and aimed to determine whether the recognized skill level of the dental professional and the type of orthodontic appliance influence the values that the public places on private adult orthodontic treatment. In total, 206 adult patients or the parents/guardians of children attending general dental practices in the northeast of England were recruited to complete a discrete choice experiment. Three attributes were included: the type of dental professional providing treatment, the type of orthodontic appliance, and cost. Also collected were demographic and orthodontic history characteristics. Results were analyzed with conditional logistic regression and elicited marginal willingness to pay (MWTP). Participants value the training and expertise of the dental professional providing private orthodontic treatment greater than the type of orthodontic appliance. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances over a fixed metal appliance. Participants value the training and expertise of the dental professional providing private adult orthodontic treatment greater than the type of orthodontic appliance. These preferences concur with other discrete choice experiments undertaken in medical specialties that included attributes focusing on the qualification, skill, or expertise of the health care professional. MWTP for orthodontic treatment increased in conjunction with the recognized skill level of the dental professional. Participants were willing to pay more for aesthetic appliances than metal fixed appliances. The cost of orthodontics is significant, and adults appreciate the importance of having options and making choices.Knowledge Transfer Statement: The results of this study suggest that patients are willing to pay more for orthodontic services provided by clinicians with higher levels of formal training. In a competitive market where the public appears to prefer the provider over treatment modality, there is an incentive for clinicians to optimize their knowledge and skills to deliver the high-quality orthodontic treatment that patients are demanding. Orthodontic clinicians should be mindful of the demand for the different adult orthodontic appliances and tailor their skill sets accordingly.

Friendly Communities and Outdoor Spaces in Contexts of Urban Population Decline

Urban population decline has been extensively described as a triggering factor for community segregation and fragmentation, as well as for land use vacancy and house/flat vacancies, resulting in rising interest in strategies of green infrastructure expansion aimed at citizens’ wellbeing and urban ecosystems. However, city-scaled green infrastructures can be formed by different typologies of outdoor spaces, providing diverse social affordances that can impact community cohesion and resilience differently. This study focuses on the relationship between preferences for particular outdoor space typologies and for community friendliness, under contexts of urban population decline as a migratory process. In the context of Lisbon, a European capital-city experiencing migration and immigration but also urban population shrinkage in some areas of its metropolitan region, the study used conjoint analysis to test participants’ preference for different attributes of their urban environment. The results showed a significant positive correlation, in the sample living in depopulating neighbourhoods, between preferences for friendlier communities and for outdoor spaces of an enclosed and protected character (r = 0.34), compared with no significant correlation in the studied non-depopulating neighbourhoods. These results do not deny the importance of public parks of wide dimensions as a strategy for shrinking cities’ green infrastructures but suggest that urban citizens living in depopulating neighbourhoods have a higher awareness of the importance of small-scale, enclosed outdoor/green spaces to give a stronger sense of social connectedness. This study contributes to the general literature on urban shrinkage by showing that these sensitive conditions can potentially change behaviour and use of public spaces in urban contexts.

Public preference for COVID-19 vaccines in China: A discrete choice experiment.

BackgroundAs the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID‐19 vaccine in China.MethodsAn online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated.ResultsData of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine.ConclusionsThe strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy.Patient or Public ContributionThe design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible.

Consumer preference for novelty in processed foods: a developing country perspective

PurposeThe paper aims to explore consumer preferences for novel and other quality attributes in processed foods. It focuses on preferences for product origin, certification on food quality and standards and tradeoffs between novelty (fortification and highly processed) and other quality attributes.Design/methodology/approachIn total, 317 consumers were randomly selected at a high-end supermarket and a traditional local market in Dar es Salaam, Tanzania. Stated and revealed preference approaches were used to investigate their preferences for different attributes in processed foods. A hypothetical choice experiment was used to assess consumer preference for six baby food attributes and the tradeoffs between the attributes, while the revealed preference method included questions on consumer's actual processed food purchasing and consumption habits. In addition, consumers were asked a series of hierarchical questions assessing the motivation underpinning their choices for different products attributes.FindingsWhen making choices for processed food attributes, consumers are reluctant to choose novel technologies and have a strong preference for natural, nutritious, tasty and quality processed food attributes. However, they are willing to forego their preference for naturalness and to overcome their reluctance to trying novel technologies when the novelty is embedded with such quality benefits as nutrition, but not so when the embedded benefit is convenience. They are also willing to trade off their preference for nutrition for a sensory taste. This suggests that micronutrient deficiencies can be reduced among women and children under five by employing the appropriate strategies in processed food formulation. Further, the preference for product origin highlights the opportunity for national brands to fill the gap created by the increasing demand for processed foods in Tanzania.Research limitations/implicationsThe study claims a developing country perspective but is only representing consumers in one city in a developing country. However, this study speculates that consumers with representative characteristics in such context are likely to behave the same. Furthermore, although this study controlled for a hypothetical bias, having a hypothetical choice experiment with non-shoppers (non-purchasers) could have triggered the hypothetical bias, making participants concentrate more on non-price than price attributes.Originality/valueThe paper offers a developing country perspective on consumers' preferences for novelty in processed foods and tradeoffs with other quality attributes.

Tailoring chemotherapy supply according to patients’ preferences: a quantitative method in colorectal cancer care

Objectives: The aim of this study was to conduct a discrete choice experiment with patients affected by colorectal cancer to understand their preferences for different attributes of the chemotherapy supply. Our overall goal is to provide evidence on the relative importance of each attribute in order to tailor chemotherapy supply according to patients' priorities in the design or reorganization processes of cancer services.Methods: Focus groups were used to identify the attributes and levels for the discrete choice experiment. The attributes were: continuity of care, understanding, information, treatment choice, and time for therapy. Respondents were asked to choose between two mutually exclusive hypothetical alternatives of chemotherapy supply. Patients completed the discrete choice experiment along with the health-related quality of life and patients’ satisfaction questions. Conditional and mixed logistic models were used to analyses the data.Results: Patients with colorectal cancer treated with chemotherapy (n = 76) completed the survey. The most important aspects of chemotherapy supply were: “Providing detailed and complete information” and “High ability in understanding” patients. Preferences were also influenced by the availability of a trusted doctor. Except for one attribute (waiting time for therapy), all other characteristics significantly influenced respondents’ preferences.Conclusions: Results should support a policy of strengthening medical doctors’ capabilities to communicate with patients, providing them complete information and involving them in the clinical decisions. Specifically, the findings should be used to improve the current provision of cancer care by identifying areas of preferred intervention from the perspectives of patients in order to tailor the service supply accordingly.