Preference Variation: Where Does Health Risk Attitude Come Into the Equation?

• Published in: Value in health Vol. 25; no. 12; pp. 2044 - 2052
• Main Authors: Huls, Samare P.I., Veldwijk, Jorien, Swait, Joffre D., Viberg Johansson, Jennifer, Ancillotti, Mirko, de Bekker-Grob, Esther W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: Attitude to Health; Choice Behavior; choice modeling; discrete choice experiment; Health Literacy; Humans; latent class; Latent Class Analysis; Patient Preference; preference elicitation; preference heterogeneity; risk attitude; discrete choice experiment; preference heterogeneity; latent class; preference elicitation; choice modeling; risk attitude
• ISSN: 1098-3015; 1524-4733; 1524-4733
• DOI: 10.1016/j.jval.2022.05.005

Decisions about health often involve risk, and different decision makers interpret and value risk information differently. Furthermore, an individual’s attitude toward health-specific risks can contribute to variation in health preferences and behavior. This study aimed to determine whether and how health-risk attitude and heterogeneity of health preferences are related. To study the association between health-risk attitude and preference heterogeneity, we selected 3 discrete choice experiment case studies in the health domain that included risk attributes and accounted for preference heterogeneity. Health-risk attitude was measured using the 13-item Health-Risk Attitude Scale (HRAS-13). We analyzed 2 types of heterogeneity via panel latent class analyses, namely, how health-risk attitude relates to (1) stochastic class allocation and (2) systematic preference heterogeneity. Our study did not find evidence that health-risk attitude as measured by the HRAS-13 distinguishes people between classes. Nevertheless, we did find evidence that the HRAS-13 can distinguish people’s preferences for risk attributes within classes. This phenomenon was more pronounced in the patient samples than in the general population sample. Moreover, we found that numeracy and health literacy did distinguish people between classes. Modeling health-risk attitude as an individual characteristic underlying preference heterogeneity has the potential to improve model fit and model interpretations. Nevertheless, the results of this study highlight the need for further research into the association between health-risk attitude and preference heterogeneity beyond class membership, a different measure of health-risk attitude, and the communication of risks. •Decisions about health often involve risk, and risk preferences may vary among people.•Interest in health preference heterogeneity and the role of risk is increasing.•Modeling health risk attitude as an individual characteristic underlying preference heterogeneity has the potential to improve model fit and model interpretations.•Further research into the relationship between health risk attitude and preference heterogeneity is warranted.