Consumer Preferences for Health and Nonhealth Outcomes of Health Promotion: Results from a Discrete Choice Experiment

• Published in: Value in health Vol. 16; no. 1; pp. 114 - 123
• Main Authors: Alayli-Goebbels, Adrienne F.G., MSc, Dellaert, Benedict G.C., PhD, Knox, Stephanie A., MPH, Ament, André J.H.A., PhD, Lakerveld, Jeroen, PhD, Bot, Sandra D.M., PhD, Nijpels, G., PhD, Severens, J.L., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.2013; Elsevier
• Subjects: Adult; Biological and medical sciences; Choice Behavior; Consumers; Decision Making; discrete choice experiment; Female; Health; Health Behavior; health promotion; Health Promotion - methods; Health Status; Humans; Internal Medicine; Interventions; Life Expectancy; Life Style; Lifestyle; Male; Medical sciences; Middle Aged; Miscellaneous; nonhealth outcomes; Outcome Assessment (Health Care) - methods; Patient Preference; Preferences; Public health. Hygiene; Public health. Hygiene-occupational medicine; discrete choice experiment; nonhealth outcomes; health promotion; lifestyle; Prognosis; Discrete choice experiments; Consumer; Health promotion; Preference; Evolution; Public health; Life style; Result
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2012.08.2211

Abstract Objective Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change. Methods A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week. Results With the exception of “time cost per week” and “start point of future health state,” all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes “endurance,” “days with sufficient relaxation,” and “future health state value” had the greatest impact on consumer choices. The “life expectancy” attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade. Conclusions Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions.