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Using Best-Worst Scaling to Understand Patient Priorities: A Case Example of Papanicolaou Tests for Homeless Women

Published on Jul 1, 2016in Annals of Family Medicine4.18
· DOI :10.1370/afm.1937
Eve Wittenberg21
Estimated H-index: 21
(Harvard University),
Monica Bharel11
Estimated H-index: 11
(Harvard University)
+ 2 AuthorsLinda Weinreb20
Estimated H-index: 20
(UMMS: University of Massachusetts Medical School)
Cite
Abstract
PURPOSE Best-worst scaling (BWS) is a survey method for assessing individuals' priorities. It identifies the extremes—best and worst items, most and least impor - tant factors, biggest and smallest influences—among sets. In this article, we demonstrate an application of BWS in a primary care setting to illustrate its use in identifying patient priorities for services. METHODS We conducted a BWS survey in 2014 in Boston, Massachusetts, to assess the relative importance of 10 previously identified attributes of Papanico - laou (Pap) testing services among women experiencing homelessness. Women were asked to evaluate 11 sets of 5 attributes of Pap services, and identify which attribute among each set would have the biggest and smallest influence on pro - moting uptake. We show how frequency analysis can be used to analyze results. RESULTS In all, 165 women participated, a response rate of 72%. We identified the most and least salient influences on encouraging Pap screening based on their frequency of report among our sample, with possible standardized scores ranging from+1.0 (biggest influence) to -1.0 (smallest influence). Most impor - tant was the availability of support for issues beyond health (+0.39), while least important was the availability of accommodations for personal hygiene (-0.27). CONCLUSIONS BWS quantifies patient priorities in a manner that is transpar - ent and accessible. It is easily comprehendible by patients and relatively easy to administer. Our application illustrates its use in a vulnerable population, showing that factors beyond those typically provided in health care settings are highly important to women in seeking Pap screening. This approach can be applied to other health care services where prioritization is helpful to guide decisions.
  • References (34)
  • Citations (2)
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References34
Newest
Published on Nov 1, 2015in American Journal of Preventive Medicine4.43
Travis P. Baggett15
Estimated H-index: 15
(Harvard University),
Yuchiao Chang77
Estimated H-index: 77
(Harvard University)
+ 3 AuthorsNancy A. Rigotti71
Estimated H-index: 71
(Harvard University)
Introduction Homeless people have a high burden of cancer risk factors and suboptimal rates of cancer screening, but the epidemiology of cancer has not been well described in this population. We assessed cancer incidence, stage, and mortality in homeless adults relative to general population standards. Methods We cross-linked a cohort of 28,033 adults seen at Boston Health Care for the Homeless Program in 2003–2008 to Massachusetts cancer registry and vital registry records. We calculated age-st...
Eve Wittenberg21
Estimated H-index: 21
(Harvard University),
Monica Bharel11
Estimated H-index: 11
(Harvard University)
+ 3 AuthorsLinda Weinreb20
Estimated H-index: 20
(UMMS: University of Massachusetts Medical School)
Objective Despite having multiple risk factors, women experiencing homelessness are screened for cervical cancer at a lower rate than women in the general US population. We report on the design of a stated preference study to assess homeless women’s preferences for cervical cancer screening interventions, to inform efforts to overcome this disparity.
Esther W. de Bekker-Grob22
Estimated H-index: 22
(EUR: Erasmus University Rotterdam),
Bas Donkers23
Estimated H-index: 23
(EUR: Erasmus University Rotterdam)
+ 1 AuthorsElly A. Stolk29
Estimated H-index: 29
(EUR: Erasmus University Rotterdam)
Discrete-choice experiments (DCEs) have become a commonly used instrument in health economics and patient-preference analysis, addressing a wide range of policy questions. An important question when setting up a DCE is the size of the sample needed to answer the research question of interest. Although theory exists as to the calculation of sample size requirements for stated choice data, it does not address the issue of minimum sample size requirements in terms of the statistical power of hypoth...
Published on Jan 1, 2015
Jordan J. Louviere78
Estimated H-index: 78
,
Terry N. Flynn31
Estimated H-index: 31
,
A. A. J. Marley23
Estimated H-index: 23
Preface Acknowledgments Theory and Methods: 1. Introduction and overview of the book 2. The BWS object case 3. The BWS profile case 4. The BWS multi-profile case 5. Basic models 6. Looking forward Applications - Case 1: 7. BWS object case application: attitudes towards end-of-life care Terry N. Flynn, Elisabeth Huynh and Charles Corke 8. How consumers choose wine: using best-worst scaling across countries Larry Lockshin and Eli Cohen 9. Best-worst scaling: an alternative to ratings data Geoffrey...
Published on Feb 1, 2015in Psychiatric Services2.25
Melissa Ross4
Estimated H-index: 4
(UMB: University of Maryland, Baltimore),
John F. P. Bridges27
Estimated H-index: 27
(Johns Hopkins University)
+ 4 AuthorsSusan dosReis27
Estimated H-index: 27
Objective:The objective of this feasibility study was to develop and pilot an instrument to elicit caregivers’ priorities when initiating attention-deficit hyperactivity disorder (ADHD) medication for their child.Methods:A best-worst scaling experiment was used to rank competing priorities when initiating ADHD medicine. Forty-six participants were recruited for a two-phase study involving survey development (phase 1, N=21) and the survey pilot (phase 2, N=25). Best-worst scores and 95% confidenc...
Published on Jan 1, 2015
Geoffrey N. Soutar42
Estimated H-index: 42
(UWA: University of Western Australia),
Jillian C. Sweeney35
Estimated H-index: 35
(UWA: University of Western Australia),
Janet R. McColl-Kennedy34
Estimated H-index: 34
Published on Nov 1, 2014in Annals of Surgical Oncology3.68
Aslam Ejaz23
Estimated H-index: 23
(UIUC: University of Illinois at Urbana–Champaign),
Gaya Spolverato28
Estimated H-index: 28
(JHUSOM: Johns Hopkins University School of Medicine)
+ 3 AuthorsTimothy M. Pawlik80
Estimated H-index: 80
(JHUSOM: Johns Hopkins University School of Medicine)
Background Surgeon experience has been shown to influence outcomes for many types of cancer. The factors that patients consider when selecting a hospital or surgeon for cancer treatment remain poorly defined.
Published on Jun 1, 2014in Respiratory Medicine3.24
Wendy J. Ungar27
Estimated H-index: 27
(U of T: University of Toronto),
Anahita Hadioonzadeh2
Estimated H-index: 2
+ 3 AuthorsLarry D. Lynd27
Estimated H-index: 27
(UBC: University of British Columbia)
Summary Background Understanding the views of parents and children is critical to designing effective asthma management programs. It was hypothesized that parents and adolescents would exhibit heterogenous preferences with regard to asthma control. Methods Fifty parents of children with asthma and 51 adolescents with asthma participated in a best–worst scaling study to quantify preferences regarding night-time symptoms, wheezing/chest tightening, changes in asthma medications, emergency visits a...
Ken Deal14
Estimated H-index: 14
(McMaster University)
People often form groups or segments that have similar interests and needs and seek similar benefits from health providers. Health organizations need to understand whether the same health treatments, prevention programs, services, and products should be applied to everyone in the relevant population or whether different treatments need to be provided to each of several segments that are relatively homogeneous internally but heterogeneous among segments. Our objective was to explain the purposes,...
Cited By2
Newest
Published on Sep 16, 2019in JAMA Internal Medicine20.77
Nancy L. Schoenborn4
Estimated H-index: 4
(JHUSOM: Johns Hopkins University School of Medicine),
Norah L. Crossnohere (OSU: Ohio State University)+ 3 AuthorsCynthia M. Boyd40
Estimated H-index: 40
(JHUSOM: Johns Hopkins University School of Medicine)
Importance Diabetes guidelines recommend considering specific factors, such as diabetes duration and life expectancy, to individualize treatment in older adults. These individualized glycemic targets inform decisions on whether to intensify or deintensify medication treatment plans. How older adults with diabetes perceive these factors used to individualize glycemic targets is unknown. Objectives To examine how older adults perceive factors used in diabetes guidelines for individualizing glycemi...
Published on Sep 1, 2019in Value in health regional issues
Alina Khabibullina (HSE: National Research University – Higher School of Economics), Christopher J. Gerry10
Estimated H-index: 10
(University of Oxford)
Abstract Objective The aim of this study was to explore the feasibility of different health-related quality-of-life valuation methods in a new setting. Based on a small feasibility study of 100 young Russians, we trialed different methodologies and identified key differences that have implications for the development of health technology assessment in Russia. Methods In face-to-face interviews, respondents completed a series of health self-assessments based on a modified version of the EQ-5D-3L,...
Published on Aug 26, 2019in Journal of General Internal Medicine4.61
Nancy L. Schoenborn4
Estimated H-index: 4
(JHUSOM: Johns Hopkins University School of Medicine),
Norah L. Crossnohere (OSU: Ohio State University)+ 7 AuthorsJohn Bridges2
Estimated H-index: 2
(OSU: Ohio State University)
Background/Objectives Many older adults receive unnecessary screening colonoscopies. We previously conducted a survey using a national online panel to assess older adults’ preferences for how clinicians can discuss stopping screening colonoscopies. We sought to assess the generalizability of those results by comparing them to a sample of older adults with low health literacy.
Published on Jul 16, 2019in Journal of Community Health1.57
Jennifer Mings (UNM: University of New Mexico), Francisco Soto Mas12
Estimated H-index: 12
(UNM: University of New Mexico)
The purpose of this cross-sectional survey study was to explore common barriers to adequate Pap smear utilization among homeless women, and the factors that may relate to cervical cancer testing in this population. Participants consisted of adult women recruited at a healthcare facility for the homeless. Data were collected through a self-completed questionnaire on knowledge, attitudes and intentions about Pap smears and cervical cancer. Analyses included descriptive and inferential statistics. ...
Published on May 1, 2019in Clinical Therapeutics2.94
Rosangel Cruz4
Estimated H-index: 4
,
Lisa Belter + 2 AuthorsJill Jarecki7
Estimated H-index: 7
Abstract Purpose Patients’ perceptions of benefit–risk are essential to informing the regulatory process and the context in which potential therapies are evaluated. To bring this critical information to regulators, Cure SMA launched a first-ever Benefit-Risk Survey for spinal muscular atrophy (SMA) to characterize decision-making and benefit–risk trade-offs in SMA associated with a potential therapy. We hypothesized that risk tolerance would be correlated with SMA type/severity and disease progr...
Published on Jul 1, 2018in Lancet Oncology35.39
Ramin Asgary11
Estimated H-index: 11
Summary Annually, 100 million people experience homelessness worldwide. Most adults that are struggling with homelessness are living to age 50 years or older and need age-appropriate screening for cancer. Cancer-related death in homeless adults is twice as high as the average in the adult population in the USA. However, few studies have examined the rates of and barriers to cancer screening in homeless people. This Review explores cancer-related health disparities between homeless people and the...
Published on May 19, 2017in Frontiers in Public Health
Eva M. Moya9
Estimated H-index: 9
(UTEP: University of Texas at El Paso),
Silvia Chavez-Baray3
Estimated H-index: 3
(UTEP: University of Texas at El Paso)
+ 2 AuthorsNahomi Martinez1
Estimated H-index: 1
(UTEP: University of Texas at El Paso)
Homelessness is a social, economic, and political crisis in the United States. In particular, the U.S.-Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, twelve persons in El Paso, Texas with experience of being homeless used the photovoice methodology to participate in a project titled, ‘The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the I...
View next paperA COMPARISON OF DISCRETE CHOICE AND BEST WORST SCALING METHODS TO ASSESS AUSTRALIAN PUBLIC PREFERENCES FOR THE FUNDING OF NEW HEALTH TECHNOLOGIES