1
|
Somta S, Völker M, Widyastari DA, Mysook S, Wongsingha N, Potharin D, Katewongsa P. Willingness-to-pay in physical activity: how much older adults value the community-wide initiatives programs? Front Public Health 2023; 11:1282877. [PMID: 38026321 PMCID: PMC10644721 DOI: 10.3389/fpubh.2023.1282877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Previous studies have shown insufficient physical activity (PA) as a significant global health concern and a major risk factor for non-communicable diseases (NCDs). Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, assessment regarding resource allocation and cost-effectiveness of existing programs is lacking. This study investigated local residents' willingness-to-pay (WTP) for community PA programs in Southern Thailand. Methods The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which community PA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of free CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bill. Results The mean WTP of Thai older adults was found to be 72 baht/month ($2/month) or 868 baht/year ($25/year). This indicated the maximum amount an older person was willing to pay for any community-based PA program. More than half the sample (54.2%) chose zero as their answer, while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas but was higher among those with a history of participation in an organized PA program. Conclusion The level of WTP can be interpreted as an indicator of community satisfaction with CWIPA. That finding can be used as evidence for the government and policy makers in allocating resources and designing future CWIPA. A variety of organized PA programs should be offered to all community members to ensure inclusivity and also to provide equal access for senior citizens.
Collapse
Affiliation(s)
- Sittichat Somta
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Marc Völker
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | | | - Sirinapa Mysook
- Sisaket Provincial Public Health Office, Mueang, Sisaket, Thailand
| | - Narakorn Wongsingha
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Danusorn Potharin
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| |
Collapse
|
2
|
Burge AT, Holland AE, McDonald CF, Hill CJ, Lee AL, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahhama A, Gillies R, Mahald A. "Willingness to Pay": The Value Attributed to Program Location by Pulmonary Rehabilitation Participants. COPD 2021; 18:281-287. [PMID: 34060968 DOI: 10.1080/15412555.2021.1924127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The "contingent valuation" method is used to quantify the value of services not available in traditional markets, by assessing the monetary value an individual ascribes to the benefit provided by an intervention. The aim of this study was to determine preferences for home or center-based pulmonary rehabilitation for participants with chronic obstructive pulmonary disease (COPD) using the "willingness to pay" (WTP) approach, the most widely used technique to elicit strengths of individual preferences. This is a secondary analysis of a randomized controlled equivalence trial comparing center-based and home-based pulmonary rehabilitation. At their final session, participants were asked to nominate the maximum that they would be willing to pay to undertake home-based pulmonary rehabilitation in preference to a center-based program. Regression analyses were used to investigate relationships between participant features and WTP values. Data were available for 141/163 eligible study participants (mean age 69 [SD 10] years, n = 82 female). In order to undertake home-based pulmonary rehabilitation in preference to a conventional center-based program, participants were willing to pay was mean $AUD176 (SD 255) (median $83 [IQR 0 to 244]). No significant difference for WTP values was observed between groups (p = 0.98). A WTP value above zero was related to home ownership (odds ratio [OR] 2.95, p = 0.02) and worse baseline SF-36 physical component score (OR 0.94, p = 0.02). This preliminary evidence for WTP in the context of pulmonary rehabilitation indicated the need for further exploration of preferences for treatment location in people with COPD to inform new models of service delivery.
Collapse
Affiliation(s)
- Angela T Burge
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Catherine J Hill
- Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Annemarie L Lee
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Narelle S Cox
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Australia
| | | | - Caroline Nicolson
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Paul O'Halloran
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Aroub Lahhama
- Institute for Breathing and Sleep, Melbourne, Australia.,Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Rebecca Gillies
- Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Department of Physiotherapy, Austin Health, Melbourne, Australia
| | - Ajay Mahald
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
3
|
Mulderij LS, Hernández JI, Mouter N, Verkooijen KT, Wagemakers A. Citizen preferences regarding the public funding of projects promoting a healthy body weight among people with a low income. Soc Sci Med 2021; 280:114015. [PMID: 34087774 DOI: 10.1016/j.socscimed.2021.114015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Overweight and obesity are a growing problem, especially among people with a low income. Policymakers aspire to alleviate this problem by implementing publicly funded projects. This study has three aims: 1) to explore citizen preferences regarding the public funding of projects promoting a healthy body weight among people with a low income, 2) to identify whether such preferences differ between citizens with a low income and those with a higher income, and 3) to identify the reasons underlying these preferences. We conducted a Participatory Value Evaluation (PVE) among 1053 Dutch citizens to achieve these aims. In an online choice experiment, respondents were asked to advise on the implementation of eight different projects that encourage a healthy body weight among citizens with a low income, with a total resource constraint of 100,000 euros. The projects were 1) lifestyle coaching including sports, 2) lifestyle coaching without sports, 3) local sports coach, 4) fruit and vegetable boxes, 5) bariatric surgery, 6) improving the living environment, 7) courses on healthy lifestyles, and 8) sports vouchers. We used the "Multiple Discrete-Continuous Extreme Value" model to estimate the preferences of respondents towards these eight projects. Fruit and vegetable boxes and sports vouchers were the most popular projects, while bariatric surgery was least popular. Respondents with a low income tended to spend less of the budget than respondents with a higher income. Respondent arguments for the choices they made were qualitatively analysed using inductive content analysis. They often mentioned the value judgements 'importance', 'healthiness' and 'usefulness', as well as project costs and efficacy, as reasons for their decisions. Policymakers could use the results to ensure their decisions on the allocation of public funding to projects that encourage a healthy weight among people with a low income are aligned with citizen preferences.
Collapse
Affiliation(s)
- Lisanne S Mulderij
- Health and Society Group, Wageningen University & Research, P.O. Box 8130, 6700, EW Wageningen, the Netherlands.
| | - José Ignacio Hernández
- Delft University of Technology, Faculty of Technology, Policy and Management, Transport and Logistics Group, Jaffalaan 5, 2628, BX, Delft, the Netherlands
| | - Niek Mouter
- Delft University of Technology, Faculty of Technology, Policy and Management, Transport and Logistics Group, Jaffalaan 5, 2628, BX, Delft, the Netherlands
| | - Kirsten T Verkooijen
- Health and Society Group, Wageningen University & Research, P.O. Box 8130, 6700, EW Wageningen, the Netherlands
| | - Annemarie Wagemakers
- Health and Society Group, Wageningen University & Research, P.O. Box 8130, 6700, EW Wageningen, the Netherlands
| |
Collapse
|
4
|
Mbada CE, Mamud SO, Odole AC, Omole JO, Oyewole OO, Ogundele AO, Fatoye FA. Development and clinimetric testing of willingness to pay tool for physiotherapy. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1627703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Chidozie E. Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Sunday O. Mamud
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adesola C. Odole
- Department of Physiotherapy, College of Medicine, University of Ibadan, Nigeria
| | - John O. Omole
- Physiotherapy Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olufemi O. Oyewole
- Physiotherapy Department, Olabisi Onabanjo University teaching Hospital, Sagamu, Nigeria
| | - Abiola O. Ogundele
- Physiotherapy Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Francis A. Fatoye
- Department of Health Profession Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
5
|
Kjær T, Højgaard B, Gyrd-Hansen D. Physical exercise versus shorter life expectancy? An investigation into preferences for physical activity using a stated preference approach. Health Policy 2019; 123:790-796. [PMID: 31200947 DOI: 10.1016/j.healthpol.2019.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/18/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
The positive life-prolonging effect of physical activity is often used as a promotion argument to motivate people to change their behaviour. Yet the decision of investing in health by exercising depends not only on the potential health effect but also on the costs of physical activity including time costs and the individual's (dis)utility of performing physical activity. The objective of this study was to investigate the trade-off between costs and benefits of engaging in physical activity. A web-based stated preference experiment was conducted to elicit individual preferences for physical activity among a representative sample of the Danish population, 18-60 years of age, categorised as moderately physically active or physically inactive. The results of the study suggest that perceived negative quality of life impact of physical activity is an important predictor of the choice of not attending physical activity, and hence should be acknowledged as a barrier to engaging in physical activity. Furthermore, we find time costs to have a significant impact on stated uptake. For individuals categorised as moderately active, the marginal health effect of physical activity is significant but minor. For inactive individuals, this effect is insignificant suggesting that information on long-term health effects does not work as motivation for engaging in exercise for this group. Instead, focus should be on reducing the perceived disutility of physical activity.
Collapse
Affiliation(s)
- Trine Kjær
- DaCHE - Danish Center for Health Economic Research, Department of Public Health, University of Southern Denmark, Winsløwsvej 9b, 1., 5230 Odense M, Denmark.
| | - Betina Højgaard
- VIVE, Danish Institute of Applied Social Science, Herluf Trolles Gade 11, 1052 København K, Denmark.
| | - Dorte Gyrd-Hansen
- DaCHE - Danish Center for Health Economic Research, Department of Public Health, University of Southern Denmark, Winsløwsvej 9b, 1., 5230 Odense M, Denmark.
| |
Collapse
|
6
|
Fatoye F, Mbada C, Oluwatobi S, Odole A, Oyewole O, Ogundele A, Ibiyemi O. Pattern and determinants of willingness-to-pay for physiotherapy services. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1591502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Chidozie Mbada
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Salami Oluwatobi
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adesola Odole
- Department of Physiotherapy, University of Ibadan, Ibadan, Nigeria
| | - Olufemi Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Abiola Ogundele
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olusola Ibiyemi
- Department of Periodontology and Community Dentistry, University of Ibadan & University College Hospital, Ibadan, Nigeria
| |
Collapse
|
7
|
Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030413. [PMID: 29495529 PMCID: PMC5876958 DOI: 10.3390/ijerph15030413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/08/2018] [Accepted: 02/25/2018] [Indexed: 11/16/2022]
Abstract
Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations.
Collapse
|
8
|
Aboagye E. Valuing Individuals' Preferences and Health Choices of Physical Exercise. Pain Ther 2017; 6:85-91. [PMID: 28260158 PMCID: PMC5447544 DOI: 10.1007/s40122-017-0067-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Indexed: 11/29/2022] Open
Abstract
The efficacy of physical exercise for the prevention and treatment of non-specific low back pain (LBP) is well documented, but little is known about how individuals value specific components of physical exercise, such as the type and design or the intensity and frequency of exercise. Other factors that influence individual differences in health choices and adherence are associated with individuals’ attitudes toward and likelihood of performing recommended exercise regimens. Current evidence shows that efficacy is similar among exercise interventions, but their features vary widely. Thus it may be difficult for clinicians to discriminate between available options in clinical practice. Considering the many challenges in determining the form of exercise best suited to the individual patient, this commentary discusses some of the practical methods that could be used to elicit individual preference for recommended health care interventions. Such methods have the advantage of providing more information for health care decision making, particularly with regard to exercise interventions for LBP. This commentary also advocates for the use of patient preference in health care decisions.
Collapse
Affiliation(s)
- Emmanuel Aboagye
- Department of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institute, Stockholm, Sweden.
| |
Collapse
|
9
|
Arsenijevic J, Groot W. Physical activity on prescription schemes (PARS): do programme characteristics influence effectiveness? Results of a systematic review and meta-analyses. BMJ Open 2017; 7:e012156. [PMID: 28153931 PMCID: PMC5293992 DOI: 10.1136/bmjopen-2016-012156] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Physical activity on prescription schemes (PARS) are health promotion programmes that have been implemented in various countries. The aim of this study was to outline the differences in the design of PARS in different countries. This study also explored the differences in the adherence rate to PARS and the self-reported level of physical activity between PARS users in different countries. METHOD A systematic literature review and meta-analyses were conducted. We searched PubMed and EBASCO in July 2015 and updated our search in September 2015. Studies that reported adherence to the programme and self-reported level of physical activity, published in the English language in a peer-reviewed journal since 2000, were included. The difference in the pooled adherence rate after finishing the PARS programme and the adherence rate before or during the PARS programme was 17% (95% CI 9% to 24%). The difference in the pooled physical activity was 0.93 unit score (95 CI -3.57 to 1.71). For the adherence rate, a meta-regression was conducted. RESULTS In total, 37 studies conducted in 11 different countries met the inclusion criteria. Among them, 31 reported the adherence rate, while the level of physical activity was reported in 17 studies. Results from meta-analyses show that PARS had an effect on the adherence rate of physical activity, while the results from the meta-regressions show that programme characteristics such as type of chronic disease and the follow-up period influenced the adherence rate. CONCLUSIONS The effects of PARS on adherence and self-reported physical activity were influenced by programme characteristics and also by the design of the study. Future studies on the effectiveness of PARS should use a prospective longitudinal design and combine quantitative and qualitative data. Furthermore, future evaluation studies should distinguish between evaluating the adherence rate and the self-reported physical activity among participants with different chronic diseases.
Collapse
Affiliation(s)
- Jelena Arsenijevic
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
10
|
Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners. PLoS One 2016; 11:e0152804. [PMID: 27046029 PMCID: PMC4821610 DOI: 10.1371/journal.pone.0152804] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 02/25/2016] [Indexed: 11/30/2022] Open
Abstract
Background Methadone maintenance treatment (MMT) reduces HIV risk behaviors and improves access to HIV-related services among drug users. In this study, we assessed the uptake and willingness of MMT patients to refer HIV testing and counseling (HTC) service to their sexual partners and relatives. Methods Health status, HIV-related risk behaviors, and HTC uptake and referrals of 1,016 MMT patients in Hanoi and Nam Dinh were investigated. Willingness to pay (WTP) for HTC was elicited using a contingent valuation technique. Interval and logistic regression models were employed to determine associated factors. Results Most of the patients (94.2%) had received HTC, 6.6 times on average. The proportion of respondents willing to refer their partners, their relatives and to be voluntary peer educators was 45.7%, 35.3%, and 33.3%, respectively. Attending MMT integrated with HTC was a facilitative factor for HTC uptake, greater WTP, and volunteering as peer educators. Older age, higher education and income, and HIV positive status were positively related to willingness to refer partners or relatives, while having health problems (mobility, usual care, pain/discomfort) was associated with lower likelihood of referring others or being a volunteer. Over 90% patients were willing to pay an average of US $17.9 for HTC service. Conclusion The results highlighted the potential role of MMT patients as referrers to HTC and voluntary peer educators. Integrating HIV testing with MMT services and applying users’ fee are potential strategies to mobilize resources and encourage HIV testing among MMT patients and their partners.
Collapse
|
11
|
Leppänen A, Biermann O, Sundberg CJ, Tomson T. Perceived feasibility of a primary care intervention for Tobacco Cessation on Prescription targeting disadvantaged groups in Sweden: a qualitative study. BMC Res Notes 2016; 9:151. [PMID: 26961759 PMCID: PMC4784339 DOI: 10.1186/s13104-016-1949-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of scientific evidence on how socioeconomically disadvantaged tobacco users can be reached with tobacco cessation interventions in Swedish primary healthcare (PHC). In this setting other lifestyle interventions are available by prescription, and there is the potential to develop a similar tool for tobacco cessation. The aim of this study was thus to explore the perceived feasibility and optimal design of Tobacco Cessation on Prescription (TCP) in PHC, targeting disadvantaged groups in Sweden. METHODS This qualitative study is based on semi-structured interviews with 32 participants including (1) three experts in lifestyle interventions on prescription, (2) 14 healthcare providers and (3) 15 clients from three PHC centres in socioeconomically disadvantaged areas in Stockholm where tobacco use is high. The interviews were audio-recorded and transcribed verbatim. The manifest content of the transcripts was analysed according to a modified conventional approach to content analysis. RESULTS The interviewees proposed that TCP should include a template comprising the client's information, evidence-based tobacco cessation options and choices for follow-up. They also suggested including information about the benefits of tobacco cessation, as well as empowerment and planning support tools. The participants also commented that other measures for tobacco cessation could be included on the prescription. From the clients' point of view, the perceived advantages of TCP were often linked to an emotional meaning (e.g. increased motivation to quit tobacco use, sign of support from the healthcare system to seek care for tobacco cessation). For providers, advantages with TCP were frequently related to a practical meaning (e.g. improved documentation and facilitation of tobacco cessation treatment). The disadvantages identified were mainly connected with the future implementation of TCP (e.g. low self-efficacy among clients and providers). CONCLUSIONS TCP was perceived to be a useful tool for both clients and providers, potentially facilitating a structured and effective approach to tobacco cessation in PHC, and targeting disadvantaged groups. More research is needed to develop the prescription and investigate its effectiveness and cost-effectiveness compared to current strategies for tobacco cessation in a PHC setting.
Collapse
Affiliation(s)
- Anne Leppänen
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
| | - Olivia Biermann
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
| | - Carl Johan Sundberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
- Department of Physiology and Pharmacology, Karolinska Institutet, von Eulers väg 8, 171 77, Stockholm, Sweden.
| | - Tanja Tomson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
| |
Collapse
|
12
|
Predictors of willingness to pay for physical activity of socially vulnerable groups in community-based programs. SPRINGERPLUS 2015; 4:527. [PMID: 26405646 PMCID: PMC4575679 DOI: 10.1186/s40064-015-1336-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/10/2015] [Indexed: 12/02/2022]
Abstract
Willingness to pay (WTP) is used to assess individuals’ value attribution to health-related quality of life interventions. Little is known about predictors of WTP for sport and physical activity in socially vulnerable groups in community-based physical activity (CBHEPA) programs. This study addresses the questions: What is the WTP for sport and physical activity of participants in CBHEPA programs, expressed in WTPmoney and WTPtime? Which factors predict WTPmoney and WTPtime? From the literature, predictors for WTP for sport and physical activity were identified: (1) personal and socio-economic predictors: income, education, age, and ethnic origin, (2) health-related predictors: perceived health, life satisfaction, sense of coherence, self-efficacy, (3) sport and physical activity-related predictors: duration and frequency of participation, leisure-time sport or physical activity, sport club membership, enjoyment, and membership fee. Data were gathered for WTPmoney and WTPtime (n = 268) in 19 groups in an evaluation study of CBHEPA programs. Ordered probit was used for analyses. WTPmoney was a monthly average of €9.6. WTPtime was on average 17.6 min travel time. Income was found as predictor for both WTPmoney and WTPtime. Other predictors for WTPmoney were: duration and frequency of program participation, enjoyment, and (former) sport club membership. Low income and younger age were found as predictors for WTPtime. Predictors for WTPmoney are related to income and sport and physical activity experiences, for WTPtime to income and age. Short-term program satisfaction is probably more decisive for WTPmoney than long-term perspectives of improving health-related quality of life.
Collapse
|
13
|
Romé ÅS, Persson U, Ekdahl C, Gard G. Costs and outcomes of an exercise referral programme – A 1-year follow-up study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2014. [DOI: 10.3109/21679169.2014.886291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
14
|
Saha S, Leijon M, Gerdtham U, Sundquist K, Sundquist J, Arvidsson D, Bennet L. A culturally adapted lifestyle intervention addressing a Middle Eastern immigrant population at risk of diabetes, the MEDIM (impact of Migration and Ethnicity on Diabetes In Malmö): study protocol for a randomized controlled trial. Trials 2013; 14:279. [PMID: 24006857 PMCID: PMC3844588 DOI: 10.1186/1745-6215-14-279] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/30/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies have shown that lifestyle interventions are effective in preventing or delaying the onset of type 2 diabetes in high-risk patients. However, research on the effectiveness of lifestyle interventions in high-risk immigrant populations with different cultural and socioeconomic backgrounds is scarce. The aim was to design a culturally adapted lifestyle intervention for an immigrant population and to evaluate its effectiveness and cost-effectiveness. METHODS/DESIGN In this randomized controlled trial, 308 participants (born in Iraq, living in Malmö, Sweden and at high risk of type 2 diabetes) will be allocated to either a culturally adapted intervention or a control group. The intervention will consist of 10 group counseling sessions focusing on diet, physical activity and behavioral change over 6 months, and the offer of exercise sessions. Cultural adaptation includes gender-specific exercise sessions, and counseling by a health coach community member. The control group will receive the information about healthy lifestyle habits provided by the primary health care center. The primary outcome is change in fasting glucose level. Secondary outcomes are changes in body mass index, insulin sensitivity, physical activity, food habits and health-related quality of life. Measurements will be taken at baseline, after 3 and 6 months. Data will be analyzed by the intention-to-treat approach. The cost-effectiveness during the trial period and over the longer term will be assessed by simulation modeling from patient, health care and societal perspectives. DISCUSSION This study will provide a basis to measure the effectiveness of a lifestyle intervention designed for immigrants from the Middle East in terms of improvement in glucose metabolism, and will also assess its cost-effectiveness. Results from this trial may help health care providers and policy makers to adapt and implement lifestyle interventions suitable for this population group that can be conducted in the community. TRIAL REGISTRATION ClinicalTrials.gov, NCT01420198.
Collapse
Affiliation(s)
- Sanjib Saha
- Department of Clinical Sciences, Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Building 60, floor 12 Jan Waldenströms gata 37, 205 02 Malmö, Sweden.
| | | | | | | | | | | | | |
Collapse
|
15
|
Martín-Fernández J, del Cura-González MI, Rodríguez-Martínez G, Ariza-Cardiel G, Zamora J, Gómez-Gascón T, Polentinos-Castro E, Pérez-Rivas FJ, Domínguez-Bidagor J, Beamud-Lagos M, Tello-Bernabé ME, Conde-López JF, Aguado-Arroyo Ó, Sanz-Bayona MT, Gil-Lacruz AI. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations. PLoS One 2013; 8:e62840. [PMID: 23626858 PMCID: PMC3633834 DOI: 10.1371/journal.pone.0062840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 03/27/2013] [Indexed: 11/19/2022] Open
Abstract
Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.
Collapse
Affiliation(s)
- Jesús Martín-Fernández
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste. Gerencia de Atención Primaria, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Willingness to pay for a cardiovascular prevention program in highly educated adults: A randomized controlled trial. Int J Technol Assess Health Care 2011; 27:283-9. [DOI: 10.1017/s0266462311000341] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives: The aim of this study was to determine adults’ Willingness To Pay (WTP) for CardioVascular Disease (CVD) intervention programs of different intensities.Methods: Three hundred fourteen participants were randomized to two study conditions: (i) CVD risk assessment/communication; (ii) CVD risk assessment/communication + a behavior change program. The behavior change program was aimed at increasing physical activity, reducing saturated fat intake and smoking cessation. It consisted of a tailored Web site and individual coaching with a self-selected dose. At post-assessment, WTP and perceived autonomy support items were included. The intervention dose was registered throughout the trial and post-hoc intervention dose groups were created. Pearson Chi-Square tests, Student's t-tests, one-way analyses of variance were used to examine WTP-differences between the study conditions and intervention dose groups.Results: Twenty-four months after baseline, 61 and 135 participants of the control and intervention condition, respectively, completed the questionnaires. No WTP difference was found between the study conditions. However, participants that selected a higher intervention dose were willing to pay significantly more for their program (p < .05).Conclusions: In general, people want to pay the same amount of money for a CVD prevention program, irrespective of the inclusion of a behavior change program. However, there seems to be an association between the self-selected dose of the latter program and the WTP.
Collapse
|