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Using discrete choice experiments to inform the design of complex interventions.

Journal Article
(Published March, 2019)
Terris-Prestholt, F. (Author),
Neke, N. (Author),
Grund, J.M. (Author),
Plotkin, M. (Author),
Kuringe, E. (Author),
Osaki, H. (Author),
Ong, J.J. (Author),
Tucker, J.D. (Author),
Mshana, G. (Author),
Mahler, H. (Author),
Weiss, H. A. (Author),
Wambura, M. (Author),
VMMC Study Team (Author)
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Complex health interventions must incorporate user preferences to maximize their potential effectiveness. Discrete choice experiments (DCEs) quantify the strength of user preferences and identify preference heterogeneity across users. We present the process of using a DCE to supplement conventional qualitative formative research in the design of a demand creation intervention for voluntary medical male circumcision (VMMC) to prevent HIV in Tanzania.

While the qualitative research informed the community mobilization intervention, the DCE guided the specific VMMC service configuration. The significant positive utilities (u) for availability of partner counselling (u = 0.43, p < 0.01) and age-separated waiting areas (u = 0.21, p < 0.05) led to the provision of community information booths for partners and provision of age-separated waiting areas. The strong disutility of female healthcare providers (u = - 0.24, p < 0.01) led to re-training all providers on client-friendliness.

This is, to our knowledge, the first study documenting how user preferences from DCEs can directly inform the design of a complex intervention. The use of DCEs as formative research may help increase user uptake and adherence to complex interventions.

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Citation: 
Terris-Prestholt F, Neke N, Grund JM, Plotkin M, Kuringe E, Osaki H, et al. Using discrete choice experiments to inform the design of complex interventions. Trials. 2019;20(1):157.