Preferences for new and existing contraceptive products (original) (raw)
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The European Journal of Contraception and Reproductive Health Care, 2013
Objectives: To determine how women and physicians rate individual characteristics of contraceptives. Methods Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors influence choice. Women and GPs were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features.
Social Science & Medicine, 2013
Recent rapid growth in the range of contraceptive products has given women more choice, but also adds complexity to the resultant decision of which product to choose. This paper uses a discrete choice experiment (DCE) to investigate the effect of adverse information and positive promotion on women's stated preferences for prescribed contraceptive products. In November 2007, 527 Australian women aged 18e49 years were recruited from an online panel. Each was randomly allocated to one of three information conditions. The control group only received basic information on contraceptive products. One treatment group also received adverse information on the risks of the combined oral pill. The other group received basic information and promotional material on the vaginal ring, newly introduced into Australia and on the transdermal patch, which is unavailable in Australia. Respondents completed 32 choice sets with 3 product options where each option was described by a product label: either combined pill, minipill, injection, implant, hormonal IUD, hormonal vaginal ring, hormonal transdermal patch or copper IUD; and by the attributes: effect on acne, effect on weight, frequency of administration, contraceptive effectiveness, doctor's recommendation, effect on periods and cost. Women's choices were analysed using a generalized multinomial logit model (G-MNL) and model estimates were used to predict product shares for each information condition. The predictions indicated that adverse information did not affect women's preferences for products relative to only receiving basic information. The promotional material increased women's preferences for the transdermal patch. Women in all groups had a low preference for the vaginal ring which was not improved by promotion. The findings highlight the need for researchers to pay attention to setting the context when conducting DCEs as this can significantly affect results.
Scientific African , 2023
There is low LARC uptake in Nigeria and not much is documented about Nigerian women‟s preferences for these products and how these preferences affect women‟s choices. Therefore, the purpose of this study is to provide empirical evidence on the decision-making behavior of Nigerian women regarding LARCs. Three hypothetical LARCs were presented. Informed by results obtained from the review of relevant literature and focus group discussion held with selected family planning services providers, the identified attributes were effect on weight, cost, LARC effectiveness and effect on bleeding patterns, each at three levels. A D-optimal design was used to construct nine choice sets. An additional choice set was included to conduct the testretest stability test. The choice sets and other socio-demographic questions formed the discrete choice experiment questionnaire. A random sample of 150 eligible women was selected from women who enrolled and attended family planning clinics in public healthcare facilities in Ibadan, Nigeria through a three-stage sampling technique. Mixed logit modelling was used to obtain estimates of the parameters and willingness to pay (WTP) for each attribute was calculated. The test-retest stability result showed that 76.7% of the respondents responded in a consistent and rational manner. The women preferred LARCs that have no effect on their weights compared to LARCs that cause either slight weight loss or gain. Also, they preferred LARCs that offer 1/1000 level of effectiveness in a year. The most preferred attribute level, „women experience infrequent bleeding‟, increases WTP by NGN 13,984.584 (USD 33.68) while the least preferred level, „women experience frequent/prolonged bleeding‟, has a negative mean WTP (-NGN 19,598.378 (-USD 47.20)) indicating dispreference for the level. Furthermore, women derived higher utilities from very cheap LARCs. Evidence-based information on women‟s preferences regarding LARC usage would help policymakers in the deployment of strategies that would ensure that preferred LARCs are procured and made readily available to women.
Background: Efforts are underway to develop an easy-to-use contraceptive microarray patch (MAP) that could expand the range of self-administrable methods. This paper presents results from a discrete choice experiment (DCE) designed to support optimal product design.Methods: We conducted a DCE survey of users and non-users of contraception in New Delhi, India (496 women) and Ibadan, Nigeria (two versions with 530 and 416 women, respectively) to assess stated preferences for up to six potential product attributes: effect on menstruation, duration of effectiveness, application pain, location, rash after application, and patch size. We estimated Hierarchical Bayes coefficients (utilities) for each attribute level and ran simulations comparing women’s preferences for hypothetical MAPs with varying attribute combinations.Results: The most important attributes of the MAP were potential for menstrual side effects (55% of preferences in India and 42% in Nigeria) and duration (13% of preferen...
Evaluating contraceptive choice through the method-mix approach
Contraception, 2000
The method-mix approach was used to evaluate informed contraceptive choices in the present study. A total of 8,077 potential clients were given a balanced presentation of all available contraceptive methods in the national program, ie, the CuT 200 intrauterine device (IUD), low-dose combined oral pills (OC), condom, and sterilization (female/ male) along with a new method, Norplant. The majority of women opted for spacing methods; among them, the IUD was preferred by about 60% of clients, followed by condoms (9%), OC (6%), and Norplant (5%). Sterilization, mainly female, was accepted by about 17% of the women making an informed choice.
Journal of Family Planning and Reproductive Health Care, 2013
My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.
An extended expectancy-value approach to contraceptive alternatives
Journal of Population Behavioral, Social, and Environmental Issues, 1978
This paper describes the application of an expectancy-value/normative-influence model to the understanding of contraceptive-choice behavior. Components of the model are identified and discussed with respect to issues raised by its application to contraceptive choice. Further, a pilot application of the approach is described. Encouraging pilot data suggest that important attitudinal and normative differences among both population and contraceptive-use groups can be identified. In a recent overview of population psychology, Thompson and David (1977, p. 140) suggest that While contraception, abortion, and sterilization counseling, availability and effective use have received a substantial amount of research attention from demographers and epidemiologists, little information is available on the couple decision-making process, nor has there been much more than a beginning toward understanding the multiple, complex, and interrelated factors which underlie repeated and continuous decision-making. One promising approach to the understanding as well as the prediction of such decision or choice behavior is represented by the attribute-specific/expectancy-value attitude models, especial
Perceived Contraceptive Attributes and Method Choice1
Journal of Applied Social Psychology, 1991
This research investigated the relationship of perceived contraceptive attributes to contraceptive choice. More specifically, the study a) examined what attributes women perceive as important in their choice of a contraceptive method; b) compared women who use the vaginal sponge with women who use oral contraceptives or the diaphragm on perceived importance of attributes; and c) compared sponge users with pill users and diaphragm users on perceived characteristics of three contraceptive methods. Data were collected in telephone interviews from a national sample of 330 current sponge users and 330 women who use other forms of female contraception. Those attributes that were rated highest concerned effectiveness and safety, whereas those that were rated lowest focused on convenience of use and interference with sexual activity. Women differed somewhat by user status on the attributes they believe are important in contraceptive choice, with each group emphasizing those attributes characterizing their own method. Moreover. each user group perceived their own method more favorably than did users of other methods. Perceptions of specific contraceptive methods. particularly the sponge. were more predictive of user status than were general importance ratings.
AIDS and Behavior, 2019
As new female-initiated HIV prevention products enter development, it is crucial to incorporate women’s preferences to ensure products will be desired, accepted, and used. A discrete-choice experiment was designed to assess the relative importance of six attributes to stated choice of a vaginally delivered HIV prevention product. Sexually active women in South Africa and Zimbabwe aged 18–30 were recruited from two samples: product-experienced women from a randomized trial of four vaginal placebo forms and product-naïve community members. In a tablet-administered survey, 395 women chose between two hypothetical products over eight choice sets. Efficacy was the most important, but there were identifiable preferences among other attributes. Women preferred a product that also prevented pregnancy and caused some wetness (p < 0.001). They disliked a daily-use product (p = 0.002) and insertion by finger (p = 0.002). Although efficacy drove preference, wetness, pregnancy prevention, and...
Complexity and doctor choices when discussing contraceptives
RePEc: Research Papers in Economics, 2015
In order to better understand choice behaviour, econometric models need to be able to reflect the complexity of decisions that individuals routinely face. We investigate the role of choice complexity in modelling medical decision-making in the case of a doctor choosing which specific contraceptive products to discuss with their patient before ultimately making a recommendation. Clinical vignettes describing patients, developed using stated preference methods, are presented to a sample of Australian general practitioners. An econometric model is developed that captures two salient sources of complexity. The first is associated with patients with particular combinations of clinical and demographic attributes that induce uncertainty around what product to recommend while the second captures variation in the ability of doctors to find appropriate patient-product matches. We are especially interested in the tendencies of doctors to discuss long-acting reversible contraception (LARC) in order to determine whether part of the explanation for the relatively low uptake of LARC in Australia is reluctance on the part of some doctors to even discuss these products.