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01.10.2015 | Original Research Article

Measuring the Preferences of Homeless Women for Cervical Cancer Screening Interventions: Development of a Best–Worst Scaling Survey

verfasst von: Eve Wittenberg, Monica Bharel, Adrianna Saada, Emely Santiago, John F. P. Bridges, Linda Weinreb

Erschienen in: The Patient - Patient-Centered Outcomes Research | Ausgabe 5/2015

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Abstract

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.

Methods

We conducted focus groups with homeless women (n = 8) on cervical cancer screening decisions and analyzed the data using thematic analysis. We applied inclusion criteria to select factors for a stated preference survey: importance to women, relevance to providers, feasibility, and consistency with clinical experience. We conducted pretests (n = 35) to assess survey procedures (functionality, recruitment, administration) and content (understanding, comprehension, wording/language, length).

Results

We chose best–worst scaling (BWS)—also known as object scaling—to identify decision-relevant screening intervention factors. We chose an experimental design with 11 “objects” (i.e., factors relevant to women’s screening decision) presented in 11 subsets of five objects each. Of 25 objects initially identified, we selected 11 for the BWS instrument: provider-related factors: attitude, familiarity, and gender; setting-related factors: acceptance and cost; procedure-related factors: explanation during visit and timing/convenience of visit; personal fears and barriers: concerns about hygiene, addiction, and delivery/fear of results; and a general factor of feeling overwhelmed.

Conclusion

Good practices for the development of stated preference surveys include considered assessment of the experimental design that is used and the preference factors that are included, and pretesting of the presentation format. We demonstrate the development of a BWS study of homeless women’s cervical cancer screening intervention preferences. Subsequent research will identify screening priorities to inform intervention design.

In this paper, we use the term “attribute” to refer to preference components that are used in any stated preference instrument. We use the term “object” to refer to an attribute specifically in the context of best–worst scaling. We use the terms “decision factor” or “component” to refer to the elements that contribute to preferences in a general, nonexperimental context.

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Titel: Measuring the Preferences of Homeless Women for Cervical Cancer Screening Interventions: Development of a Best–Worst Scaling Survey
verfasst von: Eve Wittenberg
Monica Bharel
Adrianna Saada
Emely Santiago
John F. P. Bridges
Linda Weinreb
Publikationsdatum: 01.10.2015
Verlag: Springer International Publishing
Erschienen in: The Patient - Patient-Centered Outcomes Research / Ausgabe 5/2015
Print ISSN: 1178-1653
Elektronische ISSN: 1178-1661
DOI: https://doi.org/10.1007/s40271-014-0110-z

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

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