Development of a Discrete Choice Experiment (DCE) Questionnaire to Understand Veterans’ Preferences for Tobacco Treatment in Primary Care

David A. Katz, Kenda R. Stewart, Monica Paez, Mark W. Vander Weg, Kathleen M. Grant, Christine Hamlin, Gary Gaeth

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Providers often prescribe counseling and/or medications for tobacco cessation without considering patients’ treatment preferences. Objective: The primary aims of this study are to describe (1) the development of a discrete choice experiment (DCE) questionnaire designed to identify the attributes and levels of tobacco treatment that are most important to veterans; and (2) the decision-making process in choosing between hypothetical tobacco treatments. Methods: We recruited current smokers who were already scheduled for a primary care appointment within a single Veterans Affairs (VA) healthcare system. Subjects were asked to rate the importance of selected treatment attributes and were interviewed during two rounds of pilot testing of initial DCE instruments. Key attributes and levels of the initial instruments were identified by targeted literature review; the instruments were iteratively revised after each round of pilot testing. Using a ‘think aloud’ approach, subjects were interviewed while completing DCE choice tasks. Constant comparison techniques were used to characterize the issues raised by subjects. Findings from the cognitive interviews were used to revise the initial DCE instruments. Results: Most subjects completed the DCE questionnaire without difficulty and considered two or more attributes in choosing between treatments. Two common patterns of decision-making emerged during the cognitive interviews: (1) counting ‘pros’ and ‘cons’ of each treatment alternative; and (2) using a ‘rule-out’ strategy to eliminate a given treatment choice if it included an undesirable attribute. Subjects routinely discounted the importance of certain attributes and, in a few cases, focused primarily on a single ‘must-have’ attribute. Conclusion: Cognitive interviews provide valuable insights into the comprehension and interpretation of DCE attributes, the decision processes used by veterans during completion of choice tasks, and underlying reasons for non’-compensatory decision-making.

Original languageEnglish (US)
Pages (from-to)649-663
Number of pages15
JournalPatient
Volume11
Issue number6
DOIs
StatePublished - Dec 1 2018

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Veterans
Tobacco
Primary Health Care
Decision Making
Interviews
Therapeutics
Tobacco Use Cessation
Patient Preference
Surveys and Questionnaires
Counseling
Appointments and Schedules
Delivery of Health Care

ASJC Scopus subject areas

  • Nursing (miscellaneous)

Cite this

Development of a Discrete Choice Experiment (DCE) Questionnaire to Understand Veterans’ Preferences for Tobacco Treatment in Primary Care. / Katz, David A.; Stewart, Kenda R.; Paez, Monica; Vander Weg, Mark W.; Grant, Kathleen M.; Hamlin, Christine; Gaeth, Gary.

In: Patient, Vol. 11, No. 6, 01.12.2018, p. 649-663.

Research output: Contribution to journalArticle

Katz, David A. ; Stewart, Kenda R. ; Paez, Monica ; Vander Weg, Mark W. ; Grant, Kathleen M. ; Hamlin, Christine ; Gaeth, Gary. / Development of a Discrete Choice Experiment (DCE) Questionnaire to Understand Veterans’ Preferences for Tobacco Treatment in Primary Care. In: Patient. 2018 ; Vol. 11, No. 6. pp. 649-663.
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