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Willingness to pay for mammography: item development and testing among five ethnic groups
T H Wagner1, T W Hu, G V Dueñas
1VA HSR&D Health Economics Resource Center, Menlo Park, CA, USA. twagner@stanford.edu
Health Policy (Amsterdam, Netherlands)
|October 3, 2000
Summary
Researchers developed and validated culturally appropriate willingness to pay (WTP) and willingness to travel (WTT) questions for mammography screening among diverse, low-income women. These tools are now used in clinical trials.
Area of Science:
- Health Services Research
- Health Economics
- Health Disparities
Background:
- Developing effective cancer screening interventions requires understanding patient preferences and barriers.
- Previous willingness to pay (WTP) and willingness to travel (WTT) instruments may not be culturally appropriate for diverse, low-income populations.
- Mammography screening is crucial for early breast cancer detection, but access and utilization vary significantly across demographic groups.
Purpose of the Study:
- To develop and validate culturally appropriate willingness to pay (WTP) and willingness to travel (WTT) questions for mammography screening.
- To assess the cultural appropriateness and validity of these questions among low-income, ethnically diverse women.
- To explore factors associated with WTP for mammography.
Main Methods:
- Qualitative research with 50 low-income women from five ethnic groups to develop initial WTP and WTT questions.
- Refinement of questions through interviews with 41 additional women.
- Pilot testing of refined questions on a random sample of 52 low-income, ethnically diverse women in San Francisco.
- Statistical analyses to assess validity and correlations between WTP, WTT, income, perceived risk, and knowledge.
Main Results:
- The developed WTP and WTT concepts were found to be culturally appropriate across the five studied ethnic groups.
- Analyses generally confirmed the validity of the WTP and WTT questions.
- Willingness to pay (WTP) was significantly associated with household income, perceived cancer risk, and knowledge about mammography necessity.
- Willingness to travel (WTT) showed a moderate correlation with the natural logarithm of WTP (r = 0.58, P < 0.001).
- WTP varied among different ethnic groups, despite small sample sizes.
Conclusions:
- Culturally sensitive WTP and WTT questions for mammography have been successfully developed and validated for low-income, ethnically diverse women.
- These validated instruments are suitable for use in larger clinical trials to assess patient preferences and barriers to screening.
- Future research will further explore WTP and WTT variations within and across ethnic groups to inform targeted interventions.