Using discrete choice experiments to inform the design of complex interventions

Area of Science:

• Public Health Interventions
• Health Services Research
• Behavioral Science

Background:

• Complex health interventions require user-centered design for optimal effectiveness.
• Discrete Choice Experiments (DCEs) are valuable tools for quantifying user preferences and identifying heterogeneity.
• Integrating DCEs with qualitative research can enhance the design of demand creation interventions.

Purpose of the Study:

• To demonstrate the process of using DCEs to supplement qualitative formative research.
• To inform the design of a demand creation intervention for voluntary medical male circumcision (VMMC) in Tanzania.
• To identify specific user preferences influencing VMMC service uptake.

Main Methods:

• A 3-month formative phase included in-depth interviews and focus groups to identify barriers and facilitators for VMMC.
• Qualitative findings informed the development of a DCE instrument.
• A DCE was administered to 325 men in Tanzania to measure preferences for VMMC service characteristics.

Main Results:

• Qualitative research informed community mobilization strategies.
• DCE results guided specific VMMC service configurations: positive utilities for partner counseling and age-separated waiting areas.
• Significant disutility associated with female healthcare providers led to retraining on client-friendliness.

Conclusions:

• This study is the first to document the direct application of DCE user preferences in complex intervention design.
• Using DCEs as a formative research tool can improve user uptake and adherence to health interventions.
• The combined qualitative and DCE approach provides a robust framework for designing effective public health programs.