Preferences for Neurodevelopmental Screening Modalities for Children: A Labeled Discrete Choice Experiment Using...

Healthcare access is a significant barrier in neurodevelopmental care. Various ways or modalities, including virtual care models may bridge this gap. Although studies have explored individual virtual modalities, families' preferences across them remain unexamined. This study aims to elicit families' preferences for various modalities of accessing neurodevelopmental screening (eg, face to face and virtual) for children.

We used a Discrete Choice Experiment to elicit preferences from families (parents or caregivers) of children under 5. Alternatives (screening modalities), attributes, and levels were identified using literature and expert advice. Final alternatives included video conferencing, telephone consultation, mobile application, online portal, and face to face. Bayesian d-efficient, partial choice set design presented 3 of 5 alternatives in each choice task. Final survey was pretested and piloted before online administration, yielding 502 responses. Analysis used mixed logit and latent class models.

Families preferred face-to-face screening over virtual options, including video conferencing (-1.53, 95% CI -2.45 to -0.60), mobile applications (-1.57, 95% CI -2.56 to -0.58), online portals (-1.72, 95% CI -2.58 to -0.86), and telephone consultations (-1.96, 95% CI -2.94 to -0.98). Across all alternatives, families preferred shorter duration appointments, automated feedback, and screening test administered together by parents and clinicians. Latent class analysis revealed a Digitally Oriented Class (25% probability) that preferred mobile applications and online portals over face-to-face screening.

Although virtual options may improve accessibility, they may not fully replace face-to-face neurodevelopmental screening for many families. Some families may be receptive to virtual care, particularly via mobile applications and online portals.