Preferences for Neurodevelopmental Screening Modalities for Children: A Labeled Discrete Choice Experiment Using
Pakhi Sharma1, Sanjeewa Kularatna2, Bridget Abell1
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
Insights
Families prefer in-person neurodevelopmental screening, but some are open to virtual options like mobile apps and online portals. Shorter appointments and combined parent-clinician screening are favored.
Area of Science:
- Pediatric Healthcare
- Neurodevelopmental Disorders
- Digital Health
Background:
- Healthcare access for neurodevelopmental care is challenging.
- Virtual care models show potential to bridge access gaps.
- Family preferences for different virtual screening modalities are not well understood.
Purpose of the Study:
- To determine families' preferences for accessing child neurodevelopmental screening.
- To compare preferences for face-to-face versus various virtual screening modalities.
Main Methods:
- Discrete Choice Experiment involving 502 families of children under 5.
- Evaluated modalities: video conferencing, telephone, mobile app, online portal, face-to-face.
- Utilized mixed logit and latent class models for preference analysis.
Main Results:
- Families showed a significant preference for face-to-face screening over all virtual options.
- Preferred attributes included shorter appointments and combined parent-clinician screening.
- A 'Digitally Oriented Class' (25%) preferred mobile apps and online portals.
Conclusions:
- Face-to-face screening remains preferred by most families for neurodevelopmental assessments.
- Virtual care, especially via mobile apps and online portals, may appeal to a subset of families.
- Virtual options can enhance accessibility but may not fully substitute in-person care.
Objectives:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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