Preferences for Video Consultations in Family Health Stations: A Discrete Choice Experiment Among Ultra-Orthodox...

Video consultation in family health stations offers potential for improving healthcare access for cultural and religious minority populations who face unique challenges in healthcare utilization. Ultra-Orthodox Jewish women provide a case study for understanding preferences in hard-to-reach communities.

We aimed to elicit preferences for video consultations versus in-clinic consultations at family health stations among Ultra-Orthodox women, and to demonstrate the application of discrete choice experiment methodology in religious and culturally sensitive research.

A face-to-face, paper-based, discrete choice experiment was conducted. Following culturally adapted qualitative interviews and focus groups, four attributes were examined: consultation timing, waiting time, child presence requirement, and nurse familiarity. Participants evaluated 12 choice scenarios comparing video consultations, using rabbinically approved devices, with traditional in-clinic consultations. A mixed logit model analyzed preferences and heterogeneity across demographic subgroups.

A total of 174 women participated, with a mean age of 30.0 ± 6.1 years and a mean of 3.45 ± 2.1 children. Waiting time was the strongest predictor of consultation preference (β = -1.50, p < 0.001), followed by consultation hours (β = 1.10, p < 0.001), provider familiarity (β = 0.55, p < 0.001), and child presence requirement (β = -0.51, p < 0.001). Consultation type (video vs in person) was not independently significant. Subgroup analyses showed that older women had weaker preferences for video consultation. Policy simulation estimated that optimized video consultation configurations could capture 58-78% of current in-person consultations.

This study demonstrates how discrete choice experiments can successfully elicit preferences in hard-to-reach cultural and religious communities. Service design must address specific population needs including scheduling flexibility, continuity of care, and family logistics. These findings inform culturally sensitive telemedicine implementation for diverse minority populations.