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Stakeholder preferences for multidimensional attributes in the selection of health promotion programmes in Japan: a

Yudai Honda¹, Megumi Yoshigai^1,2, Ayu Tabuchi¹

¹Department of Healthcare Economics and Quality Management, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

BMJ Public Health

|May 7, 2026

Abstract

Introduction:

Health promotion programmes play a critical role in preventing non-communicable diseases, yet their uptake remains limited. The multidimensional attributes of health promotion programmes preferred by various stakeholder groups remain poorly understood. This study aimed to examine the preferences for multidimensional attributes of health promotion programmes across four stakeholder groups: the general public, local government officials, company representatives and healthcare professionals.

Methods:

We conducted a discrete choice experiment in Japan using a fractional factorial, D-efficient design to evaluate seven attributes (physical, mental and social health, productivity, health disparity, cost and time). Mixed logit models were used to estimate attribute preferences and relative importance (RI).

Results:

3243 respondents were included in the main analysis. RI patterns were broadly similar across stakeholder groups, with cost and physical health among the most important attributes across all groups. Company representatives showed slightly higher RI for physical health (0.270) than for cost (0.257). In contrast, healthcare professionals showed higher RI for social health (0.091) than for productivity (0.071).

Conclusions:

While the RI of some attributes varied by stakeholder group, cost and physical health consistently held the highest RI values across all groups. These findings provide quantitative evidence to support the design of more equitable and effective health promotion programmes.

Keywords:

Preventive Medicine Primary Prevention Public Health

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