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Increasing the contribution of pharmacists to primary care has been long discussed, particularly in the context of health workforce shortages and the push to better integrate all providers across primary care. This study examines the employment preferences of Australian pharmacy degree holders (PDHs) elicited through a discrete choice experiment (DCE), to better understand the drivers of current labour force choices. A labelled DCE was developed incorporating the six employment sectors: hospital pharmacy, community pharmacy, primary healthcare settings, pharmaceutical industry, government/academia , and non-pharmacy-related sector. Each alternative was described by five attributes using Herzberg's Two Factor Theory as a conceptual framework. They include motivators - role and career opportunities, and hygiene factors- flexible work schedule , geographic location , and salary. Unforced choice data were analysed using conditional logit and mixed logit models. Based on a sample of 678 PDHs in Australia, our findings indicated pharmaceutical industry is the least preferred sector, followed by non-pharmacy-related sector. Motivators in the form of role and career opportunities are the most important attributes in hospital pharmacy while hygiene factors - geographic location and salary significantly drive the choice of community pharmacy and primary care settings. We provided evidence of a willingness to adopt expanded roles in community pharmacy. This unique interpretation of the key drivers of employment preference in light of motivators and hygiene factors provides policy makers with important information when designing policies to attract and retain PDHs across employment sectors. • Pharmacy degree holders' preferences were explored with a complete job choice set. • Motivators and hygiene play distinctive roles in shaping employment sector choices. • Policy reforms to expand community pharmacists' responsibilities are supported. • Combinations of motivators and hygiene factors should be used for policy reforms. [ABSTRACT FROM AUTHOR]

Gastroenteritis caused from infections with Salmonella enterica (salmonellosis) causes significant morbidity in Australia. In addition to acute gastroenteritis, approximately 8.8% of people develop irritable bowel syndrome (IBS) and 8.5% of people develop reactive arthritis (ReA). We estimated the economic cost of salmonellosis and associated sequel illnesses in Australia in a typical year circa 2015. We estimated incidence, hospitalizations, other health care usage, absenteeism, and premature mortality for four age groups using a variety of complementary data sets. We calculated direct costs (health care) and indirect costs (lost productivity and premature mortality) by using Monte Carlo simulation to estimate 90% credible intervals (CrI) around our point estimates. We estimated that 90,833 cases, 4,312 hospitalizations, and 19 deaths occurred from salmonellosis in Australia circa 2015 at a direct cost of AUD 23.8 million (90% CrI, 19.3 to 28.9 million) and a total cost of AUD 124.4 million (90% CrI, 107.4 to 143.1 million). When IBS and ReA were included, the estimated direct cost was 35.7 million (90% CrI, 29.9 to 42.7 million) and the total cost was AUD 146.8 million (90% CrI, 127.8 to 167.9 million). Foodborne infections were responsible for AUD 88.9 million (90% CrI, 63.9 to 112.4 million) from acute salmonellosis and AUD 104.8 million (90% CrI, 75.5 to 132.3 million) when IBS and ReA were included. Targeted interventions to prevent illness could considerably reduce costs and societal impact from Salmonella infections and sequel illnesses in Australia. The rate of salmonellosis in Australia is high, but the costs have not previously been assessed. Salmonellosis illness and sequelae cost Australia AUD 146.8 million circa 2015. Foodborne Salmonella infections and sequelae cost AUD 104.8 million. Quantifying costs helps prioritize interventions across the food chain to reduce societal impact. [ABSTRACT FROM AUTHOR]

Abstract An increase in sugar-sweetened beverage (SSB) prices has been suggested to reduce SSB intake to improve population health. Using a discrete choice experiment, we tested the effect of price changes on beverage choices in an online hypothetical convenience store setting amongst 1,008 Australian adults in May to June 2016. From this we calculated pre-packaged beverage price elasticities overall and for health policy-target consumer subgroups; and identified consumer subgroups likely to be most reactive to beverage price changes. Using mixed logit analysis, we found similar price elasticities for age, gender and income groups. More frequent SSB consumers tended to be less sensitive to SSB price changes. Latent class analysis revealed five consumer groups, none of which fit the desirable policy-target of highly price sensitive, frequent SSB consumers. An improved understanding of responsiveness to beverage price changes and consumer preferences could improve predictions of whose health is likely to benefit most from pricing interventions. Highlights • Sugar-sweetened beverage (SSB) price increases reduce SSB purchases among consumers. • SSB price changes have similar purchase impacts across age, gender and income groups. • More frequent SSB consumers are less responsive to SSB price changes. • SSB pricing policies may benefit consumers suffering greatest health effects less. [ABSTRACT FROM AUTHOR]

Workforce participation decisions involve multiple stages: search, screening and offer evaluation. Standard econometric practice focusses on these stages in isolation. We conceptualize the focal behaviours as separate sequential decision stages, and provide a stated preference measurement framework for online job search and choice with a behaviourally consistent modelling approach. We demonstrate this approach in an empirical application of 275 dentists who completed an online survey including two Discrete Choice Experiments: the first mimicked an online job search site in which dentists decided which jobs they would apply to and the second presented dentists with a job offer which they accepted or rejected. Modelling these tasks requires a two-stage econometric model that incorporates the likelihood of application (first stage) into the job offer choice (second stage). The model detects differences in preferences (hence behaviours) across stages, facilitating the differentiation of policy aimed at search and job choice behaviours. Job screening occurs during search and the marginal propensity to apply for a job-type differs from the offer stage. We suggest that the approach presented provides a valuable way to investigate how dentists particularly, and perhaps the health workforce more generally, respond at different stages of workforce participation decisions and discuss practical implications. • Propose a conceptual framework to separate stages of job search and evaluation. • Propose an econometric model that includes the likelihood of job search in choice. • Empirical application to understand dentist workforce supply decisions. • Job screening by attribute cut-offs occurs at the job search stage. • Survey mimics the process of online job search, application and offer evaluation. [ABSTRACT FROM AUTHOR]

In most societies resources are insufficient to provide everyone with all the health care they want. In practice, this means that some people are given priority over others. On what basis should priority be given? In this paper we are interested in the general public's views on this question. We set out to synthesis what the literature has found as a whole regarding which attributes or factors the general public think should count in priority setting and what weight they should receive. A systematic review was undertaken (in August 2014) to address these questions based on empirical studies that elicited stated preferences from the general public. Sixty four studies, applying eight methods, spanning five continents met the inclusion criteria. Discrete Choice Experiment (DCE) and Person Trade-off (PTO) were the most popular standard methods for preference elicitation, but only 34% of all studies calculated distributional weights, mainly using PTO. While there is heterogeneity, results suggest the young are favoured over the old, the more severely ill are favoured over the less severely ill, and people with self-induced illness or high socioeconomic status tend to receive lower priority. In those studies that considered health gain, larger gain is universally preferred, but at a diminishing rate. Evidence from the small number of studies that explored preferences over different components of health gain suggests life extension is favoured over quality of life enhancement; however this may be reversed at the end of life. The majority of studies that investigated end of life care found weak/no support for providing a premium for such care. The review highlights considerable heterogeneity in both methods and results. Further methodological work is needed to achieve the goal of deriving robust distributional weights for use in health care priority setting. [ABSTRACT FROM AUTHOR]

Consumer directed care (CDC) is currently being embraced internationally as a means to promote autonomy and choice for consumers (people aged 65 and over) receiving community aged care services (CACSs). CDC involves giving CACS clients (consumers and informal carers of consumers) control over how CACSs are administered. However, CDC models have largely developed in the absence of evidence on clients' views and preferences. We explored CACS clients' preferences for a variety of CDC attributes and identified factors that may influence these preferences and potentially inform improved design of future CDC models. Study participants were clients of CACSs delivered by five Australian providers. Using a discrete choice experiment (DCE) approach undertaken in a group setting between June and December 2013, we investigated the relative importance to CACS consumers and informal (family) carers of gradations relating to six salient features of CDC (choice of service provider(s), budget management, saving unused/unspent funds, choice of support/care worker(s), support-worker flexibility and level of contact with service coordinator). The DCE data were analysed using conditional, mixed and generalised logit regression models, accounting for preference and scale heterogeneity. Mean ages for 117 study participants were 80 years (87 consumers) and 74 years (30 informal carers). All participants preferred a CDC approach that allowed them to: save unused funds from a CACS package for future use; have support workers that were flexible in terms of changing activities within their CACS care plan and; choose the support workers that provide their day-to-day CACSs. The CDC attributes found to be important to both consumers and informal carers receiving CACSs will inform the design of future CDC models of service delivery. The DCE approach used in this study has the potential for wide applicability and facilitates the assessment of preferences for elements of potential future aged care service delivery not yet available in policy. [ABSTRACT FROM AUTHOR]

Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%–8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%–5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = −1.3%, range of −0.2% to −3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%–75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%–86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19. • Studies COVID-19 vaccine preferences across 18 countries/territories. • Applies a consistent survey using stated choice experiments. • Provides insights into the effects of vaccine characteristics on uptake. • Develops an interactive tool for predicting vaccine uptake. [ABSTRACT FROM AUTHOR]

This paper follows the review of empirical evidence on the existence of hypothetical bias (HB) in choice experiments (CEs) presented in Part I of this study. It observes how the variation in operational definitions of HB has prohibited consistent measurement of HB in CE. It offers a unifying definition of HB and presents an integrative framework of how HB relates to but is also distinct from external validity (EV), with HB representing one component of the wider concept of EV. The paper further identifies major sources of HB and discusses explanations as well as possible moderating factors of HB. The paper reviews methods of HB mitigation identified in the literature and the empirical evidence of their effectiveness. The review includes both ex-ante and ex-post bias mitigation methods. Ex-ante bias mitigation methods include cheap talk , real talk , consequentiality scripts , solemn oath scripts , opt-out reminders , budget reminders , honesty priming , induced truth telling , indirect questioning , time to think and pivot designs. Ex-post methods include follow-up certainty calibration scales , respondent perceived consequentiality scales , and revealed-preference-assisted estimation. It is observed that the mitigation methods and their preferred use vary markedly across different sectors of applied economics. The existing empirical evidence points to the overall effectiveness of mitigation strategies in reducing HB, although there is some variation. The paper further discusses how each mitigation method can counter a certain subset of HB sources. Considering the prevalence of HB in CEs and the effectiveness of bias mitigation methods, it is recommended that implementation of at least one bias mitigation method (or a suitable combination where possible) becomes standard practice in conducting CEs to ensure that inferences and subsequent policy decisions are as much as possible free of HB. • Definition and conceptualisation of hypothetical bias in choice experiments is revisited. • The relationship between hypothetical bias and external validity in choice experiments revisited. • Sources/explanations and moderating factors of hypothetical bias are identified. • Methods of hypothetical bias mitigation and the empirical evidence on their effectiveness reviewed. • Recommendations offered for adopting mitigation methods tailored to likely source(s) of hypothetical bias. [ABSTRACT FROM AUTHOR]

The notion of hypothetical bias (HB) constitutes, arguably, the most fundamental issue in relation to the use of hypothetical survey methods. Whether or to what extent choices of survey participants and subsequent inferred estimates translate to real-world settings continues to be debated. While HB has been extensively studied in the broader context of contingent valuation, it is much less understood in relation to choice experiments (CE). While the number of CE studies has rapidly increased, the critical issue of HB has been studied in only a small fraction of CE studies. This paper provides macro-scale insights into the literature of CE and reviews the empirical evidence for HB in CE in various fields of applied economics as well as experimental psychology and behavioural neuroscience. Results suggest mixed evidence on the prevalence, extent and direction of HB as well as considerable context and measurement dependency. While HB is found to be an undeniable issue when conducting CEs, the empirical evidence on HB does not render CEs unable to represent real-world preferences. While health-related choice experiments often find negligible degrees of HB, experiments in consumer behaviour and transport domains suggest significant degrees of HB. Environmental valuation studies provide mixed evidence. Also, across these disciplines many studies display HB in their total willingness to pay estimates and opt-in rates but not in their hypothetical marginal rates of substitution (subject to scale correction). Further, recent findings in psychology and brain imaging studies identify neurocognitive mechanisms underlying HB that may explain some of the discrepancies and unexpected findings in the mainstream CE literature. • Empirical evidence on the prevalence of hypothetical bias in choice experiments is reviewed. • The survey integrates findings of consumer, health, environmental and transport economics. • Evidence from experimental psychology partly explain mechanisms of hypothetical bias. • Hypothetical bias is found to be an undeniable issue in relation to choice experiments. • The prevalence of significant bias varies considerably across disciplines and contexts of choice. [ABSTRACT FROM AUTHOR]

Since the introduction of Discrete Choice Analysis, countless efforts have been made to enhance the efficiency of data collection through choice experiments and to improve the behavioural realism of choice models. One example development in data collection are best-worst discrete choice experiments (BWDCE), which have the benefit of obtaining a larger number of observations per respondent, allowing for reliably estimating choice models even with smaller samples. In SWDCE, respondents are asked to alternatingly select the 'best'/'worst' alternatives, until the choice set is exhausted. The use of BWDCE raises the question of decision-rule consistency through the stages of the experiment. We challenge the notion that the same fully compensatory decision rule is utilised throughout the experiment. We hypothesize that respondents may utilise one decision rule for selecting the 'best' and another for selecting the 'worst' alternatives. To test our hypothesis, we developed a model that combines the SBWMNL model for modelling best-worst data and the μRRM model that can account for variations in decision rules. Our results show that decision-rule heterogeneity does seem to be present in BWDCE: it is more likely that 'best' choices are made using a fully compensatory decision rule (maximising utility), whereas 'worst' choices are more likely made using a non-compensatory decision rule (minimising regret). Such behaviour is largely similar to how image theory describes the decision-making process in complex situations. Our findings give choice modellers new insight into the behaviour of respondents in best-worst experiments and allows them to represent their behaviour more accurately. • Adapted best-worst choice model that can account for decision rule heterogeneity. • Respondents do not use the same decision rule in best-worst choice experiments. • Successive choices in discrete choice experiments have a lower reliability. • The developed models do not produce significantly different parameter estimates. [ABSTRACT FROM AUTHOR]

Abstract: Stated-preference methods are a class of evaluation techniques for studying the preferences of patients and other stakeholders. While these methods span a variety of techniques, conjoint-analysis methods—and particularly discrete-choice experiments (DCEs)—have become the most frequently applied approach in health care in recent years. Experimental design is an important stage in the development of such methods, but establishing a consensus on standards is hampered by lack of understanding of available techniques and software. This report builds on the previous ISPOR Conjoint Analysis Task Force Report: Conjoint Analysis Applications in Health—A Checklist: A Report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. This report aims to assist researchers specifically in evaluating alternative approaches to experimental design, a difficult and important element of successful DCEs. While this report does not endorse any specific approach, it does provide a guide for choosing an approach that is appropriate for a particular study. In particular, it provides an overview of the role of experimental designs for the successful implementation of the DCE approach in health care studies, and it provides researchers with an introduction to constructing experimental designs on the basis of study objectives and the statistical model researchers have selected for the study. The report outlines the theoretical requirements for designs that identify choice-model preference parameters and summarizes and compares a number of available approaches for constructing experimental designs. The task-force leadership group met via bimonthly teleconferences and in person at ISPOR meetings in the United States and Europe. An international group of experimental-design experts was consulted during this process to discuss existing approaches for experimental design and to review the task force’s draft reports. In addition, ISPOR members contributed to developing a consensus report by submitting written comments during the review process and oral comments during two forum presentations at the ISPOR 16th and 17th Annual International Meetings held in Baltimore (2011) and Washington, DC (2012). [Copyright &y& Elsevier]

Abstract: A key objective of discrete choice experiments is to obtain sufficient quantity of high quality choice data to estimate choice models to be used to explore various policy/clinically relevant issues. This paper focuses on a relatively new form of choice experiment, ‘Best Worst Discrete Choice Experiments’ (BWDCEs) and their relevance to health research as a new way to meet such an objective. We explain what BWDCEs are, how and when to apply them and we present several analytical approaches to model the resulting data. We demonstrate this preference elicitation approach in an empirical application exploring preferences of 898 members of the general public in Edmonton and Calgary, Canada for treatment of cardiac arrest occurring in a public place and show the gains achieved compared to traditional analysis of first best data. We suggest that BWDCEs are a valuable way to investigate preferences in the health sector and discuss implications for task design, analysis and areas for future research. [Copyright &y& Elsevier]

Abstract: There is growing use of discrete choice experiments (DCEs) to investigate preferences for products and programs and for the attributes that make up such products and programs. However, a fundamental issue overlooked in the interpretation of many choice experiments is that attribute parameters estimated from DCE response data are confounded with the underlying subjective scale of the utilities, and strictly speaking cannot be interpreted as the relative “weight” or “impact” of the attributes, as is frequently done in the health economics literature. As such, relative attribute impact cannot be compared using attribute parameter size and significance. Instead, to investigate the relative impact of each attribute requires commensurable measurement units; that is, a common, comparable scale. We present and demonstrate empirically a menu of five methods that allow such comparisons: (1) partial log-likelihood analysis; (2) the marginal rate of substitution for non-linear models; (3) Hicksian welfare measures; (4) probability analysis; and (5) best–worst attribute scaling. We discuss the advantages and disadvantages of each method and suggest circumstances in which each is appropriate. [Copyright &y& Elsevier]

Despite the label "generic" health state utility instruments (HSUIs), empirical evidence shows that different HSUIs generate different estimates of Health-Related Quality of Life (HRQoL) in the same person. Once a HSUI is used to generate a QALY, the difference between HSUIs is often ignored, and decision-makers act as if 'a QALY is a QALY is a QALY'. Complementing evidence that different generic HSUIs produce different empirical values, this study addresses an important gap by exploring how HSUIs differ, and processes that produced this difference. 15 developers of six generic HSUIs used for estimating the QOL component of QALYs: Quality of Well-Being (QWB) scale; 15 Dimension instrument (15D); Health Utilities Index (HUI); EuroQol EQ-5D; Short Form-6 Dimension (SF-6D), and the Assessment of Quality of Life (AQoL) were interviewed in 2012–2013. We identified key factors involved in shaping each instrument, and the rationale for similarities and differences across measures. While HSUIs have a common purpose, they are distinctly discrete constructs. Developers recalled complex developmental processes, grounded in unique histories, and these backgrounds help to explain different pathways taken at key decision points during the HSUI development. The basis for the HSUIs was commonly not equivalent conceptually: differently valued concepts and goals drove instrument design and development, according to each HSUI's defined purpose. Developers drew from different sources of knowledge to develop their measure depending on their conceptualisation of HRQoL. We generated and analysed first-hand accounts of the development of the HSUIs to provide insight, beyond face value, about how and why such instruments differ. Findings enhance our understanding of why the six instruments developed the way they did, from the perspective of key developers of those instruments. Importantly, we provide additional, original explanation for why a QALY is not a QALY is not a QALY. • We generated and analysed unique data: interviews with developers of all six major HSUIs. • HSUIs are assumed comparable but beyond face value measure different constructs. • Deep processual, conceptual, and disciplinary differences distinguish the six HSUIs. • We developed a new explanation of how a QALY is not a QALY with implications for economic evaluation. • First-hand accounts provide valuable insights for those contemplating future HSUI development. [ABSTRACT FROM AUTHOR]

Health programs/services are often bundled, allowing for both substitution and complementarity. We adapt Discrete Choice Experiments to capture bundling, with application to a case study of exercise and nutrition; complementarity arises due to the goal of improving health. Our contributions are (1) to present a menu-based choice experiment to explore bundling; (2) to analyse the menu-based data using an extension of the choice set generation model (GenL) to account for correlations between bundles and component singles. A nationally representative sample of 333 Australians chose between a nutrition program only; exercise program only; both nutrition and exercise programs; or their status quo. Overall, we show that by incorporating the menu choice task and introducing the combined alternative, we capture a significant portion of the population seeking both exercise and nutrition components. We estimate a latent class GenL model, and identify two latent classes: Class 1 preferred to choose programs on offer, and Class 2 was more price sensitive and had a stronger preference for staying with their status quo. We show in the post-estimation analysis that heterogeneity in preferences translates into heterogeneity in the way alternatives are bundled, indicating that the combined offering is appealing to specific classes of individuals who prefer bundling. By implementing the menu choice task, researchers and policymakers can effectively identify, cater to and influence the demand for combined exercise and nutrition options, leading to more targeted and impactful interventions in promoting healthier lifestyle choices. • We propose a menu-based choice experiment to explore bundling for health-related options. • Bundling accounts for a significant portion of demand in a case study exploring choice of nutrition and exercise programs. • Ignoring bundling leads to an overstatement of demand for single alternatives, leading to misprediction of demand. • Combined offering is appealing to specific classes of individuals who prefer bundling. • We provide insights as to why policy interventions to improve uptake may not be effective for everybody. [ABSTRACT FROM AUTHOR]

People's time is a limited resource and, in economic evaluations that adopt a societal perspective, it is important that it is valued and accounted for. Yet, in economic evaluations of interventions for children and young people (CYP), attempts to take into account the opportunity cost of their time are rare. To understand why this is the case, we need to first understand what views health economists hold in relation to CYP time, and what challenges they face in incorporating this in their evaluations. We planned and carried out an international survey of health economists. We used a combination of approaches to identify potential survey respondents (the survey's sampling frame), we developed a questionnaire that sought to capture respondents' views and practice through close- and open-ended questions, we piloted the questionnaire through a series of cognitive interviews, and we e-mailed unique links to the final version of the questionnaire to 1956 individuals in the sampling frame. We analysed data using quantitative (descriptive and inferential statistics) and qualitative (thematic analysis) methods. We received 274 complete responses. Most respondents (87%) believe CYP time should be considered for inclusion in economic evaluations conducted from a societal perspective. However, they identify a number of obstacles to doing so, most prominently uncertainties around appropriate practice (e.g., when CYP's time should or should not be included in calculations), methodological gaps (e.g., what value to attach to CYP's time), and practical difficulties in measuring displaced time in CYP. Reporting on their own practice, most respondents found it challenging to consider CYP time in their studies, and stressed the need for clear guidance on when, and further research on how, to appropriately account for CYP's time in economic evaluations. We offer our views on how to move the topic forwards and make suggestions further research. • Children and young people's time is rarely accounted for in economic evaluations. • We surveyed health economists to understand their views and practice on the topic. • Respondents pointed out various challenges and gaps in available methods. • Research is needed on how to value and include CYP time in economic evaluations. [ABSTRACT FROM AUTHOR]

Background Limited evidence has been gathered on the real-world impact of sugar-sweetened beverage price changes on purchasing behavior over time or in community-retail settings. Objective Our aim was to determine changes in beverage purchases, business outcomes, and customer and retailer satisfaction associated with a retailer-led sugar-sweetened beverage price increase in a convenience store. We hypothesized that purchases of less-healthy beverages would decrease compared to predicted sales. Design A convergent parallel mixed methods design complemented sales data (122 weeks pre-intervention, 17 weeks during intervention) with stakeholder interviews and customer surveys. Participants/setting Electronic beverage sales data were collected from a convenience store in Melbourne, Australia (August through November 2015). Convenience store staff completed semi-structured interviews (n=4) and adult customers exiting the store completed surveys (n=352). Intervention Beverages were classified using a state government framework. Prices of “red” beverages (eg, nondiet soft drinks, energy drinks) increased by 20%. Prices of “amber” (eg, diet soft drinks, small pure fruit juices) and “green” beverages (eg, water) were unchanged. Main outcome measures Changes in beverage volume, item sales, and revenue during the intervention were compared with predicted sales. Statistical analyses Sales data were analyzed using time series segmented regression while controlling for pre-intervention trends, autocorrelation in sales data, and seasonal fluctuations. Results Beverage volume sales of red (−27.6%; 95% CI −32.2 to −23.0) and amber (−26.7%; 95% CI −39.3 to −16.0) decreased, and volume of green beverages increased (+26.9%; 95% CI +14.1 to +39.7) in the 17th intervention week compared with predicted sales. Store manager and staff considered the intervention business-neutral, despite a small reduction in beverage revenue. Fifteen percent of customers noticed the price difference and 61% supported the intervention. Conclusions A 20% sugar-sweetened beverage price increase was associated with a reduction in their purchases and an increase in purchases of healthier alternatives. Community retail settings present a bottom-up approach to improving consumer beverage choices. [ABSTRACT FROM AUTHOR]

Objectives To improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people. Methods An online discrete choice experiment (DCE) was conducted among 1261 representatives of the Dutch general population aged 60 years or older. In the DCE, we used influenza vaccination scenarios based on five vaccination characteristics: effectiveness, risk of severe side effects, risk of mild side effects, protection duration, and absorption time. A heteroscedastic multinomial logit model was used, taking scale and preference heterogeneity (based on 19 patient characteristics) into account. Results Vaccination and patient characteristics both contributed to explain influenza vaccination uptake. Assuming a base case respondent and a realistic vaccination scenario, the predicted uptake was 58%. One-way changes in vaccination characteristics and patient characteristics changed this uptake from 46% up to 61% and from 37% up to 95%, respectively. The strongest impact on vaccination uptake was whether the patient had been vaccinated last year, whether s/he had experienced vaccination side effects, and the patient’s general attitude towards vaccination. Conclusions Although vaccination characteristics proved to influence influenza vaccination uptake, certain patient characteristics had an even higher impact on influenza vaccination uptake. Policy makers and general practitioners can use these insights to improve their communication plans and information regarding influenza vaccination for individuals aged 60 years or older. For instance, physicians should focus more on patients who had experienced side effects due to vaccination in the past, and policy makers should tailor the standard information folder to patients who had been vaccinated last year and to patient who had not. [ABSTRACT FROM AUTHOR]

This exploratory study sought to investigate the effect of cognitive functioning on the consistency of individual responses to a discrete choice experiment (DCE) study conducted exclusively with older people. Methods A DCE to investigate preferences for multidisciplinary rehabilitation was administered to a consenting sample of older patients (aged 65 years and older) after surgery to repair a fractured hip (N = 84). Conditional logit, mixed logit, heteroscedastic conditional logit, and generalized multinomial logit regression models were used to analyze the DCE data and to explore the relationship between the level of cognitive functioning (specifically the absence or presence of mild cognitive impairment as assessed by the Mini-Mental State Examination) and preference and scale heterogeneity. Results Both the heteroscedastic conditional logit and generalized multinomial logit models indicated that the presence of mild cognitive impairment did not have a significant effect on the consistency of responses to the DCE. Conclusions This study provides important preliminary evidence relating to the effect of mild cognitive impairment on DCE responses for older people. It is important that further research be conducted in larger samples and more diverse populations to further substantiate the findings from this exploratory study and to assess the practicality and validity of the DCE approach with populations of older people. [ABSTRACT FROM AUTHOR]

Evidence surrounding utilities for health states, derived either directly from the application of preference-based valuation methods or indirectly from the application of preference-based quality of life instruments, is increasingly being utilised to inform the cost-effectiveness of child health interventions. Proxy (parent or health professional) assessments are common in this area. This study sought to investigate the degree of convergence in childhood utilities generated directly or indirectly within dyad child and proxy assessments. A systematic literature review was conducted following PRISMA guidelines. A comprehensive literature search strategy conducted across six search engines (PubMed, Embase, Web of Science, PsychoINFO, EconLit, CINAHL and Cochrane Library). Original peer-reviewed articles that reported utilities derived directly or indirectly using simultaneous dyad child and proxy assessments were extracted. Mean and median utilities, correlation coefficients and levels of agreement were extracted, catalogued and assessed. A total of 35 studies that reported utilities for two or more respondent types were identified. Of these, 29 studies reported dyad childhood self-report and proxy utilities whilst six studies reported levels of agreement and/or correlations only without documenting overall utilities. Proxy assessment was most often conducted by parents with the HUI3 representing the most commonly applied instrument across a range of health conditions. The utilities derived from child and parent proxy assessment were bidirectional with parental proxies tending to underestimate and health professional proxies tending to overestimate relative to child self-reports. Inter-rater agreement between child self-reports and parent-proxy reports were poorer for more subjective attributes (cognition, emotion and pain), relative to physical attributes (mobility, self-care, speech, vision) of health-related quality of life. Childhood utilities derived from children or proxies are not interchangeable. The choice of self or proxy assessor may have potentially significant implications for economic evaluations of child health interventions. • Differences exist between utilities elicited via child self-reports and proxies. • The direction and magnitude of such differences are not homogenous. • Utilities elicited via chid self-reports and proxies are not interchangeable. • Both set of assessments may provide greater insight into predictors of utilities. [ABSTRACT FROM AUTHOR]