Exploring Social Preferences for Health and Well-Being Across the Digital Divide: A Qualitative Investigation Based on Tasks Taken From an Online Discrete Choice Experiment.

Increasingly, discrete choice experiments (DCEs) are conducted online, with little consideration of the digitally excluded, who are unable to participate. Policy makers or others considering online research data need clarity about how views might differ across this "digital divide." We took tasks from an existing online DCE designed to elicit social preferences for health and well-being outcomes. We aimed to explore (1) how telephone interview participants answered a series of choice tasks taken from an online DCE and (2) whether and how decision making for these tasks differed between digitally excluded and nonexcluded participants. We conducted semistructured telephone interviews with members of the public (n = 27), recruited via an existing social research panel. Data were analyzed thematically to identify key approaches to decision making. Twelve participants were classed as "digitally excluded," and 15 as "digitally nonexcluded." Responses were similar between the 2 samples for most choice tasks. We identified 3 approaches used to reach decisions: (1) simplifying, (2) creating explanatory narratives, and (3) personalizing. Although these approaches were common across both samples, understanding the exercise seemed more challenging for the digitally excluded sample. This novel study provides some assurance that the participants' views over the choice tasks used are similar across the digital divide. The challenges we identified with understanding highlight the need to carefully examine the views held by the digitally excluded. If online data are to inform policy making, it is essential to explore the views of those who cannot participate in online DCEs. • Discrete choice experiments (DCEs) can elicit health and well-being preferences for informing policy and are increasingly undertaken online, but those who are digitally excluded cannot participate in such exercises, so their views and preferences are excluded from informing policy decisions. Whether their views and preferences are similar or different from those who can participate in online DCEs is unknown. • We identified no clear differences in views about health and well-being outcomes across the digital divide; however, task comprehension was more challenging for some digitally excluded. We used qualitative telephone interviews, taking tasks from an existing online DCE survey, to explore whether and how social preferences for health and well-being differ between a digitally excluded and a nondigitally excluded sample. This is a novel approach that could be used by other DCE-related studies. • Although this study found no difference in views across the digital divide, it is still important for online studies of social preferences to explore the views of the digitally excluded, given that resource allocation decisions should be based on a broad understanding of social preferences. If decision makers are to consider such online data for policy making, it is essential to explore the views of those who cannot participate in online DCEs. [ABSTRACT FROM AUTHOR]