Using Best-Worst Scaling to Understand Patient Priorities: A Case Example of Papanicolaou Tests for Homeless Women
UMass Chan Affiliations
Department of Family Medicine and Community HealthDocument Type
Journal ArticlePublication Date
2016-07-01Keywords
best-worst scalingcervical cancer
conjoint analysis
homeless
methods
stated preferences
vulnerable populations
Behavior and Behavior Mechanisms
Community Health and Preventive Medicine
Family Medicine
Health Services Administration
Obstetrics and Gynecology
Women's Health
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Show full item recordAbstract
PURPOSE: Best-worst scaling (BWS) is a survey method for assessing individuals' priorities. It identifies the extremes-best and worst items, most and least important factors, biggest and smallest influences-among sets. In this article, we demonstrate an application of BWS in a primary care setting to illustrate its use in identifying patient priorities for services. METHODS: We conducted a BWS survey in 2014 in Boston, Massachusetts, to assess the relative importance of 10 previously identified attributes of Papanicolaou (Pap) testing services among women experiencing homelessness. Women were asked to evaluate 11 sets of 5 attributes of Pap services, and identify which attribute among each set would have the biggest and smallest influence on promoting uptake. We show how frequency analysis can be used to analyze results. RESULTS: In all, 165 women participated, a response rate of 72%. We identified the most and least salient influences on encouraging Pap screening based on their frequency of report among our sample, with possible standardized scores ranging from+1.0 (biggest influence) to -1.0 (smallest influence). Most important was the availability of support for issues beyond health (+0.39), while least important was the availability of accommodations for personal hygiene (-0.27). CONCLUSIONS: BWS quantifies patient priorities in a manner that is transparent and accessible. It is easily comprehendible by patients and relatively easy to administer. Our application illustrates its use in a vulnerable population, showing that factors beyond those typically provided in health care settings are highly important to women in seeking Pap screening. This approach can be applied to other health care services where prioritization is helpful to guide decisions.Source
Ann Fam Med. 2016 Jul;14(4):359-64. doi: 10.1370/afm.1937. Link to article on publisher's site
DOI
10.1370/afm.1937Permanent Link to this Item
http://hdl.handle.net/20.500.14038/39989PubMed ID
27401425Related Resources
ae974a485f413a2113503eed53cd6c53
10.1370/afm.1937