Measuring commissioners’ willingness-to-pay for community based childhood obesity prevention programmes using a discrete choice experiment

Abstract

Background In the UK, rates of childhood obesity remain high. Community based programmes for child obesity prevention are available to be commissioned by local authorities. However, there is a lack of evidence regarding how programmes are commissioned and which attributes of programmes are valued most by commissioners. The aim of this study was to determine the factors that decision-makers prioritise when commissioning programmes that target childhood obesity prevention. Methods An online discrete choice experiment (DCE) was used to survey commissioners and decision makers in the UK to assess their willingness-to-pay for childhood obesity programmes. Results A total of 64 commissioners and other decision makers completed the DCE. The impact of programmes on behavioural outcomes was prioritised, with participants willing to pay an extra £16,600/year if average daily fruit and vegetable intake increased for each child by one additional portion. Participants also prioritised programmes that had greater number of parents fully completing them, and were willing to pay an extra £4810/year for every additional parent completing a programme. The number of parents enrolling in a programme (holding the number completing fixed) and hours of staff time required did not significantly influence choices. Conclusions Emphasis on high programme completion rates and success increasing children’s fruit and vegetable intake has potential to increase commissioning of community based obesity prevention programmes.

A cluster RCT and process evaluation of an implementation optimisation intervention to promote parental engagement enrolment and attendance in a childhood obesity prevention programme: results of the Optimising Family Engagement in HENRY (OFTEN) trial

“…Justification of this approach was considered at length by the team and in discussion with the independent steering committee. Given that commissioners value both enrolment and attendance [ 42 ], it was agreed that improvements in either would be deemed effective (and subsequent adjustment was made to the analysis to account for multiplicity).…”

“…However, subsequent null trial findings indicated that this was not appropriate. Instead, a discrete choice study [ 50 ] was conducted to consider, more widely, what delivery elements of obesity prevention programmes are most valued by commissioners [ 42 ]. The sample size within the published protocol did not allow for analysis of two primary endpoints and incorrectly included reference to a single composite endpoint.…”

A cluster RCT and process evaluation evaluating the effectiveness of an optimisation intervention to promote parental engagement in a childhood obesity prevention programme: Results of the Optimising Family Engagement in HENRY (OFTEN) trial

“…However, subsequent null trial ndings indicated that this was not appropriate. Instead, a discrete choice study (39) was conducted to consider, more widely, what delivery elements of obesity prevention programmes are most valued by commissioners (40). The sample size within the published protocol did not allow for analysis of two primary endpoints and incorrectly included reference to a single composite endpoint.…”

Examining Ways to Improve Weight Control Programs’ Population Reach and Representativeness: A Discrete Choice Experiment of Financial Incentives

“…We used a discrete choice experiment (DCE) to understand public preferences towards different financial incentive attributes. The DCE has been used widely in health economics and the studies that examine preferences towards weight loss program attributes are especially relevant to this study [28][29][30]. The application of choice experiment allows us to examine a wider range of incentive attributes (i.e., more and broader ranges of levels within each attribute), overcoming the limitations of actual field experiments (i.e., limited scope, limited representativeness, and limited incentive designs).…”