Using Latent Class Analysis to Model Preference Heterogeneity in Health: A Systematic Review

Zhou, Mo; Thayer, Winter M.; Bridges, John F.P.

doi:10.1007/s40273-017-0575-4

Cited by 108 publications

(118 citation statements)

References 117 publications

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“…In this study, latent class analysis was used to identify groups which behaved most similarly in terms of their choices. Such analysis is a potentially powerful means of describing groups displaying similar choice behaviour, but, as yet, it is used in less than half of published studies in health care (Zhou et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Given the potential for such groups to exist, we used latent class analysis (Pacifico & Yoo, ), similar to cluster analysis, to analyse the choices women made. This assumes that the probability an individual will choose a particular option is conditional on them belonging to a particular group and is a widely used in the analysis of choices in health care (Zhou, Thayer, & Bridges, ). The latent class analysis tested the likelihood that women belonged to a given group based on their demographic characteristics (age, household income and education), whether they were concerned about cancer recurrence when completing the choice tasks, their prior participation in cancer screening, and accounting for the pooled nature of the survey.…”

Section: Methodsmentioning

confidence: 99%

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My mind is made up: Cancer concern and women’s preferences for contralateral prophylactic mastectomy

et al. 2019

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The fear of cancer recurrence is cited as a motivator of women's preferences between routine monitoring and contralateral prophylactic mastectomy (CPM) as methods of managing ongoing breast cancer risk. We conducted a discrete choice experiment among a general community sample of women who completed 12 hypothetical choices between routine monitoring and CPM described by aspects of treatment efficacy, safety, cost and involvement in decision‐making. Respondents also completed a modified cancer worry question to assess cancer concern. Approximately 57.5% of 464 women always chose one option, typically routine monitoring. The majority (71.5%) reported being concerned about cancer recurrence when completing choice tasks. Latent class analysis identified three groups: preferred routine monitoring; preferred CPM; and “traders” (willing to swap between options). Among traders, women were less likely to choose an option associated with higher risk of recurrence. Women were more likely to choose options associated with less‐intrusive monitoring methods and where they were involved in decision‐making. Women concerned about cancer recurrence were more likely to choose CPM over monitoring. This study shows that women's preferences about how to manage breast cancer recurrence risk reflect the importance of the associated health effects, experience of care and attitudes to cancer recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

My mind is made up: Cancer concern and women’s preferences for contralateral prophylactic mastectomy

et al. 2019

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“…Is the Theory of Planned Behavior linked to latent class membership? Psychological measures can predict and explain membership in unobserved latent classes, inform the content of advertising strategies and health communication messages, and enable implementation teams to tailor AB programs to local contexts (Zhou et al, 2018). We predicted that latent classes anticipating more benefits to AB programs (Attitudes) would be more amenable to social influences encouraging participation (Subjective Norms), express greater confidence in their ability to participate (Perceived Behavioral Control), identify fewer barriers to implementation, and reside in latent classes that were more intent on participating.…”

Section: The Current Studymentioning

confidence: 99%

“…To avoid an unrepresentative local solution, we computed each model 250 times from semi-random starting points and retained the best fitting model (Berlin et al, 2014;Hauber et al, 2016;Nylund, Asparouhov, & Muthén, 2007;Vermunt & Magidson, 2005). Decisions regarding the number of latent classes to retain at Levels 2 and Level 3 were based on fit indices (e.g., Bayesian Information Criterion (BIC)), latent class size, and conceptual utility (Berlin et al, 2014;Lanza & Rhoades, 2013;Zhou et al, 2018). Educators at Level 2 and schools at Level 3 were assigned to a latent class with the highest posterior probability of group membership (Hauber et al, 2016;Vermunt, 2008;Zhou et al, 2018).…”

Section: Fitting a Latent Class Modelmentioning

confidence: 99%

“…Identifying psychological and demographic factors associated with class membership is an important step in the conduct of latent class analyses (Berlin, Williams, & Parra, 2014;Zhou, Thayer, & Bridges, 2018). A number of studies, for example, have reported that the components of the Theory of Planned Behavior are associated with membership in latent classes preferring different approaches to the implementation of school-based mental health services (Cunningham et al, 2009(Cunningham et al, , 2014.…”

Section: Introductionmentioning

confidence: 99%

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What Influences Educators’ Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment

Cunningham

Rimas

Vaillancourt

et al. 2019

School Mental Health

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We used a discrete choice conjoint experiment to model the anti-bullying (AB) program preferences of 1080 junior kindergarten to Grade 8 educators. Participants chose between hypothetical AB programs that varied combinations of 12 design attributes. Multi-level latent class analysis yielded three classes: All-in Supervisors (21.5%) preferred that all teaching staff supervise playgrounds and hallways; Facilitators (61.6%) preferred that students take ownership of AB activities with 25% of educators supervising playgrounds and hallways; and Reluctant Delegators (16.9%) preferred delegating the supervision of playgrounds and hallways to non-teaching staff. This class reported higher dispositional reactance, more implementation barriers, and more psychological reactance to these initiatives. They were less sensitive to social influences and less intent on participating in AB activities. Multi-level analysis showed a greater proportion of Reluctant Delegators clustered in one of the two groups of schools. The program choices of all classes were sensitive to the support of principals, colleagues, students, and, to a lesser extent, parents. All classes preferred programs conducted from kindergarten through Grade 12 that addressed the problems underlying bullying while valuing firm and consistent consequences for all students. Educators preferred AB programs selected by individual schools, rather than governments.

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Patient Preferences for Strategies to Improve Tuberculosis Diagnostic Services in Zambia

et al. 2022

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IMPORTANCE Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes. OBJECTIVE To assess whether patients with TB have differential preferences for strategies to improve the public health reach of TB diagnostic services. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study was undertaken in which a discrete choice experiment (DCE) was administered between September 18, 2019, and January 17, 2020, to 401 adults (>18 years of age) with microbiologically confirmed TB in Lusaka, Zambia. The DCE had 7 attributes with 2 to 3 levels per attribute related to TB service enhancements. Latent class analysis was used to identify segments of participants with unique preferences. Multiscenario simulations were used to estimate shares of preferences for different TB service improvement strategies. MAIN OUTCOMES AND MEASURESThe main outcomes were patient preference archetypes and estimated shares of preferences for different strategies to improve TB diagnostic services. Collected data were analyzed between January 3, 2022, to July 2, 2022. RESULTS Among 326 adults with TB (median [IQR] age, 34 [27-42] years; 217 [66.8%] male; 158 [48.8%] HIV positive), 3 groups with distinct preferences for TB service improvements were identified. Group 1 (192 participants [58.9%]) preferred a facility that offered same-day TB test results, shorter wait times, and financial incentives for testing. Group 2 (83 participants [25.4%])preferred a facility that provided same-day TB results, had greater privacy, and was closer to home. Group 3 (51 participants [15.6%]) had no strong preferences for service improvements and had negative preferences for receiving telephone-based TB test results. Groups 1 and 2 were more likely to report at least a 4-week delay in seeking health care for their current TB episode compared with group 3 (29 [51.3%] in group 1, 95 [35.8%] in group 2, and 10 [19.6%] in group 3; P < .001). Strategies to improve TB diagnostic services most preferred by all participants were same-day TB test results alone (shares of preference, 69.9%) and combined with a small financial testing incentive (shares of preference, 79.3%), shortened wait times (shares of preference, 76.1%), or greater privacy (shares of preference, 75.0%). However, the most preferred service improvement strategies differed substantially by group. CONCLUSIONS AND RELEVANCEIn this study, patients with TB had heterogenous preferences for TB diagnostic service improvements associated with differential health care-seeking behavior.Tailored strategies that incorporate features most valued by persons with undiagnosed TB, including same-day results, financial incentives, and greater privacy, may optimize reach by overcoming key barriers to timely TB care engagement.

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Using Latent Class Analysis to Model Preference Heterogeneity in Health: A Systematic Review

Cited by 108 publications

References 117 publications

My mind is made up: Cancer concern and women’s preferences for contralateral prophylactic mastectomy

My mind is made up: Cancer concern and women’s preferences for contralateral prophylactic mastectomy

What Influences Educators’ Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment

Patient Preferences for Strategies to Improve Tuberculosis Diagnostic Services in Zambia

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