Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, Caphri, The Netherlands.
Value Health. 2013 Jan-Feb;16(1):114-23. doi: 10.1016/j.jval.2012.08.2211.
Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change.
A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week.
With the exception of "time cost per week" and "start point of future health state," all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes "endurance," "days with sufficient relaxation," and "future health state value" had the greatest impact on consumer choices. The "life expectancy" attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade.
Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions.
健康促进（HP）干预的结果超出了健康范围。此类更广泛的非健康结果通常在经济评估研究中被忽视。为了能够考虑到这些结果，需要深入了解 HP 干预产生的非健康结果的类型及其与健康结果的相对重要性。本研究探讨了在生活方式行为改变的背景下，消费者对 HP 的健康和非健康结果的偏好。
在生活方式干预（n=132）和对照组（n=141）参与者中进行了离散选择实验。受访者在 16 种生活方式行为改变后可能经历的情况之间做出了 16 种二元选择。这些情况由 10 个属性描述：未来健康状态的价值、未来健康状态的起点、预期寿命、理想尺码以上的服装尺寸、有足够放松的天数、耐力、对生活方式选择的体验控制、伴侣和/或孩子的生活方式改善、每月费用和每周时间成本。
除了“每周时间成本”和“未来健康状态起点”之外，所有属性都显著决定了消费者的选择。因此，健康和非健康结果都影响了消费者的选择。价格属性与其他属性之间的边际替代率表明，属性“耐力”、“有足够放松的天数”和“未来健康状态价值”对消费者选择的影响最大。“预期寿命”属性的影响相对较低，对于低于 3 年的增加，受访者不愿意进行交易。
在这项研究中，生活方式行为改变的健康结果和非健康结果对消费者都很重要。决策者应响应消费者的偏好，并在决定 HP 干预措施时考虑非健康结果。
