Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada.
BMC Public Health. 2022 Jun 13;22(1):1178. doi: 10.1186/s12889-022-13539-5.
To assess public support of tailored and targeted public health interventions for marginalized communities.
We conducted a discrete choice experiment using a web-based survey advertised to Facebook and Instagram users living in Canada, aged > 16. Participants were asked to choose between funding two hypothetical public health programs. Each program was described by its purpose; expected increase in life expectancy; and target audience. Demographically weighted generalized linear mixed-effects models were constructed to identify program factors associated with program selection.
Participants completed up to 8 discrete choice comparison exercises each resulting in 23,889 exercises were completed by 3054 participants. Selected programs were less likely to focus on prevention (vs. treatment). For each 1-year increase in the marginal years of life gained, there was a 15% increase in the odds of a program being selected. Interventions tailored to marginalized communities or targeting stigmatized health conditions were less likely to be selected compared to interventions targeted to the general population or targeting chronic health conditions. Noteworthy exceptions included an increased preference for interventions aligning with the perceived needs or cultural expectations for marginalized communities.
Stigmatizing perceptions of health conditions and key populations likely influence public health programming preferences of Canadians.
Informational campaigns highlighting disparities experienced by marginalized populations may improve support for targeted and tailored interventions.
评估公众对面向边缘社区的定制和靶向公共卫生干预措施的支持程度。
我们使用基于网络的调查进行了离散选择实验，该调查针对居住在加拿大的年龄大于 16 岁的 Facebook 和 Instagram 用户进行宣传。参与者被要求在两个假设的公共卫生计划之间进行选择。每个计划都通过其目的、预期寿命的增加和目标受众来描述。构建了人口加权广义线性混合效应模型，以确定与计划选择相关的计划因素。
参与者完成了最多 8 个离散选择比较练习，每个练习都有 3054 名参与者完成了 23889 次练习。选择的计划不太可能侧重于预防（而不是治疗）。每增加一年获得的边缘寿命，选择计划的几率就会增加 15%。与针对普通人群或针对慢性健康状况的干预措施相比，针对边缘化社区量身定制或针对污名化健康状况的干预措施不太可能被选中。值得注意的例外情况包括，人们更倾向于选择与边缘化社区的感知需求或文化期望相一致的干预措施。
对健康状况和重点人群的污名化看法可能会影响加拿大人对公共卫生计划的偏好。
强调边缘化人群所经历的差距的宣传活动可能会提高对有针对性和定制干预措施的支持。
