Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

Genie, Mesfin G; Loría-Rebolledo, Luis Enrique; Paranjothy, Shantini; Powell, Daniel; Ryan, Mandy; Sakowsky, Ruben Andreas; Watson, Verity

doi:10.1136/bmjopen-2020-043477

Cited by 21 publications

(24 citation statements)

References 35 publications

(24 reference statements)

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“…Between May and November 2020, many noteworthy health preference studies examined various aspects of COVID-19 in the United States [6] and in other countries [7][8][9][10][11][12][13]. Hopefully, many more studies will follow, building an evidentiary basis to inform the development of public health programs [14].…”

Section: Introductionmentioning

confidence: 99%

United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

Craig

2021

Patient

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Background Shortly after the 2020 US election, initial evidence on first-generation COVID-19 vaccines showed 70–95% efficacy and minimal risks. Yet, many US adults expressed reluctance. Aims The aim of this study was to compare persons willing and unwilling to be vaccinated against COVID-19 and to estimate the effects of vaccination attributes on uptake: proof of vaccination, vaccination setting, effectiveness, duration of immunity, and risk of severe side effects. Method Between 9 and 11 November 2020, 1153 US adults completed a discrete choice experiment (DCE) on Phase 2 of the CDC Vaccination Program (August 2021). Each of its eight choice tasks had three vaccination alternatives and “no vaccination for 6 months.” An opt-out inflated logit model was estimated to test for respondent differences and attribute effects. Results Respondent demographics were unrelated to one’s willingness to be vaccinated ( p value 0.533), but those with less education were more likely to be unwilling ( p < 0.001). Among those willing, uptake ranged from 61.70 to 97.75%, depending on the vaccination attributes. Effectiveness and safety had the largest effects. Offering proof of vaccination and a choice of setting increased uptake as much as increasing immunity from 3 to 6 months. Conclusions To maximize uptake, the CDC Program should standardize proof of vaccination and offer a choice of setting, instead of a one-size-fits-all approach. If the first-generation vaccines are efficacious, widely available, and free, overall predicted uptake is 68.81% by the end of Phase 2 (August 2021), which is well below the 75–90% needed for herd immunity. Further health preference research is necessary to uncover and address unwillingness and reluctance to vaccinate against COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-021-00508-0.

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Section: Introductionmentioning

confidence: 99%

United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

Craig

2021

Patient

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“…A more detailed description of the development stage can be found in the study’s published protocol. [22]…”

Section: Methodsmentioning

confidence: 99%

“…The minimal sample size for the DCE given the eight tasks per respondent, a baseline choice probability of 50% (given there were two options in each choice set), an accuracy level of 90% and a confidence level of 95%, using Louviere’s formula for choice proportions, was 49 respondents. [22] Given that we aimed to estimate preferences using flexible logit models, we aimed for a conservative size of 1000 per nation in the UK.…”

Section: Methodsmentioning

confidence: 99%

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Public acceptability of non-pharmaceutical interventions to control a pandemic in the United Kingdom: a discrete choice experiment

Loría-Rebolledo

Ryan

Watson

et al. 2021

Preprint

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Objective To understand how individuals make trade-offs between features of lockdown interventions to control a pandemic across the four nations of the United Kingdom. Design Survey that included a Discrete Choice Experiment (DCE). The survey design was informed using policy documents, social media analysis and with input from remote think aloud interviews with members of the public (n=23). Setting Nation-wide survey across the four nations of the United Kingdom. Representative sample in terms of age and sex for each of the nations recruited using an online panel between 29th October and 12th December 2020. Participants Individuals who are over 18 years old. A total of 4120 adults completed the survey (1112 in England, 848 in Northern Ireland, 1143 in Scotland and 1098 in Wales). Primary outcome measure Adult preferences for, and trade-offs between, type of lockdown restrictions, length of lockdown, postponement of routine healthcare, excess deaths, impact on ability to buy things and unemployment. Results In all four countries, one out of five respondents were willing to reduce excess deaths at all costs. The majority of adults are willing to accept higher excess deaths if this means lockdowns that are less strict, shorter and do not postpone routine healthcare. On average, respondents in England were willing to accept a higher increase in excess deaths to have less strict lockdown restrictions introduced compared to Scotland, Northern Ireland, and Wales, respectively. Conclusions The majority of the UK population is willing to accept the increase in excess deaths associated with introducing less strict lockdown restrictions. The acceptability of different restriction scenarios varies according to the features of the lockdown and across countries. Authorities can use information about trade-off preferences to inform the introduction of different lockdown restriction levels, and design compensation policies that maximise societal welfare.

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“…After the outbreak of SARS-CoV-2 (Corona virus), contact and exit restrictions, distance between people, hygiene rules, mandatory masking, and other interventions were introduced to protect public health and prevent overburdening the health care system. These measures have an impact on economic, social, and cultural life [1][2][3]. Lockdowns have been conducted repeatedly over several weeks, and in some cases have transitioned to tighter lockdown.…”

Section: Introductionmentioning

confidence: 99%

Population preferences for non-pharmaceutical interventions to control the SARS-CoV-2 pandemic: trade-offs among public health, individual rights, and economics

2022

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Problem Policymakers must decide on interventions to control the pandemic. These decisions are driven by weighing the risks and benefits of various non-pharmaceutical intervention alternatives. Due to the nature of the pandemic, these decisions are not based on sufficient evidence regarding the effects, nor are decision-makers informed about the willingness of populations to accept the economic and health risks associated with different policy options. This empirical study seeks to reduce uncertainty by measuring population preferences for non-pharmaceutical interventions. Methods An online-based discrete choice experiment (DCE) was conducted to elicit population preferences. Respondents were asked to choose between three pandemic scenarios with different interventions and impacts of the Corona pandemic. In addition, Best–worst scaling (BWS) was used to analyze the impact of the duration of individual interventions on people’s acceptance. The marginal rate of substitution was applied to estimate willingness-to-accept (WTA) for each intervention and effect by risk of infection. Results Data from 3006 respondents were included in the analysis. The DCE showed, economic effect of non-pharmaceutical measures had a large impact on choice decisions for or against specific lockdown scenarios. Individual income decreases had the most impact. Excess mortality and individual risk of infection were also important factors influencing choice decisions. Curfews, contact restrictions, facility closures, personal data transmissions, and mandatory masking in public had a lesser impact. However, significant standard deviations in the random parameter logit model (RPL) indicated heterogeneities in the study population. The BWS results showed that short-term restrictions were more likely to be accepted than long-term restrictions. According to WTA estimates, people would be willing to accept a greater risk of infection to avoid loss of income. Discussion The results can be used to determine which consequences of pandemic measures would be more severe for the population. For example, the results show that citizens want to limit the decline in individual income during pandemic measures. Participation in preference studies can also inform citizens about potential tradeoffs that decision-makers face in current and future decisions during a pandemic. Knowledge of the population’s preferences will help inform decisions that consider people’s perspectives and expectations for the future. Survey results can inform decision-makers about the extent to which the population is willing to accept certain lockdown measures, such as curfews, contact restrictions, lockdowns, or mandatory masks.

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Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

Cited by 21 publications

References 35 publications

United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

Public acceptability of non-pharmaceutical interventions to control a pandemic in the United Kingdom: a discrete choice experiment

Population preferences for non-pharmaceutical interventions to control the SARS-CoV-2 pandemic: trade-offs among public health, individual rights, and economics

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