University of Twente Student Theses

Conjoint analysis of community-based childhood obesity prevention: people's preferences regarding the outcomes of obesity prevention programs and their willingness to pay for a change in the outcomes

Ilgun, Michael (2012) Conjoint analysis of community-based childhood obesity prevention: people's preferences regarding the outcomes of obesity prevention programs and their willingness to pay for a change in the outcomes.

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Abstract:	INTRODUCTION: In current evaluations of obesity prevention programs for children the effectiveness of the program is mainly based on weight loss. Sustainability of effects after the program, however, co-depends on individual’s continuous adherence to healthy eating habits and exercise behaviors. This adherence is not only determined by weight loss but is also co-determined by, for example, social factors and psychological factors. It is also important to consider costs incurred by households because community-based prevention programs typically rely upon their participation. Because the own contribution may influence the motivation for participation and continuation of the desired behavior, it may also affect the reach and sustainability of program effects. OBJECTIVE: The primary aim of this research was to identify what outcome measures capture people’s preferences in youth obesity prevention and how much people were willing to pay for a change in an outcome measure. In this research it was investigated which outcome measures, beyond weight loss, were relevant to children and their parents. In the process a conjoint analysis was conducted. Data of approximately 150 households were collected for analysis. METHODS: Data was collected through a discrete choice experiment among parents and children living in the municipalities Cuijk and Rijnwaarden in the Netherlands. A d-efficient design with a balanced overlap was developed. Twenty random and two fixed choice-tasks (for consistency purposes) were used. To improve the statistical strength of the questionnaire, four different versions of the questionnaire were developed in which the levels of the outcome measures (attributes) varied. Using the results of an extensive literature search conducted in 2011 on outcome measures related with overweight the following attributes were included in the questionnaire: weight, mental wellbeing, social wellbeing, lifestyle, and monthly household costs. Dummy coding was used for the levels of the attributes. The conditional logit model was used for the analysis, which was performed in SPSS with a Cox regression analysis. RESULTS: One hundred thirty respondents completed the questionnaire, from which 126 (97%) passed the consistency test. All the levels, with the exception of the cost attribute levels, had the expected sign and were significant at the 5% level. Most preferred outcome measure was weight, followed by mental wellbeing, lifestyle, and social wellbeing. Coefficient of the cost level €20 was positive rather than negative as expected, suggesting that respondents were willing to pay more for less desirable outcomes compared to the coefficient of the reference cost level €10 (€143 for a loss of one utility). Reexamination of the data indicated that respondents were most likely cost insensitive up to and including the cost level €20. Ignoring this problem and calculating the cost coefficient using the cost levels €10 and €30 coefficients as reference levels, resulted in respondents willing to pay: €950 for a change from ‘obese’ to ‘normal weight’ (€706+€244),€724 for a change from ‘worse than average’ mental wellbeing to ‘better than average’ mental wellbeing (€627+€97), €487 for a change from ‘worse than average’ social wellbeing to ‘better than average’ social wellbeing (€428+€59), and €552 for a change from ‘unhealthy lifestyle’ to ‘healthy lifestyle’. CONCLUSION: Children and their parents value the level of weight as the most preferred outcome, followed by mental wellbeing, lifestyle, and social wellbeing. Willingness to Pay for a change in an outcome is much more than €30 for respondents with a household income close to or above the national average household income of €33,000.
Item Type:	Essay (Master)
Faculty:	BMS: Behavioural, Management and Social Sciences
Subject:	85 business administration, organizational science
Programme:	Health Sciences MSc (66851)
Link to this item:	https://purl.utwente.nl/essays/61944
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