Patricia M Herman1, Maia Ingram2, Charles E Cunningham3, Heather Rimas4, Lucy Murrieta5, Kenneth Schachter2, Jill Guernsey de Zapien2, Scott C Carvajal6. 1. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. pherman@rand.org. 2. University of Arizona, Zuckerman College of Public Health, 1295 N Martin Avenue, Tucson, AZ, 85724, USA. 3. Department of Psychiatry and Behavioural Neurosciences, Jack Laidlaw Chair in Patient-Centered Health Care, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada. 4. Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada. 5. Sunset Community Health Center, 2060 W. 24th Street, Yuma, AZ, 85364, USA. 6. Arizona Prevention Research Center, University of Arizona, Zuckerman College of Public Health, 1295 N Martin Avenue, Tucson, AZ, 85724, USA.
Abstract
BACKGROUND: Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services. OBJECTIVES: This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework. RESEARCH DESIGN: Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis. SUBJECTS: Focus group data were collected from 64 patients of a Federally-Qualified Health Center (FQHC) serving a predominantly low-income Hispanic population. A total of 604 patients in the waiting rooms of the FQHC responded to the DCE. MEASURES: The DCE contained 15 choice tasks that each asked respondents to choose between three mental health services options described by the levels of two (of eight) attributes based on themes that emerged from focus group data. RESULTS: The addition of the DCE was found to be feasible and useful in providing distinct information on relative patient preferences compared with the focus group analyses alone. According to market simulations, the package of mental health services guided by the results of the DCE was preferred by patients. CONCLUSIONS: Unique patterns of patient preferences were uncovered by the DCE and these findings were useful in identifying pragmatic solutions to better address the mental health service needs of this population. However, for this resource-intensive method to be adopted more broadly, the scale of the primary care setting and/or scope of the issue addressed have to be relatively large.
BACKGROUND: Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services. OBJECTIVES: This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework. RESEARCH DESIGN: Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis. SUBJECTS: Focus group data were collected from 64 patients of a Federally-Qualified Health Center (FQHC) serving a predominantly low-income Hispanic population. A total of 604 patients in the waiting rooms of the FQHC responded to the DCE. MEASURES: The DCE contained 15 choice tasks that each asked respondents to choose between three mental health services options described by the levels of two (of eight) attributes based on themes that emerged from focus group data. RESULTS: The addition of the DCE was found to be feasible and useful in providing distinct information on relative patient preferences compared with the focus group analyses alone. According to market simulations, the package of mental health services guided by the results of the DCE was preferred by patients. CONCLUSIONS: Unique patterns of patient preferences were uncovered by the DCE and these findings were useful in identifying pragmatic solutions to better address the mental health service needs of this population. However, for this resource-intensive method to be adopted more broadly, the scale of the primary care setting and/or scope of the issue addressed have to be relatively large.
Authors: Deborah Marshall; John F P Bridges; Brett Hauber; Ruthanne Cameron; Lauren Donnalley; Ken Fyie; F Reed Johnson Journal: Patient Date: 2010-12-01 Impact factor: 3.883
Authors: Robert A Bell; Debora A Paterniti; Rahman Azari; Paul R Duberstein; Ronald M Epstein; Aaron B Rochlen; Megan Dwight Johnson; Sharon E Orrange; Christina Slee; Richard L Kravitz Journal: Patient Educ Couns Date: 2009-08-11
Authors: M Ryan; D A Scott; C Reeves; A Bate; E R van Teijlingen; E M Russell; M Napper; C M Robb Journal: Health Technol Assess Date: 2001 Impact factor: 4.014