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Healthcare Worker Preferences for Active Tuberculosis Case Finding Programs in South Africa: A Best-Worst Scaling Choice Experiment

Author

Listed:
  • Nathan N O’Hara
  • Lilla Roy
  • Lyndsay M O’Hara
  • Jerry M Spiegel
  • Larry D Lynd
  • J Mark FitzGerald
  • Annalee Yassi
  • Letshego E Nophale
  • Carlo A Marra

Abstract

Objective: Healthcare workers (HCWs) in South Africa are at a high risk of developing active tuberculosis (TB) due to their occupational exposures. This study aimed to systematically quantify and compare the preferred attributes of an active TB case finding program for HCWs in South Africa. Methods: A Best–Worst Scaling choice experiment estimated HCW’s preferences using a random-effects conditional logit model. Latent class analysis (LCA) was used to explore heterogeneity in preferences. Results: “No cost”, “the assurance of confidentiality”, “no wait” and testing at the occupational health unit at one’s hospital were the most preferred attributes. LCA identified a four class model with consistent differences in preference strength. Sex, occupation, and the time since a previous TB test were statistically significant predictors of class membership. Conclusions: The findings support the strengthening of occupational health units in South Africa to offer free and confidential active TB case finding programs for HCWs with minimal wait times. There is considerable variation in active TB case finding preferences amongst HCWs of different gender, occupation, and testing history. Attention to heterogeneity in preferences should optimize screening utilization of target HCW populations.

Suggested Citation

  • Nathan N O’Hara & Lilla Roy & Lyndsay M O’Hara & Jerry M Spiegel & Larry D Lynd & J Mark FitzGerald & Annalee Yassi & Letshego E Nophale & Carlo A Marra, 2015. "Healthcare Worker Preferences for Active Tuberculosis Case Finding Programs in South Africa: A Best-Worst Scaling Choice Experiment," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-13, July.
    • Handle: RePEc:plo:pone00:0133304
    DOI: 10.1371/journal.pone.0133304
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    References listed on IDEAS

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    2. Emily Lancsar & Jordan Louviere, 2008. "Conducting Discrete Choice Experiments to Inform Healthcare Decision Making," PharmacoEconomics, Springer, vol. 26(8), pages 661-677, August.
    3. Flynn, Terry N. & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2007. "Best-worst scaling: What it can do for health care research and how to do it," Journal of Health Economics, Elsevier, vol. 26(1), pages 171-189, January.
    4. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74, pages 132-132.
    5. Rajnish Joshi & Arthur L Reingold & Dick Menzies & Madhukar Pai, 2006. "Tuberculosis among Health-Care Workers in Low- and Middle-Income Countries: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 3(12), pages 1-16, December.
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