title: High-risk individuals' willingness to pay for diabetes risk-reduction programs.
abstract: OBJECTIVE
  The purpose of this study was to estimate how much at-risk individuals are willing to pay for type 2 diabetes primary prevention programs.
  
  
  METHODS
  An Internet-based, choice-format conjoint survey was presented to individuals at elevated risk for type 2 diabetes. Hypothetical diabetes risk-reduction programs included seven features: diet, exercise, counseling, medication, weight loss goal, risk reduction, and program costs. The sample included 582 individuals aged > or =45 years, two-thirds of whom were obese. Conditional logit models were used to calculate participants' willingness to pay for risk reduction programs. Each respondent's self-assessed risk of developing diabetes was compared with an objective measure based on a diabetes screening tool.
  
  
  RESULTS
  Many respondents underestimated their personal risk of developing diabetes. Those with a low perceived risk were less likely to indicate that they would participate in a diabetes prevention program. Individuals had the strongest preference for programs with large weight loss goals, fewer restrictions on diet, and larger reductions in the risk of diabetes. Respondents were willing to pay approximately $1,500 over 3 years to participate in a lifestyle intervention program similar to the Diabetes Prevention Program. Individuals with a high perceived risk were willing to pay more than individuals with lower perceived risk.
  
  
  CONCLUSIONS
  Many individuals will be willing to participate in interventions to delay or prevent diabetes if the interventions are subsidized, but most will be unwilling to pay the full program cost. Our results also offer insights for designing risk-reduction programs that appeal to potential participants.
authors.affiliation: RTI-UNC Center for Excellence in Health Promotion Economics, RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA.
authors.forename: F Reed
authors.initials: FR
authors.lastname: Johnson
authors.forename: Ranjani
authors.initials: R
authors.lastname: Manjunath
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mansfield
authors.forename: Laurel J
authors.initials: LJ
authors.lastname: Clayton
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hoerger
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
mesh_terms: D001294:Attitude to Health; D003376:Counseling; D003920:Diabetes Mellitus / Q000191:economics* / Q000517:prevention & control / Q000523:psychology*; D004032:Diet; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D040242:Risk Reduction Behavior; D015431:Weight Loss