title: Consumer preferences for health and nonhealth outcomes of health promotion: results from a discrete choice experiment.
abstract: OBJECTIVE
  Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change.
  
  
  METHODS
  A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week.
  
  
  RESULTS
  With the exception of "time cost per week" and "start point of future health state," all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes "endurance," "days with sufficient relaxation," and "future health state value" had the greatest impact on consumer choices. The "life expectancy" attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade.
  
  
  CONCLUSIONS
  Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions.
authors: Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, Caphri, The Netherlands. a.goebbels@maastrichtuniversity.nl
authors: Adrienne F G
authors: AF
authors: Alayli-Goebbels
authors: Benedict G C
authors: BG
authors: Dellaert
authors: Stephanie A
authors: SA
authors: Knox
authors: André J H A
authors: AJ
authors: Ament
authors: Jeroen
authors: J
authors: Lakerveld
authors: Sandra D M
authors: SD
authors: Bot
authors: G
authors: G
authors: Nijpels
authors: J L
authors: JL
authors: Severens
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D057240:Patient Preference