Individual preferences for the design of a health coaching-based lifestyle promotion program among middle-aged adults in Hong Kong: a discrete choice experiment.

Abstract

Objectives: Health coaching is an effective approach to motivating lifestyle modifications and preventing the onset of non-communicable diseases. This study aims to examine middle-aged adults' preferences for health coaching programs to improve public acceptance of these programs.

Methods: A discrete choice experiment (DCE) was conducted among adults aged 35-59 years in Hong Kong who were recruited from a population-based cohort established to evaluate outcomes related to long COVID. The DCE attributes and levels were selected based on a literature review and qualitative interviews (n = 10) with users and providers from a local health coaching program. The selected attributes included program duration, delivery mode of coaching sessions, frequency of coaching sessions, availability of blood tests, core program format, smartwatch usage, and out-of-pocket payment. An online survey with 10 choice sets was conducted to collect participants' choices regarding health coaching services with (copayment scenario, 10 choices) and without out-of-pocket payment (no copayment scenario, 10 choices). A mixed logit model and a latent class model were used for the analysis.

Results: A total of 912 responses were collected, of which 554 valid records were included in the analysis. In the copayment scenario, participants preferred programs that provided a smartwatch and a lower copayment rate. In the no copayment scenario, participants preferred a moderate coaching frequency, communication via phone calls or text messages, and provision of a smartwatch. Distinct preference groups were identified, including those who preferred face-to-face versus remote modes of delivery, high versus low contact frequency, and those who were sensitive versus insensitive to cost.

Conclusions: Lower copayment and smartwatch provision improve acceptance of health coaching programs. Substantial preference heterogeneity for program duration, health coaching frequency, and delivery mode was found. While material incentives are important for improving acceptance of health coaching, considerable preference heterogeneity for non-monetary attributes suggests that options for health coaching program intensity can be offered along with subsidies or lower out-of-pocket payment to promote these services.