Lawrence Mwenge, Matthew Quaife, Lucheka Sigande, Sian Floyd, Melvin Simuyaba, Mwelwa Phiri, Chisanga Mwansa, Mutale Kabumbu, Musonda Simwinga, Kwame Shanaube, Ab Schaap, Sarah Fidler, Richard Hayes, Helen Ayles, Bernadette Hensen, Peter Hangoma
{"title":"与用户共同设计医疗保健干预：一项离散选择实验，以了解赞比亚卢萨卡年轻人对性和生殖健康服务的偏好。","authors":"Lawrence Mwenge, Matthew Quaife, Lucheka Sigande, Sian Floyd, Melvin Simuyaba, Mwelwa Phiri, Chisanga Mwansa, Mutale Kabumbu, Musonda Simwinga, Kwame Shanaube, Ab Schaap, Sarah Fidler, Richard Hayes, Helen Ayles, Bernadette Hensen, Peter Hangoma","doi":"10.1007/s40271-025-00737-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Like in many countries, coverage of sexual and reproductive health (SRH) services among adolescents and young people (AYP) aged 15-24 remains low in Zambia. Increasing coverage of SRH services requires interventions that are responsive to the needs and preferences of AYP. We conducted a discrete choice experiment (DCE) to elicit AYP's preferences for SRH service delivery in Lusaka, Zambia.</p><p><strong>Methods: </strong>A cross-sectional DCE was conducted with AYP aged 15-24 years. Consenting participants were presented with alternative SRH service delivery strategies represented by six attributes, namely: location, type of provider, type of services, service differentiation by sex, availability of edutainment, and opening hours. Multinomial logit and random parameters logit models were used to analyse the data. All variables were effect coded.</p><p><strong>Results: </strong>A total of 423 AYP aged 15-24 years (61% female) completed the DCE. Respondents preferred SRH services that were integrated with other healthcare services (b = 0.65, p < 0.001), delivered by medical staff and peer support workers (b = 0.44, p < 0.001), and provided at a hub within a health facility (b = 0.62, p < 0.001). AYP also preferred services to be available on weekends during the daytime (b = 0.37, p < 0.001). Participants also preferred alternatives which included edutainment (b = 0.22, p < 0.001). Service differentiation by sex had little effect on the preference for SRH service delivery (b = - 0.05, p = 0.08). The coefficient for the \"neither\" option was negative and statistically significant (b = - 5.31, p < 0.001), implying that AYP did not favor routine SRH service delivery in an outpatient department.</p><p><strong>Conclusion: </strong>Efforts to increase SRH service utilization among AYP should focus on providing comprehensive SRH services that are integrated with other healthcare services. These services should be delivered by a combination of medical staff and peer supporter workers in youth-friendly spaces. Careful attention should be paid to opening times to ensure that these are convenient to AYP.</p>","PeriodicalId":51271,"journal":{"name":"Patient-Patient Centered Outcomes Research","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Co-designing Healthcare Interventions with Users: A Discrete Choice Experiment to Understand Young People's Preferences for Sexual and Reproductive Health Services in Lusaka, Zambia.\",\"authors\":\"Lawrence Mwenge, Matthew Quaife, Lucheka Sigande, Sian Floyd, Melvin Simuyaba, Mwelwa Phiri, Chisanga Mwansa, Mutale Kabumbu, Musonda Simwinga, Kwame Shanaube, Ab Schaap, Sarah Fidler, Richard Hayes, Helen Ayles, Bernadette Hensen, Peter Hangoma\",\"doi\":\"10.1007/s40271-025-00737-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Like in many countries, coverage of sexual and reproductive health (SRH) services among adolescents and young people (AYP) aged 15-24 remains low in Zambia. Increasing coverage of SRH services requires interventions that are responsive to the needs and preferences of AYP. We conducted a discrete choice experiment (DCE) to elicit AYP's preferences for SRH service delivery in Lusaka, Zambia.</p><p><strong>Methods: </strong>A cross-sectional DCE was conducted with AYP aged 15-24 years. Consenting participants were presented with alternative SRH service delivery strategies represented by six attributes, namely: location, type of provider, type of services, service differentiation by sex, availability of edutainment, and opening hours. Multinomial logit and random parameters logit models were used to analyse the data. All variables were effect coded.</p><p><strong>Results: </strong>A total of 423 AYP aged 15-24 years (61% female) completed the DCE. Respondents preferred SRH services that were integrated with other healthcare services (b = 0.65, p < 0.001), delivered by medical staff and peer support workers (b = 0.44, p < 0.001), and provided at a hub within a health facility (b = 0.62, p < 0.001). AYP also preferred services to be available on weekends during the daytime (b = 0.37, p < 0.001). Participants also preferred alternatives which included edutainment (b = 0.22, p < 0.001). Service differentiation by sex had little effect on the preference for SRH service delivery (b = - 0.05, p = 0.08). The coefficient for the \\\"neither\\\" option was negative and statistically significant (b = - 5.31, p < 0.001), implying that AYP did not favor routine SRH service delivery in an outpatient department.</p><p><strong>Conclusion: </strong>Efforts to increase SRH service utilization among AYP should focus on providing comprehensive SRH services that are integrated with other healthcare services. These services should be delivered by a combination of medical staff and peer supporter workers in youth-friendly spaces. Careful attention should be paid to opening times to ensure that these are convenient to AYP.</p>\",\"PeriodicalId\":51271,\"journal\":{\"name\":\"Patient-Patient Centered Outcomes Research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Patient-Patient Centered Outcomes Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40271-025-00737-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient-Patient Centered Outcomes Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40271-025-00737-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
导言：与许多国家一样，赞比亚15-24岁青少年和青年的性健康和生殖健康服务覆盖率仍然很低。提高性健康和生殖健康服务的覆盖率，需要采取符合计划需要和偏好的干预措施。我们进行了一项离散选择实验（DCE），以引出赞比亚卢萨卡的AYP对SRH服务提供的偏好。方法：15 ~ 24岁AYP患者行横断面DCE。向同意的参与者展示了由六个属性表示的替代性性健康和健康服务提供策略，即：地点、提供者类型、服务类型、按性别区分的服务、教育娱乐的可用性和开放时间。采用多项logit和随机参数logit模型对数据进行分析。所有变量都进行了效果编码。结果：共有423名15-24岁的AYP（61%为女性）完成了DCE。被调查者更喜欢与其他保健服务相结合的性健康和生殖健康服务（b = 0.65, p < 0.001），由医务人员和同伴支持工作者提供（b = 0.44, p < 0.001），并在卫生机构内的中心提供（b = 0.62, p < 0.001）。AYP还倾向于在周末白天提供服务（b = 0.37, p < 0.001）。参与者还更喜欢包括寓教于乐在内的替代方案（b = 0.22, p < 0.001）。性别服务差异对SRH服务提供偏好影响不大（b = - 0.05, p = 0.08）。“两者都不是”选项的系数为负且具有统计学意义（b = - 5.31, p < 0.001），这意味着AYP不支持门诊的常规SRH服务提供。结论：提高青少年生殖健康服务利用率的重点应放在提供与其他医疗服务相结合的综合生殖健康服务上。这些服务应由医务人员和同侪支持工作者在青年友好空间共同提供。应仔细注意开放时间，以确保方便AYP。
Co-designing Healthcare Interventions with Users: A Discrete Choice Experiment to Understand Young People's Preferences for Sexual and Reproductive Health Services in Lusaka, Zambia.
Introduction: Like in many countries, coverage of sexual and reproductive health (SRH) services among adolescents and young people (AYP) aged 15-24 remains low in Zambia. Increasing coverage of SRH services requires interventions that are responsive to the needs and preferences of AYP. We conducted a discrete choice experiment (DCE) to elicit AYP's preferences for SRH service delivery in Lusaka, Zambia.
Methods: A cross-sectional DCE was conducted with AYP aged 15-24 years. Consenting participants were presented with alternative SRH service delivery strategies represented by six attributes, namely: location, type of provider, type of services, service differentiation by sex, availability of edutainment, and opening hours. Multinomial logit and random parameters logit models were used to analyse the data. All variables were effect coded.
Results: A total of 423 AYP aged 15-24 years (61% female) completed the DCE. Respondents preferred SRH services that were integrated with other healthcare services (b = 0.65, p < 0.001), delivered by medical staff and peer support workers (b = 0.44, p < 0.001), and provided at a hub within a health facility (b = 0.62, p < 0.001). AYP also preferred services to be available on weekends during the daytime (b = 0.37, p < 0.001). Participants also preferred alternatives which included edutainment (b = 0.22, p < 0.001). Service differentiation by sex had little effect on the preference for SRH service delivery (b = - 0.05, p = 0.08). The coefficient for the "neither" option was negative and statistically significant (b = - 5.31, p < 0.001), implying that AYP did not favor routine SRH service delivery in an outpatient department.
Conclusion: Efforts to increase SRH service utilization among AYP should focus on providing comprehensive SRH services that are integrated with other healthcare services. These services should be delivered by a combination of medical staff and peer supporter workers in youth-friendly spaces. Careful attention should be paid to opening times to ensure that these are convenient to AYP.
期刊介绍：
The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence.
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