Preferences and willingness to pay for early childhood healthy lifestyle initiative outcomes: A discrete choice experiment.

Background: Understanding stakeholder preferences and values for early childhood initiatives to support healthy diets, physical activity and reduce sedentary behaviour is key for effective intervention design and resource allocation. This study aims to estimate the preferences for and value of outcomes from the perspectives of parents/caregivers of Australian children aged from birth to 5 years.

Methods: Discrete choice experiment, 466 parent/caregivers recruited from online platform. Participants selected between two healthy lifestyle initiatives or a "neither" option. Initiatives were described by attributes including cost, participation and outcomes. Mixed multinomial logistic models were used to determine preferences and willingness-to-pay per annum framed as an increase in income taxes.

Results: Effect on diet was the most important influence on parent/caregiver choice to participate (p < 0.01), followed by effect on physical activity (p < 0.01), wellbeing (p < 0.01) and healthy growth (p < 0.01). Parents/caregivers were less sensitive to cost for initiatives aimed at specific children (e.g., targeted initiatives for a priority population). Willingness-to-pay estimates ranged from AUD$176 for improved wellbeing to $219 for healthier diets.

Conclusions: Results suggest that leveraging the potential for healthier diets, followed by healthier physical activity behaviours, as a key benefit of participation may be particularly attractive to parents/caregivers. In addition, some level of equity preference could be acceptable to parents/caregivers in the allocation of scarce resources.