Understanding Preferences for Preconception Care in Australia: Insights From a Discrete Choice Experiment

了解澳大利亚孕前保健偏好:来自离散选择实验的启示

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Abstract

BACKGROUND: Preconception care (PCC) aims to optimise health before pregnancy by addressing risk factors. This improves conception rates, pregnancy outcomes, and the health of future generations. Despite its benefits, preconception care in Australia is underutilised due to the rate of unplanned pregnancies and inadequate care before pregnancy. Evidence is lacking on consumer preferences for PCC services. METHODS: A discrete choice experiment was designed to investigate preferences of Australian adults for the delivery of PCC services in primary care. An online survey including 12 choice tasks describing alternate PCC service configurations was completed by a sample of the general population. Data were analysed using mixed logit and latent class models to identify key attributes influencing decision-making and explore preference heterogeneity. RESULTS: A total of 485 respondents of a generally representative sample of Australian adults completed the online survey. Most respondents (67%) indicated that they had either not heard of PCC or were unsure if they had. Choice modelling results indicated strong preferences for PCC services delivered face-to-face, particularly by specialist obstetricians. Lower out-of-pocket costs and the inclusion of incentives were also important drivers of preferences. CONCLUSIONS: Increasing awareness of PCC and its importance to the health of parents and babies is essential to improve uptake. Reducing costs and offering incentives may further encourage engagement with PCC services. The results highlight the lack of knowledge concerning the skills of nurse practitioners and pharmacists who are well placed to contribute to PCC delivery in primary care.

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