Patient message preferences to promote clinical conversations about chronic obstructive pulmonary disease (COPD): A discrete choice experiment

Samantha R Paige; Janice L Krieger; Maribeth Williams; Ramzi G Salloum

doi:10.1016/j.pecinn.2023.100168

Patient message preferences to promote clinical conversations about chronic obstructive pulmonary disease (COPD): A discrete choice experiment

PEC Innov. 2023 May 25:2:100168. doi: 10.1016/j.pecinn.2023.100168. eCollection 2023 Dec.

Authors

Samantha R Paige^{1

2

3}, Janice L Krieger¹, Maribeth Williams⁴, Ramzi G Salloum²

Affiliations

¹ STEM Translational Communication Center, University of Florida, Gainesville, FL 32611, USA.
² Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
³ Health & Wellness Solutions, Johnson & Johnson Services, Inc., New Brunswick, NJ 08933, USA.
⁴ Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA.

Abstract

The purpose of this study was to identify message features that motivate patients to initiate clinical conversations about Chronic Obstructive Pulmonary Disease (COPD). A secondary aim was to determine whether preferred message features vary by socio-demographic and behavioral characteristics. A discrete choice experiment was conducted in August 2020. Participants were asked to select which messages would motivate them to speak with a clinician about COPD. This included selecting messages across 8 choice sets, or a systematic combination of messages reflecting 6 attributes (e.g., susceptibility, call-to-action, emotion-frame, efficacy, message source, organizational support). The final sample was 928, which included adults (M = 62.07; SD = 10.14 years old) who identified as non-Hispanic, white, and with at least some college experience. Message attributes ranked from most to least important were COPD susceptibility (25.53% [95% CI = 24.39, 26.66]), message source (19.32% [95% CI = 18.41-20.24]), COPD organization logo (19.13%; [95% CI = 18.26, 20.01]), call-to-action (14.12%; [95% CI = 13.40, 14.85], emotion-frame (13.24% [95% CI = 12.55-13.94]), and efficacy (8.65%; [95% CI = 8.20-9.09]). Participants preferred susceptibility messages about COPD signs/symptoms rather than risk behaviors related to smoking tobacco and environmental exposures. They also preferred messages from medical authorities (i.e., clinicians, COPD organization), a call-to-action that supports their autonomy in screening decision-making, and a message that conveys hope for living a healthy life with COPD and builds their self-efficacy to get screened. Differences in message preferences were detected according to age, gender, race, ethnicity, education level, and current vs. former smoking status. This study identified message features that motivate clinical conversations about COPD, especially those from subgroups who are disproportionately at-risk for its late-stage diagnosis.

Keywords: COPD; Discrete choice experiment; Health communication; Intervention.