RT Journal Article
SR Electronic
T1 Using Best-Worst Scaling to Understand Patient Priorities: A Case Example of Papanicolaou Tests for Homeless Women
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 359
OP 364
DO 10.1370/afm.1937
VO 14
IS 4
A1 Eve Wittenberg
A1 Monica Bharel
A1 John F. P. Bridges
A1 Zachary Ward
A1 Linda Weinreb
YR 2016
UL http://www.annfammed.org/content/14/4/359.abstract
AB PURPOSE Best-worst scaling (BWS) is a survey method for assessing individuals’ priorities. It identifies the extremes—best and worst items, most and least important factors, biggest and smallest influences—among sets. In this article, we demonstrate an application of BWS in a primary care setting to illustrate its use in identifying patient priorities for services.METHODS We conducted a BWS survey in 2014 in Boston, Massachusetts, to assess the relative importance of 10 previously identified attributes of Papanicolaou (Pap) testing services among women experiencing homelessness. Women were asked to evaluate 11 sets of 5 attributes of Pap services, and identify which attribute among each set would have the biggest and smallest influence on promoting uptake. We show how frequency analysis can be used to analyze results.RESULTS In all, 165 women participated, a response rate of 72%. We identified the most and least salient influences on encouraging Pap screening based on their frequency of report among our sample, with possible standardized scores ranging from+1.0 (biggest influence) to −1.0 (smallest influence). Most important was the availability of support for issues beyond health (+0.39), while least important was the availability of accommodations for personal hygiene (−0.27).CONCLUSIONS BWS quantifies patient priorities in a manner that is transparent and accessible. It is easily comprehendible by patients and relatively easy to administer. Our application illustrates its use in a vulnerable population, showing that factors beyond those typically provided in health care settings are highly important to women in seeking Pap screening. This approach can be applied to other health care services where prioritization is helpful to guide decisions.