David Cameron

Bridging the gaps among research, policy and practice in ten low- and middle-income countries: Development and testing of a questionnaire for researchers

BackgroundA questionnaire could assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. No questionnaire focused on researchers engagement in bridging activities related to high-priority topics (or the potential correlates of their engagement) has been developed and tested in a range of low- and middle-income countries (LMICs).MethodsCountry teams from ten LMICs (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal, and Tanzania) participated in the development and testing of a questionnaire. To assess reliability we calculated the internal consistency of items within each of the ten conceptual domains related to bridging activities (specifically Cronbachs alpha). To assess face and content validity we convened several teleconferences and a workshop. To assess construct validity we calculated the correlation between scales and counts (i.e., criterion measures) for the three countries that employed both and we calculated the correlation between different but theoretically related (i.e., convergent) measures for all countries.ResultsInternal consistency (Cronbachs alpha) for sets of related items was very high, ranging from 0.89 (0.86-0.91) to 0.96 (0.95-0.97), suggesting some item redundancy. Both face and content validity were determined to be high. Assessments of construct validity using criterion-related measures showed statistically significant associations for related measures (with gammas ranging from 0.36 to 0.73). Assessments using convergent measures also showed significant associations (with gammas ranging from 0.30 to 0.50).ConclusionsWhile no direct comparison can be made to a comparable questionnaire, our findings do suggest a number of strengths of the questionnaire but also the need to reduce item redundancy and to test its capacity to monitor changes over time.

The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey

We present the results of a randomized experiment to test the effectiveness and cost-effectiveness of response incentives for a stated-preference survey of a general community population. The survey was administered using a mixed-mode approach, in which community members were invited to participate using a traditional mailed letter using contact information for a representative sample of the community; but individuals completed the survey via the web, which exploited the advantages of electronic capture. Individuals were randomized to four incentive groups: (a) no incentive, (b) prepaid cash incentive (

Clinicians' assessments of practice guidelines in oncology: The CAPGO survey

2), (c) a low lottery (10 prizes of

Willingness-to-Pay for Parallel Private Health Insurance: Evidence from a Laboratory Experiment

25) and (d) a high lottery (2 prizes of

Judgments regarding the fair division of goods: the impact of verbal versus quantitative descriptions of alternative divisions

250). Letters of invitation were mailed to 3,000 individuals. In total, 405 individuals (14.4%) contacted the website and 277 (9.8%) provided complete responses. The prepaid cash incentive generated the highest contact and response rates (23.3 and 17.3%, respectively), and no incentive generated the lowest (9.1 and 5.7%, respectively). The high lottery, however, was the most cost-effective incentive for obtaining completed surveys: compared with no incentive, the incremental cost-effectiveness ratio (ICER) per completed survey for high lottery was

Willingness-To-Pay for Parallel Private Health Insurance: Evidence from a Laboratory Experiment (Volonté De Payer Pour Des Services Parallèles D’Assurance Santé: Résultats D’Une Expérience De Laboratoire)

13.89; for prepaid cash, the ICER was

Practitioner Feedback on Lung Cancer Practice Guidelines in Ontario

18.29. This finding suggests that the preferred response incentive for community-based, stated-preference surveys is a lottery with a small number of large prizes.

A Behavioral Economic Study of Tax Rate Selection by the Median Voter: Can the Tax Rate Be Influenced by the Name of the Publicly Provided Private Good?

OBJECTIVESnPromoting the adoption of clinical practice guidelines is a challenging task. Research shows that adopters beliefs about guidelines and the process of their development are important predictors of guideline use. Our objective is to report on the development and refinement of an instrument designed to measure oncologists assessments of guidelines in oncology.nnnMETHODnA theoretically derived instrument was drafted. Oncologists were asked to complete a questionnaire for each draft guideline they were asked to review. Factor analyses and multilevel modeling techniques were undertaken to explore the properties of the instrument and refine it.nnnRESULTSnA total of 488 Ontario clinicians were sent 1494 new questionnaires regarding 34 clinical practice guidelines produced between 1999 and 2002. A refined eighteen-item questionnaire with four stable factors that predicted 60 percent of the variance emerged. The factors are interpreted as guideline quality, applicability, acceptability, and comparative value. The four factors predicted oncologists endorsements of draft guidelines and, with the exception of quality, predicted their intentions to use the guidelines. As expected, variation in the factor scores could be attributed more to the differences among the oncologist who completed the survey than to the differences among the guidelines themselves.nnnCONCLUSIONSnAn instrument composed of four stable and theoretically relevant factors emerged. The findings support the hypothesis that beliefs about guideline attributes and development attributes relate to oncologists endorsement of and intentions to use guidelines. Our next step is to link the responses of the survey with actual clinical behavior.

An experimental investigation of mixed systems of public and private health care finance

Debate over the effects of public versus private health care finance persists in both academic and policy circles. This paper presents the results of a revealed preference laboratory experiment that tests how characteristics of the public health system affect a subjects willingness-to-pay (WTP) for parallel private health insurance. Consistent with the theoretical predictions of Cuff et al. (2010), subjects’ average WTP is lower and the size of the private insurance sector smaller when the public system allocates health care based on need rather than randomly and when the probability of receiving health care from the public system is high. (Les debats continuent quant aux effets compares du financement prive et public des soins de santea la fois dans le monde academique et le monde des definisseurs de politiques. Ce memoire presente les resultats d’une experience de laboratoire destinee a reveler les preferences et a montrer comment des caracteristiques du systeme public de soins de sante affectent la volonte de payer pour des services paralleles d’assurance sante privee. En ligne avec les predictions theoriques de Cuff et al. (2010), la volonte moyenne de payer est plus faible et la taille du secteur de l’assurance privee plus petite quand le regime public est fonde sur les besoins plutot qu’aleatoire, et quand la probabilite de recevoir les soins du regime public est elevee.)

Support for public provision of a private good with top-up and opt-out: A controlled laboratory experiment

This article uses a stated-preference survey to investigate the impact on judgments regarding the fair division of a fixed supply of a good of differing types of information by which to describe five distributional principles. The three types of information are quantitative information only (the predominant approach in existing studies), verbal information only, and both quantitative and verbal information. The five distributional principles are equal division among recipients, Rawlsian maximin, total benefit maximization (TBM), equal benefit (EB) for recipients, and allocation according to relative need (RN) among recipients. We find important informational effects on judgments of the fair division of each of two health-related goods (pain-relief pills and apples consumed to obtain an essential vitamin): judgments based on quantitative information only are consistent with previous research; changing to verbal descriptions causes a notable shift in support among principles, and in particular greater support for the principle of TBM; judgments based on both quantitative and verbal information match more closely those made with only quantitative information. The pattern of judgments is consistent with the hypothesis that subjects do not fully understand the relationship between the conceptual meaning of the principles (as described verbally) and their implied quantitative divisions. We also find evidence of modest differential judgments across goods (pills vs. apples), sample effects (university vs. community), and sex effects, and little support for a non-zero allocation principle.