What are colorectal cancer survivors' preferences for dietary advice? A best-worst discrete choice experiment

Stuart J Wright, Debbie Gibson, Martin Eden, Simon Lal, Chris Todd, Andy Ness, Sorrel Burden, Stuart J Wright, Debbie Gibson, Martin Eden, Simon Lal, Chris Todd, Andy Ness, Sorrel Burden

Abstract

Purpose: Studies on healthy lifestyle interventions in survivors of colorectal cancer have been disappointing, demonstrating only modest changes. This study aims to quantify people's preferences for different aspects of dietary intervention.

Method: A best-worst discrete choice experiment was designed and incorporated into a questionnaire including participants' characteristics and a self-assessment of lifestyle.

Results: The response rate was 68% and 179 questionnaires were analysed. When analysing aggregate preferences, the modes of information provision selected as the most preferred were "face-to-face" (willingness to pay (WTP) £63.97, p ≤ 0.001) and "telephone" (WTP £62.36, p < 0.001) discussions whereas group discussions were preferred least (WTP -£118.96, p ≤ 0.001). Scenarios that included hospitals were most preferred (WTP £17.94, p = 0.031), and the favoured provider was bowel cancer nurses (WTP £75.11, p ≤ 0.001). When investigating preference heterogeneity, three sub-groups were identified: Firstly, "technophiles" preferring email (WTP £239.60, p ≤ 0.001) were male, were younger and had fewer risk factors. Secondly, a "one-to-one" group had strong preference for interventions over the telephone or at their local doctors and were older (WTP £642.13, p ≤ 0.001). Finally, a "person-centred" group preferred face-to-face individual or group sessions (WTP £358.79, p < 0.001) and had a high risk lifestyle.

Conclusion: For survivors of colorectal cancer, there is not one approach that suits all when it comes to providing dietary advice.

Implications for cancer survivors: This is important information to consider when planning healthy lifestyle interventions which include dietary advice for survivors of colorectal cancer. Aligning services to individuals' preferences has the potential to improve patient experience and outcomes by increasing uptake of healthy lifestyle advice services and promoting a more tailored approach to dietary modifications, acknowledging sub-groups of people within the total population of colorectal cancer survivors.

Keywords: Colorectal cancer; Conjoint experiments; Discrete choice experiments; Information dietary; Survivorship.

Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

Funding

The study was funded as part of a Senior Clinical Lectureship on the Clinical Academics Training programme, National Institute of Health Research, UK.

Ethics approval and consent to participate

Ethics approval was gained from NRES Committee London - South East (Research Ethics Committee reference /LO/0399). A patient information sheet was provided, and participant consent was assumed on the receipt of a completed questionnaire.

Availability of data and material

These data are not publically available, but investigators who wish to access specific parts of the data should contact the corresponding author.

Figures

Fig. 1
Fig. 1
An example question with different attributes and levels

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