Developing Attributes and Attribute-Levels for a Discrete-Choice Experiment: An Example for Interventions of Impulsive Violent Offenders
Discrete-Choice Experiments (DCEs) are used to assess the strength of preferences and value of interventions, but researchers using the method have been criticised for failing to either undertake or publish the rigorous research for selecting the necessary attributes and levels. The aim of this study was to elicit attributes to inform a DCE to assess societal and offenders’ preferences for, and value of, treatment of impulsive-violent offenders. In doing so, this paper thoroughly describes the process and methods used in developing the DCE attributes and levels.
Four techniques were used to derive the final list of attributes and levels: (1) a narrative literature review to derive conceptual attributes; (2) seven focus group discussions (FGDs) comprising 25 participants including offenders and the general public and one in-depth interview with an offender’s family member to generate contextual attributes; (3) priority-setting methods of voting and ranking to indicate participants’ attributes of preference; (4) a Delphi method consensus exercise with 13 experts from the justice health space to generate the final list of attributes.
Following the literature review and qualitative data collection, 23 attributes were refined to eight using the Delphi method. These were: treatment effectiveness, location and continuity of treatment, treatment type, treatment provider, voluntary participation, flexibility of appointments, treatment of co-morbidities and cost.
Society and offenders identified similar characteristics of treatment programs as being important. The mixed methods approach described in this manuscript contributes to the existing limited methodological literature in DCE attribute development.
We acknowledge all focus group and in-depth interview participants (who chose anonymity), for their time and involvement in this study. We also acknowledge the following experts (listed are those that provided consent to be identified) in the justice and health space, who responded positively to an invitation to participate in the Delphi method process of this study: Forensic Psychiatrists: David Greenberg, Daria Korobanova; Criminologists: Melanie Simpson. Caitlin Hughes, Stacie Tzoumakis; Justice Health nurses: Noella Ellis, John Nguyen; Psychologists: Emma Barrett, Anindita Sudewo. We acknowledge the REINVESt study coordinator, Lee Knight, for his role in coordinating study participants for the FGDs and providing general guidance on the tools used and the conduct of the interviews.
Stella, Marian, Georgina, Peter and Tony were involved in the design of the study, data analysis, and write up. Stella and Tony were involved in the recruitment of participants. Stella and Lise (with Lise taking lead in interviewing) were involved in the conducting of FGDs and interview and qualitative data analysis. Paul was involved in the analysis of FGDs. Paul and Stella were involved in the design, conduct and analysis of the Delphi method component (with Paul taking the lead in its conduct). All authors contributed majorly to the write up of the manuscript.
Compliance with Ethical Standards
This study was funded by Grants from the National Health and Medical Research Council, under the Centre of Research Excellence in Offender Health Australia [grant number RG124596]. It is part of the research done by the Justice and Health program, Kirby Institute.
The study received ethics approval from three committees: UNSW human research ethics committee, Corrective Services NSW human research ethics committee, and Aboriginal Health and Medical Research Council human research committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflicts of Interest
All authors, that is Stella Nalukwago Settumba, Marian Shanahan, Tony Butler, Peter Schofield, Lise Lafferty, Paul Simpson and Georgina M. Chambers, have no conflicts of interest to declare.
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