A Comparison of Methods for Capturing Patient Preferences for Delivery of Mental Health Services to Low-Income Hispanics Engaged in Primary Care

  • Patricia M. HermanEmail author
  • Maia Ingram
  • Charles E. Cunningham
  • Heather Rimas
  • Lucy Murrieta
  • Kenneth Schachter
  • Jill Guernsey de Zapien
  • Scott C. Carvajal
Original Research Article



Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services.


This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework.

Research Design

Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis.


Focus group data were collected from 64 patients of a Federally-Qualified Health Center (FQHC) serving a predominantly low-income Hispanic population. A total of 604 patients in the waiting rooms of the FQHC responded to the DCE.


The DCE contained 15 choice tasks that each asked respondents to choose between three mental health services options described by the levels of two (of eight) attributes based on themes that emerged from focus group data.


The addition of the DCE was found to be feasible and useful in providing distinct information on relative patient preferences compared with the focus group analyses alone. According to market simulations, the package of mental health services guided by the results of the DCE was preferred by patients.


Unique patterns of patient preferences were uncovered by the DCE and these findings were useful in identifying pragmatic solutions to better address the mental health service needs of this population. However, for this resource-intensive method to be adopted more broadly, the scale of the primary care setting and/or scope of the issue addressed have to be relatively large.


Focus Group Mental Health Service Choice Task Conjoint Analytic Importance Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to acknowledge the partnership of the Sunset Community Health Center in carrying out this research, and the Sunset Community Health Workers who participated in research activities.

Compliance with Ethical Standards

This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Pilot Project Program award (1IP2PI000275-01). The participation of Dr. Cunningham and Ms. Rimas was supported by the Jack Laidlaw Chair in Patient-Centered Health Care. Lucy Murrieta is an employee of the FQHC that was the subject of this research. With the exception of Ms. Murrieta’s employment status, all authors declare that they have no conflicts of interest, financial or otherwise, with respect to this research. Our study received exempt approval from the University of Arizona Institutional Review Board. Informed consent was obtained from all individual participants included in this study.

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. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Patricia M. Herman
    • 1
    Email author
  • Maia Ingram
    • 2
  • Charles E. Cunningham
    • 3
  • Heather Rimas
    • 4
  • Lucy Murrieta
    • 5
  • Kenneth Schachter
    • 2
  • Jill Guernsey de Zapien
    • 2
  • Scott C. Carvajal
    • 6
  1. 1.RAND CorporationSanta MonicaUSA
  2. 2.University of Arizona, Zuckerman College of Public HealthTucsonUSA
  3. 3.Department of Psychiatry and Behavioural Neurosciences, Jack Laidlaw Chair in Patient-Centered Health Care, Faculty of Health Sciences, Michael G. DeGroote School of MedicineMcMaster UniversityHamiltonCanada
  4. 4.Department of Psychiatry and Behavioral NeurosciencesMcMaster UniversityHamiltonCanada
  5. 5.Sunset Community Health CenterYumaUSA
  6. 6.Arizona Prevention Research CenterUniversity of Arizona, Zuckerman College of Public HealthTucsonUSA

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