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Maternal choices and preferences for screening strategies of gestational diabetes mellitus: an exploratory study using discrete choice experiment

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posted on 2023-05-21, 14:52 authored by Xu, T, Jing, Y, Guo, X, Julie CampbellJulie Campbell, Hasnat AhmadHasnat Ahmad, Qing Xia, Lai, X, Yan, D, Ma, L, Fang, H, Andrew PalmerAndrew Palmer

Aims:This study aimed to investigate maternal preferences for gestational diabetes mellitus (GDM) screening options in rural China to identify an optimal GDM screening strategy.

Methods: Pregnant women at 24–28 gestational weeks were recruited from Shandong province, China. A discrete choice experiment (DCE) was conducted to elicit pregnant women’s preferences for GDM screening strategy defined by five attributes: number of blood draws, out-of-pocket costs, screening waiting-time, number of hospital visits, and positive diagnosis rate. A mixed logistic model was employed to quantify maternal preferences, and to estimate the relative importance of included attributes in determining pregnant women’s preferences for two routinely applied screening strategies (“one-step”: 75 g oral glucose tolerance test [OGTT] and “two-step”: 50 g glucose challenge-test plus 75 g OGTT). Preference heterogeneity was also investigated.

Results:N = 287 participants completed the DCE survey. All five predefined attributes were associated with pregnant women’s preferences. Diagnostic rate was the most influential attribute (17.5 vs. 8.0%, OR: 2.89; 95%CI: 2.10 to 3.96). When changes of the attributes of “two-step” to “one-step” strategies, women’s uptake probability from full “two-step” to “one-step” significantly increased with 71.3% (95%CI: 52.2 to 90.1%), but no significant difference with the first of “two-step” (−31.0%, 95%CI: −70.2 to 8.1%).


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Frontiers in Public Health



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Menzies Institute for Medical Research


Frontiers Research Foundation

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© 2022 Xu, Jiang, Guo, Campbell, Ahmad, Xia, Lai, Yan, Ma, Fang and Palmer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) .

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Socio-economic Objectives

Public health (excl. specific population health) not elsewhere classified

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