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APHA Scientific Session and Event Listing

Christine Unson, Dr, Department of Public Health, Southern Connecticut State University, 44 Farhman Road, New Haven, CT 06515, (203) 392 7029, Unsonc1@southernct.edu

PURPOSE: Research investigating how patients choose from several treatment alternatives is limited. Most health behavior research is conducted in the context of one behavior (treatment vs. no treatment). This exploratory study examines the attributes that older women consider most important when selecting a medication to treat or prevent osteoporosis. METHOD: 107 African-American women were selected from voter registration rolls of a metropolitan city and by snowballing technique. Each treatment (1) calcium/vitamin D, 2) estrogen replacement therapy, 3) bisphosphonates, and 4) selective estrogen receptive modulators and (5) no treatment were characterized in terms of price, increase/decrease in risks for breast cancer, blood clots, and decrease in hip and spinal fractures. Conjoint analysis was used to generate 16 hypothetical medications based on combinations of these attributes. The women rated whether they were likely or not likely to use these hypothetical medications. RESULTS: The average participant was 70.1 years (SD 6.7), had 11.4 years (SD 3.9) of schooling, and a monthly household income of $1,560 (SD $1,500). Utility scores which indicate preference based on these ratings show that increased risks of cancer and blood clots followed by reductions in hip and spinal fracture risks were the most important attributes that determined a woman's choice. Goodness-of-fit measures were acceptable. Overall, the most preferred modes of treatment were calcium/vitamin D and no treatment. CONCLUSION: Risk avoidance appears to be given more consideration than increased benefits in women's decisions to select from alternative medications for osteoporosis. Findings can help increase understanding of patients' decision-making processes.

Learning Objectives:

• Become familiar with the issues concerning decision-making in the context of several treatment alternatives
• Learn about Conjoint Analysis, a statistical procedure for estimating preference scores of attributes of a set of treatment alternatives
• Learn about older African-American women's concerns regarding medications for osteoporos

Keywords: Decision-Making, Medicine

Presenting author's disclosure statement:

Not Answered