Developing a Preference Assessment Tool for Use among Minority and Low Literacy Primary Care Patients

Incorporating patients’ preferences into healthcare decisions has been identified as one mechanism for reducing health disparities. Some research suggests that providers need to tailor medical recommendations to the preferences of their patients. Yet there are few tools to facilitate clarification of preferences for health services. This paper reports the process of testing an innovative preference elicitation technique—conjoint analysis—among minorities and low literacy patients using the example of colorectal cancer (CRC) screening. CRC screening exemplifies preference-sensitive healthcare as there exist several screening options. However, screening rates among minorities are low. Better methods for preference assessment could improve patient-provider communication and increase patient adherence. This study used qualitative methods and piloting to refine and finalize a conjoint analysis preference assessment instrument. We conclude that conjoint analysis is a viable preference assessment methodology for use in vulnerable populations with appropriate tailoring of materials. Future work will evaluate integrating this method into clinical decision tools.