Using repeated choice experiments to evaluate the impact of policy changes on cervical screening

Abstract

Australia was one of the first countries to introduce a publicly funded Human Papilloma Virus (HPV) vaccine program, and its introduction coincided with a media campaign to promote regular cervical screening. One issue with HPV vaccination is how it impacts on demand for screening. This study examines changes in women's screening preferences following these two interventions, using a novel approach to policy evaluation based on repeated discrete choice experiments. The study extends our previous analysis of attitudes to screening by taking advantage of the timing of the choice experiments to examine the impact of the two policy changes on determinants of screening. We find that, unexpectedly, willingness to screen is generally lower post-interventions. The reason for this trend appears to be related to HPV vaccination. We also find that interventions have minor impacts on how women value screening attributes. Our approach allows us to examine the impact of provider behaviour. A simulation demonstrates that under certain conditions, participation rates can be increased by 40% to 50% if health providers actively encourage women to undertake a cervical screening test.