Modelling attribute non-attendance in choice experiments for rural landscape valuation

Non-market effects of agriculture are often estimated using discrete choice models from stated preference surveys. In this context we propose two ways of modelling attribute non-attendance. The first involves constraining coefficients to zero in a latent class framework, whereas the second is based on stochastic attribute selection and grounded in Bayesian estimation. Their implications are explored in the context of a stated preference survey designed to value landscapes in Ireland. Taking account of attribute non-attendance with these data improves fit and tends to involve two attributes one of which is likely to be cost, thereby leading to substantive changes in derived welfare estimates.

Are caregiving responsibilities associated with non-attendance at breast screening?

Background: Previous research showed that deprived individuals are less likely to attend breast screening and those providing intense amounts of informal care tend to be more deprived than non-caregivers. The aim of this study was to examine the relationship between informal caregiving and uptake of breast screening and to determine if socio-economic gradients in screening attendance were explained by caregiving responsibilities.

It's not that I don't care, I just don't care very much: confounding between attribute non-attendance and taste heterogeneity

With the growing interest in the topic of attribute non-attendance, there is now widespread use of latent class (LC) structures aimed at capturing such behaviour, across a number of different fields. Specifically, these studies rely on a confirmatory LC model, using two separate values for each coefficient, one of which is fixed to zero while the other is estimated, and then use the obtained class probabilities as an indication of the degree of attribute non-attendance. In the present paper, we argue that this approach is in fact misguided, and that the results are likely to be affected by confounding with regular taste heterogeneity. We contrast the confirmatory model with an exploratory LC structure in which the values in both classes are estimated. We also put forward a combined latent class mixed logit model (LC-MMNL) which allows jointly for attribute non-attendance and for continuous taste heterogeneity. Across three separate case studies, the exploratory LC model clearly rejects the confirmatory LC approach and suggests that rates of non-attendance may be much lower than what is suggested by the standard model, or even zero. The combined LC-MMNL model similarly produces significant improvements in model fit, along with substantial reductions in the implied rate of attribute non-attendance, in some cases even eliminating the phenomena across the sample population. Our results thus call for a reappraisal of the large body of recent work that has implied high rates of attribute non-attendance for some attributes. Finally, we also highlight a number of general issues with attribute non-attendance, in particular relating to the computation of willingness to pay measures.

Stated attribute non-attendance in successive choice experiments

Attribute non-attendance in choice experiments affects WTP estimates and therefore the validity of the method. A recent strand of literature uses attenuated estimates of marginal utilities of ignored attributes. Following this approach, we propose a generalisation of the mixed logit model whereby the distribution of marginal utility coefficients of a stated non-attender has a potentially lower mean and lower variance than those of a stated attender. Model comparison shows that our shrinkage approach fits the data better and produces more reliable WTP estimates. We further find that while reliability of stated attribute non-attendance increases in successive choice experiments, it does not increase when respondents report having ignored the same attribute twice.

Joint use of attribute importance rankings and non-attendance data in choice experiments

The joint and alternative uses of attribute non-attendance and importance ranking data within discrete choice experiments are investigated using data from Lebanon examining consumers’ preferences for safety certification in food. We find that both types of information; attribute non-attendance and importance rankings, improve estimates of respondent utility. We introduce a method of integrating both types of information simultaneously and find that this outperforms models where either importance ranking or non-attendance data are used alone. As in previous studies, stated non-attendance of attributes was not found to be consistent with respondents having zero marginal utility for those attributes

Understanding barriers to attendance and non-attendance at Arts and Cultural Institutions: A Conceptual Framework

This paper draws together themes from within the leisure, arts and other literature related to why people might not attend cultural institutions and identifies eight barriers: 1) Physical; 2) Personal Access; 3) Cost; 4) Time and Timing; 5) Product; 6) Personal Interest; 7) Socialisation/Understanding; and 8) Information. Many of these barriers appear to be interrelated and as such strategies to address non-visitation will most likely need to be complex to allow the full range of barriers to be addressed.

Marketing cultural attractions : understanding non-attendance and visitation barriers

Purpose – The purpose of this paper is to draw together the previous academic and industry research on non-attendance of cultural attractions, followed by qualitative in-depth interviews to identify commonalities or gaps in the previous research on barriers, constraints and inhibitors, as well as to propose linkages between these.

Design/methodology/approach – A multi-method approach is used – where barriers, constraints and inhibitors are identified by means of thematic content analysis of the literature. A set of probing questions is developed based on these themes and is then examined in in-depth interviews with individuals that had not visited cultural attractions in the past two years, in an attempt to triangulate data, as well as to identify connections between barriers.

Findings – From the literature, eight interconnected barriers to visitation are identified: physical access; personal access; cost; time and timing; product; personal interest and peer group; socialisation and understanding; and information. The in-depth interviews generally support these, although it is also identified that there are complex interrelationships between the issues.

Originality/value – This paper addresses the neglected question of why people do not attend cultural attractions by triangulating thematic findings from the content analysis of diverse literature with in-depth interview responses from one non-visitor segment. This results in an interconnected model of barriers that can be used to assist managers to develop strategies addressing low visitation rates within targeted segments.

Health care professionals' views of paediatric outpatient non-attendance:implications for general practice

Background. Non-attendance at paediatric hospital outpatient appointments poses potential risks to children's health and welfare. Prevention and management of missed appointments depends on the perceptions of clinicians and decision makers from both primary and secondary care, including general practitioners (GPs) who are integral to non-attendance follow-up. Objectives. To examine the views of clinical, managerial and executive health care staff regarding occurrence and management of non-attendance at general paediatric outpatient clinics. Methods. A qualitative study using individual semi-structured interviews was carried out at three English Primary Care Trusts and a nearby children's hospital. Interviews were conducted with 37 staff, including GPs, hospital doctors, other health care professionals, managers, executives and commissioners. Participants were recruited through purposive and 'snowball' sampling methods. Data were analysed following a thematic framework approach. Results. GPs focused on situational difficulties for families, while hospital-based staff emphasized the influence of parents' beliefs on attendance. Managers, executives and commissioners presented a broad overview of both factors, but with less detailed views. All groups discussed sociodemographic factors, with non-attendance thought to be more likely in 'chaotic families'. Hospital interviewees emphasized child protection issues and the need for thorough follow-up of missed appointments. However, GPs were reluctant to interfere with parental responsibilities. Conclusion. Parental motivation and practical and social barriers should be considered. Responsibilities regarding missed appointments are not clear across health care sectors, but GPs are uniquely placed to address non-attendance issues and are central to child safeguarding. Primary care policies and strategies could be introduced to reduce non-attendance and ensure children receive the care they require. © The Author 2013.

A mixed methods investigation of parental factors in non-attendance at general paediatric hospital outpatient appointments

Non-attendance at paediatric outpatient appointments results in delayed diagnosis and treatment, putting children at risk of avoidable ill health, and incurring considerable health service costs. Links between missed appointments and clinical, socio-demographic, and access-related factors have been indicated, but parental cognitions associated with non-attendance have yet to be investigated. The aims of this project were to evaluate the effectiveness and theoretical bases of existing interventions designed to reduce non-attendance; to consider the ways in which missed appointments are managed by healthcare providers; to explore parents’ beliefs and experiences of attending and missing appointments; and to investigate the factors underlying these beliefs. A systematic literature review focusing on non-attendance interventions was conducted Within a mixed methods framework, interviews were conducted with healthcare professionals, subsequent interviews were conducted with parents who had attended or missed a General Paediatric outpatient appointment, and a cross-sectional questionnaire study of parents’ beliefs was implemented. The systematic review revealed that text message appointment reminders are effective at reducing non-attendance rates, but that no interventions have thus far been developed using theories of behaviour. Healthcare professionals recognised both barriers and parents’ beliefs as influences on attendance, but also believed there were ‘types’ of families who miss appointments. Healthcare professionals disagreed somewhat about how non-attendance should best be managed. The parent interview study found six themes. The findings reflect parents’ perceptions about the importance of attending and of their ability to attend. The results of the questionnaire study corroborate this structure of beliefs as the analysis produced two factors, the perceived ‘worth’ of attending and anticipated ‘worry’ when attending. This thesis demonstrates an original approach to investigating non-attendance at children’s outpatient appointments, using mixed methods and adopting a psychological rather than service-use perspective. The findings contribute to Health Psychology theory and offer recommendations for healthcare providers.