Exploring valuation of a modified EQ-5D-Y-3L adapted for 2–4 year olds: a think-aloud study

This study aimed to establish the feasibility of using discrete choice experiments (DCE) to value health states described by the modified EQ-5D-Y-3L adapted for 2-4-year-olds, and to explore participants’ views on relevant preferences, valuation perspective, age framing, and spillover effects, and how all of these are impacted by parental status. Online interviews were conducted with Australian adults, comprising six think-aloud DCE (imagining a hypothetical 3-year-old) and open-ended questions to explore the key aims. Interview transcripts were double-coded using an inductive and deductive approach and analysed using framework analysis. A total of 17 participants took part (parents/caregivers, n = 9; non-parents, n = 8). Participants emphasised the inclusion of preferences from parents/caregivers or professionals who interact with children. Participants tended to instinctively think of their own child or a child they know. Both caregiver and future spillover effects were observed, and participants included information beyond the description of the task when providing valuations. Participants reported a high level of ease and understanding in completing the DCE tasks. DCE appears to be feasible for obtaining stated preferences regarding dimension importance for the modified EQ-5D-Y-3L adapted for 2-4-year-olds. Participants expressed views that preferences for these health states should be elicited from adults with experience of young children. It is important for future valuation studies to examine the types of spillover effects and other factors influencing participants’ assessments of health states for young children.