Co-designing a joint protection program for hand osteoarthritis: a latent-class discrete choice experiment of patient preferences

Abstract Objectives To quantify patient preferences for key Joint Protection Program (JPP) delivery components and identify preference segments to inform a patient-centred, technology-enabled program. Methods Attributes and levels were developed via 3 focus groups with 16 people living with HOA. A discrete choice experiment (six attributes with two levels each; 16 choice tasks; three unlabelled alternatives; no opt-out) was fielded online. Choices were analyzed using latent-class choice models with effects coding with 1–6 class solutions were compared by AIC/BIC and segment sizes. Within-class relative attribute importance was calculated from part-worth ranges and overall (class-adjusted) importance was computed using class membership probabilities. Results A total of 150 participants with HOA completed the survey (89% women; mean age 68 years). Latent-class modelling identified five distinct preference segments (segment sizes: 34%, 18%, 10.7%, 21.3%, and 16%). Across segments, clinician-led Q&A (class-adjusted importance 23.7%) and clinician-delivered exercise demonstrations (21.5%) consistently drove choices. Other features showed marked heterogeneity: one large segment strongly preferred short (2–7 min) videos (importance 56.1%), while others were indifferent to video length; interaction mode split respondents between asynchronous forums and live monthly meetings; and lived-experience guest speakers were valued by some segments but actively traded off by others. Quizzes were conflicting, adding value in some classes and reducing it in others. Conclusion Delivery preferences were heterogeneous, but clinician involvement Q&A and clinician‑led demonstrations anchored preferences. The remaining features functioned as tuneable options. A configurable JPP that preserves clinician touchpoints and allows patients to select preferred formats is best aligned with revealed preferences.