Valuing Australian parent preferences for community-based nutrition and physical activity initiatives: a discrete choice experiment

Parent engagement in community-based obesity prevention interventions (CBOPIs) enhances obesity prevention outcomes. Actions from CBOPIs may also have climate change-related impacts, but little is known about specific elements of CBOPIs that promote parental engagement, and whether parents prefer CBOPIs that aim to address obesity alone or obesity and climate change warrants further investigation. An unlabelled 12-choice task discrete choice experiment (DCE) was undertaken, using a D-efficient design and incorporating two CBOPI alternatives plus an opt-out alternative. CBOPIs were described by six attributes: cost, aim, involvement, effectiveness, convenience, and social opportunities. Attributes were informed by a literature review of enablers and barriers to parent participation. The survey was electronically distributed to parents of primary-school-aged children in each Australian state and territory during April-May 2024. Data were analysed using conditional logit models, and willingness-to-pay for attributes was estimated. Parents (n = 438) preferred less costly CBOPIs (P < .001) that aim to address both healthy lifestyles and climate change (P = .086). Parents preferred short-term, manageable disruptions to family schedules to accommodate CBOPI participation (P = <.001) over no intervention. They were willing to pay an additional $3.97 per fortnight (∼$104.000 per year) for CBOPI participation to be convenient (standard error 1.380, P = .004). Our findings suggest that parents preferred CBOPIs that aim to address both healthy lifestyles and climate change. This suggests that incorporating climate change action into CBOPIs may increase parent support and consequently support CBOPI outcomes for both obesity prevention and climate change action.