Public preferences for mosquito-borne disease prevention interventions in metropolitan France: a discrete choice experiment

Abstract Background Mosquito-borne diseases (MBDs), e.g., dengue, are an emerging public health threat in metropolitan France. While various preventive strategies exist, their real-world success depends on public uptake and adherence. However, research quantifying population preferences for these interventions remains scarce in non-endemic European settings. This study aimed to elicit preferences for key MBD preventive interventions to inform the design of acceptable health policies. Methods We conducted a cross-sectional online survey in November 2023, recruiting a representative sample of adults aged 18–79 residing in metropolitan France ( N = 2,087). We employed a discrete choice experiment (DCE) to elicit preferences. Participants completed ten unlabeled, forced-choice A vs. B tasks, selecting between two hypothetical intervention scenarios defined by four attributes: participation (e.g., government-led vs. individual), intervention frequency, environmental effects, and human health side effects. Average preferences and preference heterogeneity for each MBD attribute were retrieved from mixed multinomial logistic (MMNL) models with correlated random parameters. The drivers of preference heterogeneity were further assessed using interaction effects with respondents’ characteristics and simulations were performed to assess optimal interventions that achieved greatest gains in aggregated utility. Results All attributes influenced hypothetical decisions. Respondents exhibited the strongest aversion to interventions with systematic negative effects on animals and vegetation (β = -1.77), followed closely by those carrying risks of rare but serious human health side effects (β = -1.48). In terms of governance, government-led implementation was preferred over approaches relying on individual or community compliance. Notably, measures dependent on full community participation were disliked (β = -0.50). While interventions requiring greater time commitment reduced utility (β = -0.22), convenience was a secondary driver compared to health safety. Simulation analysis indicated that installing insect screens yielded the highest predicted utility, while chemical fumigation would generate highest welfare losses. Conclusions Public acceptability of MBD prevention in France hinges critically on environmental and health safety rather than convenience. The findings reveal a preference for centralized, government-managed interventions over those requiring coordinated community effort and compliance. To maximize uptake, policymakers should prioritize environmentally safe interventions and adopt transparent communication strategies that directly address public concerns regarding ecological impact and health side effects.