Participation and psychosocial supports in the school setting for children with type 1 diabetes: A discrete choice experiment of carer priority.

School-based diabetes care is an important consideration for clinicians and families alike. This Discrete-Choice Experiment describes parental preference for enhanced psychosocial and activity-focused supports over academic supports for children with Type 1 diabetes in Australian primary and secondary schools.

The role of mental health in online gambling decisions: A discrete choice experiment.

People with mental health problems are more likely to experience problems due to gambling, an intersection of two sources of social disadvantage. However, the mechanisms by which this occurs remain unclear. Analysing if choices while gambling differ for people with mental health problems, and whether these differences involve characteristics linked with gambling harms, can improve this understanding. Evidence on this is limited because most studies rely on survey questions or aggregate data which are either self-reported, unlikely to allow for identification of separate features of gambling options, or do not observe the full set of options people are choosing between. Discrete Choice Experiments can circumvent these issues by observing the gambling environment and individual's gambling choices. This study uses a Discrete Choice Experiment to analyse people's choices while gambling, and if these differ for people with mental health problems. Participants were offered a series of 6 choice sets representing online gambling on horse racing; each presented two hypothetical horse races, both with eight horses, differing in the information they provided. Participants chose which race (if any) and horse they would bet on. The choices were modelled using mixed logit models. People with mental health problems had (i) a lower preference for betting on races with information about horses' recent form and (ii) preferred betting on horses with higher odds. (i) Could indicate that they put less thought into their bet, a sign of gambling as an escape. (ii) Could indicate that they are more risk seeking. These are two gambling characteristics linked with problems due to gambling and are plausible mechanisms by which people with mental health problems may be more likely to develop problems due to gambling.

Preferences of parents for mental health services to suit children with chronic medical conditions.

Objectives To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care. Methods A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children's Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity. Results The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities. Conclusions Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care.

An Economic Model of Gambling Behaviour: A Two-Stage Approach.

Gambling can cause significant harms and these can result in a net negative utility from participation, although lower levels of participation have potential benefits and can yield positive net utility. It is therefore important to understand and distinguish between these two stages of gambling behaviour. Currently, economic models have had limited focus on explaining why someone would gamble despite it yielding a negative utility. Here, we present a two-stage model, motivated by empirical literature and intuitive assumptions, that improves on existing economic models by distinguishing between the likelihood of gambling participation and of gambling that yields a negative utility. The model's predictions are empirically testable, consistent with existing literature, and add new insights. The model's ability to distinguish between the two stages helps to inform interventions that aim to reduce the prevalence of gambling-related harm while avoiding the need for restrictive approaches that aim to eliminate gambling altogether.