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Purpose: The goal of the study was to develop and pilot test a tool that can be used by state health departments as an aid in deciding which HIV prevention interventions ought to be funded. It serves to assist health department officials to organize their though processes by using explicit criteria to evaluate proposed HIV prevention interventions ensure that decision-makers consider all important factors in a systematic and comprehensive manner.
Methods: The model chosen for this project was a multi-attribute utility framework, which may best be thought of as a variant of an expected utility model commonly encountered in research on human judgment and decision making. Variables for the model were derived according to the following steps. First, a broad list of organizational, programmatic, and social attributes was created based on focus groups with health department personnel from across the United States (U.S.). These attributes were identified as being of greatest importance in the decision to fund HIV prevention interventions. Second, attributes were weighted by decision-makers (HIV Prevention Community Planning Group Co-Chairs) across the U.S. in relation to their relative importance in the funding process. Third, the attributes were rated by two pilot sites (two state health departments in the U.S.) with respect to HIV prevention interventions to be funded at these sites. The multi-attribute model was used to combine attribute weights and ratings for HIV prevention interventions being proposed by local agencies thereby yielding a score for each intervention. Once each intervention had a score, the next step entailed a linear programming maximization technique that maximized HIV prevention intervention scores subject to each health department’s budget constraint.
Results: For the first pilot site, the multi-attribute model recommended funding all of the proposed interventions, except two. In this case, almost all of the interventions could be funded because the health department budget was slightly smaller than the total cost of all the interventions. A similar situation held for the second pilot site: the budget was sufficient to fund almost all HIV prevention interventions.
Conclusions: Our tool could considered as a welcomed addition to the health departments’ way of funding HIV prevention interventions. The model can help decision-makers maximize the value of spending on HIV prevention.
See more of Poster Session - Clinical Strategies; Judgment and Decison Making
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)