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Evaluates private forest landowner participation in the Natural Heritage Program of North Carolina. Effectiveness of voluntary conservation programs in recognizing and preserving the value of special places on private forestlands; Elements of natural diversity; Mechanisms for voluntary protection.

Introduction: Despite recent advances in treatment for psoriatic arthritis (PsA), many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain. To further characterize these unmet needs, we evaluated patients' experiences regarding the burden of PsA symptoms and disease impacts, and patients' preferences for treatment. Methods: Patients from ArthritisPower, a rheumatology research registry, completed a web-based survey. Object case best–worst scaling (BWS) was used to evaluate the relative burden of 11 PsA-related symptoms and the relative importance of improvement in nine PsA-related disease impacts. BWS data were analyzed using a random-parameters logit model. Patient demographics, preferences for mode and frequency of therapy, and preferences for methotrexate were analyzed descriptively. Results: Among the 332 participants, most were White (94%), female (80%), with mean age of 54 years (SD 11.4). In the BWS, joint pain was the most bothersome symptom, followed by other musculoskeletal pain and fatigue. The BWS for disease impacts found that improvements in the ability to perform physical activities were most important, followed by improvements in the ability to function independently, sleep quality, and the ability to perform daily activities. The most burdensome symptoms and desired disease impact improvements were similar in patients regardless of their experience with biologic disease-modifying antirheumatic drugs. The most preferred mode and frequency of treatment administration was oral, once-daily medication (preferred by 38% of respondents), and 74% prioritized therapies that significantly improved joint-related symptoms versus psoriasis-related symptoms. The majority of respondents (65%) preferred PsA treatment regimens that did not include methotrexate. Conclusions: Patients with PsA from a rheumatology registry found musculoskeletal pain symptoms to be the most bothersome and prioritized improvements to functional impacts of their disease. These findings can better inform development of new therapies and guide shared patient-provider treatment decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative interviews were conducted and a survey instrument was developed to inform the implementation of a general population screening program for T1D in children and to quantify screening-test attributes relevant to parents and physicians in the United States. Methods: Semi-structured qualitative interviews were conducted with parents and physicians to understand views on general population screening for T1D and identify important attributes of screening programs. Using the results, a discrete-choice experiment (DCE) survey instrument was developed to quantify preferences over multiple options. The survey was pretested using interviews to confirm attribute relevance and respondent comprehension. Results: In the qualitative interviews (10 parents, 10 physicians), test accuracy and the availability of treatments to delay onset or lessen T1D-associated health risks ranked as important. Parents' concerns included the need for venipuncture and the cost of the test. Physicians' concerns included the emotional impact of positive results on families and test reimbursement. A DCE survey was developed with 5 attributes covering when, where, and how the sample for screening is obtained; cost; monitoring and education to reduce the risk of DKA; and availability of an optional treatment to delay T1D. In the pretest interviews (15 parents, 15 pediatricians), the relevance of the attributes was confirmed. The pretest sample placed the most value on reducing the risk of DKA and the availability of a treatment to delay T1D onset. Low cost and convenience were considered key to widespread adoption by pediatricians. Conclusions: Two sets of interviews confirmed an interest in general population T1D screening, but follow-up treatment for a positive result was the key driver for acceptance. The survey will be administered to 1,000 parents and 500 pediatricians to quantify the importance of screening attributes with the goal of informing the implementation of a general population T1D screening program. Disclosure: J.L. Dunne: None. J. Sutphin: Other Relationship; Self; Multiple Companies. J.S. Bushman: None. B. Fontanals-Cirera: None. J.R. Coulter: Other Relationship; Self; Multiple companies. C.T. Hutton: None. A. Koralova: Research Support; Spouse/Partner; Bristol-Myers Squibb Company. C.M. Ervin: Other Relationship; Self; Multiple companies. C. Mansfield: Other Relationship; Self; Multiple companies. Funding: JDRF; The Leona M. and Harry B. Helmsley Charitable Trust [ABSTRACT FROM AUTHOR]

Introduction: Qualitative and quantitative methods provide different and complementary insights into patients' preferences for treatment. Objective: The aim of this study was to use a novel, mixed-methods approach employing qualitative and quantitative approaches to generate preliminary insights into patient preferences for the treatment of a rare disease—generalized myasthenia gravis (gMG). Methods: We conducted a mixed-methods study to collect exploratory qualitative and quantitative patient preference information and generate informative results within a condensed timeline (about 4 months). Recruitment was facilitated by an international health research firm. Study participants first reviewed a brief document describing six treatment attributes (to facilitate more efficient review of the material during the focus groups) and were then provided a link to complete an online quantitative survey with a single risk threshold task. They then participated in online focus groups, during which they discussed qualitative questions about their experience with gMG treatment and completed up to three quantitative threshold tasks, the first of which repeated the threshold task from the online survey. Results: The study elicited both quantitative data on 18 participants' risk tolerance and qualitative data on their treatment experience, additional treatment attributes of importance, the reasoning behind their preferences, and the trade-offs they were willing to make. Most participants (n = 15) chose the same hypothetical treatment in the first threshold task in the online survey and the focus groups. Focus group discussions provided insights into participants' choices in the threshold tasks, confirmed that all the attributes were relevant, and helped clarify what was important about the attributes. Conclusions: Patient preference information can be collected using a variety of approaches, both qualitative and quantitative, tailored to fit the research needs of a study. The novel mixed-methods approach employed in this study efficiently captured patient preference data that were informative for exploratory research, internal decision making, and future research. [ABSTRACT FROM AUTHOR]

Introduction: Existing biomedical HIV prevention options, though highly effective, present substantial adherence challenges. End‐user input on early‐stage design of new HIV prevention approaches is critical to yielding products that achieve high uptake and adherence. The iPrevent Study examined youths' preferences for key attributes of long‐acting Pre‐Exposure Prophylaxis (PrEP), with a focus on characteristics pertinent to product delivery alongside key modifiable product attributes. Methods: A discrete choice experiment was conducted with female and male youth aged 18 to 24 in two high‐density communities in Cape Town, South Africa during the period July 2017 to January 2019. Sexually active, PrEP‐naïve youth were recruited using population‐based sampling; targeted sampling was used to enrol men who have sex with men (MSM). In a series of nine questions, participants were asked to choose between two hypothetical products composed of five attributes (form, dosing frequency, access, pain, insertion site). We used a random‐parameters logit model to estimate preference weights and trade‐offs among product alternatives. We examined differences across three subgroups: females, men who have sex with only women (MSW) and MSM. Results: A total of 807 participants (401 female) were enrolled with a median age of 21 years. Males included 190 MSM. Most youth had tested for HIV (95%) and reported being HIV‐negative (91%). Across all groups, duration of effectiveness was the most important attribute, with strong preference for less frequent dosing. Injections were favoured over implants, though these preferences were strongest for females and MSM. Females preferred a product offered at a health clinic and disliked pharmacy access; all groups preferred the arm as the insertion site. Youth were willing to trade their preferred product form for longer duration. Conclusions: Youth indicated strong preferences for longer duration products. Each attribute nonetheless influenced preferences, offering insight into trade‐offs that inform long‐acting PrEP development. [ABSTRACT FROM AUTHOR]

Aim: Patient preferences for the features of targeted chronic lymphocytic leukemia (CLL) therapies may differ. Materials & methods: A discrete-choice experiment (DCE) survey was administered to 229 respondents recruited through the CLL Society. Results: Respondents placed most importance on increasing the chance of progression-free survival (PFS) at 2 years from 70 to 90% and confirming results with measurable residual disease (MRD) testing instead of routine testing. Respondents also preferred daily oral administration over intravenous infusion every 4 weeks, fixed-duration treatments over treat-to-progression treatments and treatments with lower side effect risks. Reducing risk of tumor lysis syndrome was least important relative to changes in other attributes. Conclusion: The combination of improving PFS combined with confirming results using MRD testing was more important than changes in all other study attributes included in the DCE. Results from this study can help inform shared decision-making when selecting therapies for CLL.