"If you were a policymaker, which treatment would you disinvest? A participatory value evaluation on public preferences for active disinvestment of health care interventions in the Netherlands."

Authors: A. H. Rotteveel, M. S. Lambooij, E. A. B. Over, J. I. Hernández, A. W. M. Suijkerbuijk, A. T. de Blaeij, G. A. de Wit and N. Mouter.

Currently, it is not known what attributes of health care interventions citizens consider important in disinvestment decision-making (i.e. decisions to discontinue reimbursement). Therefore, this study aims to investigate the preferences of citizens of the Netherlands toward the relative importance of attributes of health care interventions in the context of disinvestment. A participatory value evaluation (PVE) was conducted in April and May 2020. In this PVE, 1143 Dutch citizens were asked to save at least €100 million by selecting health care interventions for disinvestment from a list of eight unlabeled health care interventions, described solely with attributes. A portfolio choice model was used to analyze participants’ choices. Participants preferred to disinvest health care interventions resulting in smaller gains in quality of life and life expectancy that are provided to older patient groups. Portfolios (i.e. combinations of health care interventions) resulting in smaller savings were preferred for disinvestment over portfolios with larger savings. The disinvestment of health care interventions resulting in smaller health gains and that are targeted at older patient groups is likely to receive most public support. By incorporating this information in the selection of candidate interventions for disinvestment and the communication on disinvestment decisions, policymakers may increase public support for disinvestment.


"Public Preferences for Policies to Promote COVID-19 Vaccination Uptake: A Discrete Choice Experiment in The Netherlands."

Authors: Niek Mouter, Sander Boxebeld, Job van Exel, Ardine de Wit, Mattijs Lambooij, Roselinde Kessels and Maarten van Wijhe

The COVID-19 pandemic forms an unprecedented public health, economic, and social crisis. Uptake of vaccination is critical for controlling the pandemic. Nevertheless, vaccination hesitancy is considerable, requiring policies to promote uptake. We investigate Dutch citizens’ preferences for policies that aim to promote vaccination through facilitating choice of vaccination, profiling it as the norm, making vaccination more attractive through rewards, or punishing people who reject vaccination.We conducted a discrete choice experiment in which 747 respondents were asked to choose between policies to promote vaccination uptake and their impacts on the number of deaths, people with permanent health problems, households with income loss, and a tax increase. Respondents generally had a negative preference for policies that promote vaccination. They particularly disliked policies that punish those who reject the vaccine and were more favorable toward policies that reward vaccination, such as awarding additional rights to vaccinated individuals through vaccination passports. Respondents who reject vaccination were in general much more negative about the policy options than respondents who consider accepting the vaccine. Nevertheless, vaccination passports are supported by both respondents who accept the vaccine, those who reject vaccination, and those who are unsure about vaccination.



"When Digital Mass Participation Meets Citizen Deliberation: Combining Mini- and Maxi-Publics in Climate Policy-Making."

Authors: Anatol Itten and Niek Mouter

The upcoming vogue of climate assemblies and other forms of mini-publics are to give citizens a central role in climate policy-making and to break the political impasse. Yet climate mini-publics face challenges in political environments too, such as co-option, favoring expert opinions, and losing touch with the broader public. To remedy such pitfalls, recent papers have argued to combine synchronous deliberations of small groups of citizens with online participation procedures for the larger public. In this article, we report the results of a three-step combination model, where first a mini-public in the region of Súdwest-Fryslân (NL) was given a “carte blanche” to draft the content and the parameters of several related policy alternatives. Second, their proposals were fed into a digital participation tool to consult the wider public. Third, a citizens forum translated the outcomes of the maxi-public into policy recommendations, which were unanimously approved by the municipal council. In this paper, we report our findings of combining mini- and maxi-publics and how the actors involved evaluated the strengths and weaknesses of the combination of these two participatory approaches.

"Citizen preferences regarding the public funding of projects promoting a healthy body weight among people with a low income."

Authors: Lisanne Mulderij, José Ignacio Hernández, Niek Mouter, Kirsten Verkooijen and Annemarie Wagemakers

This paper examined citizen preferences for the public funding of projects to promote a healthy body weight among people with a low income. The study used a Participatory Value Evaluation (PVE) with Dutch citizens. An online choice experiment was used to ask respondents to advise on the implementation of eight different projects, with a total resource constraint of 100,000 euros. The most popular projects were fruit and vegetable boxes and sports vouchers, while bariatric surgery was least popular. Respondents with a low income tended to spend less of the budget than respondents with a higher income. Reasons for decisions were qualitatively analysed and included importance, healthiness, usefulness, costs, and efficacy. Policymakers could use the results to ensure their decisions on the allocation of public funding to projects that encourage a healthy weight among people with a low income are aligned with citizen preferences.


'What Values should an Agent Align with? An Empirical Comparison of General and Context-Specific Values.'

Authors: Enrico Liscio, Michiel van der Meer, Luciano C. Siebert, Catholijn M. Jonker and Pradeep K. Murukannaiah

The pursuit of values drives human behavior and promotes cooperation. Existing research is focused on general values (e.g., Schwartz) that transcend con- texts. However, context-specific values are necessary to (1) understand human deci- sions, and (2) engineer intelligent agents that can elicit and align with human values. We propose Axies, a hybrid (human and AI) methodology to identify context- specific values. Axies simplifies the abstract task of value identification as a guided value annotation process involving human annotators. Axies exploits the growing availability of value-laden text corpora and Natural Language Processing to assist the annotators in systematically identifying context-specific values. We evaluate Axies in a user study involving 80 human subjects. In our study, six annotators generate value lists for two timely and important contexts: COVID-19 mea- sures and sustainable ENERGY. We employ two policy experts and 72 crowd workers to evaluate Axies value lists and compare them to a list of general (Schwartz) values. We find that Axies yields values that are (1) more context-specific than general val- ues, (2) more suitable for value annotation than general values, and (3) independent of the people applying the methodology.


"Participatory value evaluation for the evaluation of flood protection schemes"

Authors: Niek Mouter, Paul Koster and Thijs Dekker

Participatory Value Evaluation (PVE) is a new survey method which elicits citizens' preferences over the allocation of public budgets as well as their private income. In a PVE, citizens are asked to choose the best portfolio of projects given a governmental and a private budget constraint. First, this paper aligns PVE with the traditional Kaldor-Hicks welfare economics framework underlying many Cost-Benefit Analyses. Second, this paper positions PVE against other valuation methods. Third, this paper applies the PVE method to evaluate the impacts of projects mitigating flood risks in the Netherlands. This empirical application reveals that Dutch citizens indicate a preference for projects that combine strengthening dikes and give space to the river to flood safely, particularly when such projects positively influence biodiversity and recreational opportunities.

"Public participation in crisis policymaking. How 30,000 Dutch citizens advised their government on relaxing COVID-19 lockdown measures"

Authors: Niek Mouter, Jose Ignacio Hernandez and Anatol Itten

After the COVID-19 outbreak, governments have taken unprecedented measures to stop the spread of the virus. Public participation in decisions about (the relaxation of) these measures is strikingly absent, despite recommendations in the literature. Participants received information regarding the societal impacts of each relaxation option, such as the impact of the option on the healthcare system. The results of the PVE informed policymakers about people’s preferences regarding (the impacts of) the relaxation options. We show how these preferences can be used to rank options in terms of desirability. 


“Including young people, cutting time and producing useful outcomes: Participatory value evaluation as a new practice of public participation in the Dutch energy transition”

Authors: Niek Mouter, Ruth Shortall, Shannon Spruit and Anatol Itten.

To achieve a successful energy transition, it is vital to integrate citizens’ needs into government policies through participatory processes. Because PVE was originally designed as an economic evaluation method, it is unclear whether it can be deployed for effective participation. This study investigates how PVE could be deployed for effective participation of citizens in the energy transition through a real-world experiment in the Netherlands. We aimed to conduct the PVE in line with goals of stakeholders which is the most important requirement for effective participation. We fully achieved three goals that were defined by stakeholders: PVE enables participation of people that normally do not participate (particularly young people); low time investment of civil servants; outcomes of a PVE should be useful for decision-making. We partly achieved two goals: PVE raises awareness among citizens about decisions and implications of the energy transition; participation should be meaningful for citizens.


"Contrasting the recommendations of participatory value evaluation and cost-benefit analysis in the context of urban mobility investments"

Authors: Niek Mouter, Paul Koster and Thijs Dekker.

Participative Value Evaluation is a new method to assess the desirability of government projects. In a PVE, individuals choose their preferred portfolio of government projects given a limited government budget. Based on these choices, preferences of individuals for (the effects of) government projects can be determined. Cost-benefit analysis (CBA) is an alternative assessment method used to assess the desirability of government projects. This paper aims to investigate whether PVE and CBA lead to different policy recommendations in the context of urban mobility investments. A PVE and several CBAs have been carried out for 16 urban mobility investment projects. In this study, indicative indications were found that projects aimed at improving road safety and improvements for cyclists/pedestrians score higher in the PVE, while car projects score higher in the CBA analysis.

“An introduction to Participatory Value Evaluation”

Authors: Niek Mouter, Paul Koster and Thijs Dekker.

Participatory Value Evaluation is a new economic evaluation method that can analyze the welfare effects of government policies based on preferences expressed by individuals about the allocation of public resources and their private income. The essence of a PVE is that participants in an (online) experiment are shown a restriction and a number of possible policy options, including the effects of the options. Participants then have to make choices within the restriction. This paper positions PVE in relation to the social cost-benefit analysis (SCBA) and previous innovations in valuing government projects. In addition, this paper illustrates PVE on the basis of a case study in which 2,900 citizens make choices regarding a flood risk management programme. Click below to go to the paper.


“Participatory Value Evaluation: a novel method to evaluate future urban mobility investments”

Authors: Niek Mouter, Paul Koster and Thijs Dekker.

The social cost-benefit analysis (SCBA) is widely used to evaluate transport projects. However, the SCBA is criticized in the planning literature because, according to planners, broader preferences about transport projects are not included in the SCBA. This paper aims to explore which broader preferences about transportation projects can be included in a PVE. The study is being conducted in a case study for the Amsterdam Transport Region. It follows from the case study that respondents in a PVE also include broader preferences about transport projects in their choice.

"Do individuals have different preferences as consumer and citizen? The trade-off between travel time and safety"

Authors: Niek Mouter, Sander van Cranenburgh and Bert van Wee.

Several scientists criticize the CBA's premise that the effects of government policy can be valued via the number of euros that individuals are willing to pay for an effect. The scientists argue that the trade-offs that individuals as consumers make between private resources and private goods may differ from the way in which the same individuals as citizens believe that the government (on their behalf) should make trade-offs between public resources and public goods. In this study, we demonstrate through choice experiments that individuals indeed have different preferences as consumers and citizens when making a trade-off between travel time and safety. As citizens, they attach more value to road safety than to travel time compared to the choices they make as consumers.

"The consumer-citizen duality: Ten reasons why citizens prefer safety and drivers desire speed"

Authors: Niek Mouter, Sander van Cranenburgh and Bert van Wee

In social cost-benefit analyzes (SCBAs), the effects of infrastructure projects are valued on the basis of the willingness to pay approach. Several scientists criticize this premise of the SCBA, because the trade-offs that individuals as consumers make between private resources and private goods may differ from the way in which the same individuals as citizens believe that the government (on their behalf) should make trade-offs between public resources and public goods. This is also known as the 'consumer-citizen duality'. In a previous study, it was established that the Dutch, as citizens, attach more value to road safety than to travel time compared to the choices they make as consumers. This study identifies 10 explanations for the consumer-citizen duality.

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