Search Results (1,704)

Background: Obesity is a growing public health crisis in Saudi Arabia. Community pharmacists are well-positioned to deliver accessible weight management services, but data on public willingness to pay (WTP) for these interventions remains limited. Aim: To assess the willingness of the Saudi Arabian public to pay for community pharmacist-led weight management services and identify factors associated with WTP. Methods: A cross-sectional, face-to-face survey was conducted among adults in a medical city in Riyadh between October 2025 and January 2026. WTP was elicited using the Payment Card method based on a hypothetical pharmacist-led service scenario. Payment values were validated by an expert panel. Univariable and multivariable regression models were used to identify independent predictors of WTP and payment amounts. Results: Of 746 participants, 66% expressed willingness to pay for the service. The most frequently selected maximum payment was 50 SAR per session. Multivariable logistic regression revealed that WTP was significantly associated with younger age, higher monthly income, perceived usefulness of pharmacy services (aOR: 3.10; 95% CI: 1.83–5.26), frequent pharmacy visits, and prior or desired access to a dietitian. Clinical burden, including BMI and chronic conditions, did not significantly influence WTP. Among those willing to pay, male gender was independently associated with a lower stated payment amount compared to females (β = −3.8 SAR; p = 0.006). Conclusions: Among adults attending a large academic medical city in Riyadh, there is substantial willingness to pay for pharmacist-led weight management services, with perceived value and healthcare engagement as the primary drivers. These preliminary findings warrant replication in broader, nationally representative samples. Full article

Parking management has become an increasingly important challenge in rapidly growing urban areas, yet evidence from intermediate Latin American cities remains scarce. This study analyzes parking choice behavior across Ecuadorian cities using a national stated preference (SP) experiment validated through revealed preference (RP) data and estimated via discrete choice models. Data were collected between 1 April and 3 May 2026 from 2150 active drivers across 12 cities spanning the Coast, Highlands, and Amazon regions. Multinomial Logit (MNL) and Mixed Logit (MIXL) models were estimated to evaluate the effects of parking cost, walking distance, search time, security, and surveillance on parking decisions. Results showed that all three cost-related attributes significantly reduced parking utility, while security improvements increased the probability of selecting formal parking alternatives. The MIXL model outperformed MNL specifications (ΔAIC = 211.84), revealing significant unobserved heterogeneity in cost (SD = 0.45) and security preferences (SD = 0.29). Willingness-to-pay estimates reached USD 0.64 per 100 m reduction in walking distance and USD 0.69 per 10-min reduction in search time, with substantial inter-city variability. Despite low current adoption (18.4%), willingness to use digital reservation systems exceeded 75% across income groups. The findings underscore the need for locally calibrated, context-sensitive parking policies and support differentiated smart parking strategies in developing urban systems. Full article

La Paz Bay is one of the most important destinations for recreational fishing events in Baja California Sur, Mexico, with significant tourist activity that supports ecosystem services and provides economic benefits to participants, benefits that have not yet been economically measured. The aim of this study was to estimate the willingness to pay (WTP) of anglers who participated in sport-fishing events and to propose tourism promotion and recreational fisheries management strategies. Applying 184 face-to-face surveys at sport fishing events in LPB held in 2022 and 2023 to collect information regarding fishers’ and fishing trips characteristics, and using the individual travel cost method to estimate the individual WTP per angler, which ranges from USD 50.96 to 625.63, and the recreational economic value of fishing events in La Paz was estimated at USD 0.89 to 1.11 million. Strategies for conserving species reserved for sport fishing and promoting tourism are discussed, which could help improve tournament activity and promote the rational use of natural resources. This study represents the first effort aiming to value sport fishing events in Mexico. Also, demonstrates the economic relevance of sport fishing events for recreational fisheries management and tourism-promoting policies in LPB. It provides evidence that conserving sport-fishing species could enhance management strategies and sustainable tourism promotion policies for this recreational activity. Full article

Agricultural production is increasingly threatened by climate variability, limited access to quality inputs, and market shocks in developing countries. Insurance–input bundles, which integrate crop insurance with inputs like fertiliser and seed, have emerged as a promising tool for improving productivity and resilience among smallholder farmers. This study adopts a structured (systematic narrative) literature review approach, synthesising evidence from 152 studies to examine farmers’ awareness, attitudes, willingness to pay, participation, satisfaction, and productivity outcomes associated with insurance–input bundles. The findings show that awareness remains uneven and often limited by weak extension systems and low financial literacy, while farmers’ attitudes are strongly shaped by past experiences, cultural perceptions, and institutional trust. Furthermore, affordability constraints and risk misinterpretation reduce willingness to pay, whereas perceived value and institutional credibility significantly enhance demand for bundled products. Across the reviewed literature, adoption is shown to be a non-linear and interdependent process influenced by behavioural, economic, and institutional factors, where breakdowns in trust, affordability, or information can limit participation. Evidence further indicates that insurance–input bundles promote the adoption of improved inputs, increase yields, and enhance income stability, although these impacts are highly context-dependent and mediated by implementation quality, including timely payouts and effective service delivery. The review contributed to the literature by advancing a systems-based understanding of bundled insurance adoption, highlighting the central role of institutional reliability, behavioural responses, and implementation quality. Lastly, the review underscores the need for strong institutions, integrated extension systems and farmer-centred design to ensure sustainable scaling. Full article

Electric vehicles (EVs) are increasingly recognized as a sustainable transportation solution; however, mass-market adoption in Thailand remains limited due to infrastructure constraints, technological complexity, and evolving consumer perceptions. This study examines the effects of charging infrastructure accessibility, perceived ease of use, and psychological driving experience on consumers’ willingness to pay (WTP) for EVs. A quantitative approach was employed using survey data collected from 400 EV users and analyzed through Structural Equation Modeling (SEM). Grounded in the Technology Acceptance Model (TAM) and the Theory of Consumption Values (TCV), the study reveals that charging infrastructure accessibility significantly enhances perceived ease of use, driving experience, and WTP. In addition, perceived ease of use and driving experience positively influence consumers’ financial commitment toward EV adoption and partially mediate the relationship between infrastructure accessibility and WTP. The findings indicate that EV consumer valuation is shaped by both functional infrastructure readiness and psychological user experience. The study contributes to EV consumer behavior literature by integrating cognitive and experiential perspectives and provides practical implications for policymakers and industry stakeholders seeking to accelerate EV adoption in Thailand. Full article

In recent years, with the significant decline in fine particulate matter (PM_2.5) concentrations, ozone (O₃) has emerged as a major composite air pollutant during the warm season in China, attracting increasing attention due to its associated health burden and economic costs. This study focuses on Tianjin, using ozone monitoring data from 2017 to 2023 combined with health statistics to assess the health impacts and economic losses attributable to ozone pollution. First, ozone exposure indicators and compliance criteria were constructed based on national air quality standards, and the interannual variation and spatial differences of O₃ levels were analyzed at both citywide and district scales. Second, multiple machine learning classification models, including logistic regression, decision tree, k-nearest neighbors, and gradient boosting, were developed using ozone and meteorological variables to predict the occurrence risks of five diseases: cardiovascular diseases, respiratory diseases, hand-foot-and-mouth disease (HFMD), influenza, and dengue fever. Finally, excess cases were estimated using health impact functions, and the associated economic losses were quantified by combining the value of a statistical life (VSL) with cost-of-illness and willingness-to-pay (WTP) approaches. The results showed that the annual evaluation value of ozone in Tianjin, defined as the 90th percentile of the daily maximum 8 h average O₃ concentration, exhibited a pattern of initially increasing, then decreasing, and subsequently rebounding. It peaked at 201 µg/m³ in 2018, declined to a minimum of 164 µg/m³ in 2021, and rebounded to 188 µg/m³ in 2023. Machine-learning results indicated that the logistic regression model showed relatively stable overall performance across predictions of different diseases, while the gradient boosting tree model also achieved high accuracy in predicting certain infectious diseases. Overall, ozone pollution exhibits significant heterogeneous effects across different disease types, and the associated health-related economic losses show stage-wise fluctuations in response to pollution levels. Based on these findings, it is recommended to implement refined control measures during periods of high ozone exceedance and in key regions, while strengthening protection for vulnerable populations such as the elderly, children, and patients with respiratory diseases, in order to achieve synergistic improvements in air quality management and public health outcomes. Full article

Background: Biliary tract cancers (BTCs), encompassing cholangiocarcinoma and gallbladder carcinoma, are aggressive malignancies with poor prognosis and increasing incidence in selected regions worldwide. Advances in imaging, biomarker profiling, immunotherapy, and targeted therapies have improved treatment options but have also increased the economic pressure on health systems. Understanding the economic evidence on BTC is therefore important for resource allocation and health technology assessment. Methods: We systematically searched PubMed/MEDLINE, Embase, Scopus, and Web of Science for peer-reviewed economic studies of BTC published from January 2010 to March 2025. Eligible studies included cost-effectiveness, cost–utility, cost–benefit, cost-of-illness, and resource-use analyses. The review followed PRISMA reporting principles. Reporting completeness was assessed using CHEERS 2022, and methodological credibility was appraised using the Drummond framework. Results: Twenty studies were included: 13 cost-effectiveness or cost–utility analyses and seven cost-of-illness or resource-use studies. Conventional chemotherapy strategies, including gemcitabine plus cisplatin in some settings and other cytotoxic combinations in selected jurisdictions, generally produced more favorable economic results than newer systemic therapies, although findings varied by country, threshold, comparator, and price assumptions. First-line immunotherapy combinations and biomarker-directed targeted therapies frequently produced ICERs above jurisdiction-specific willingness-to-pay thresholds at current prices, often requiring substantial price reductions to approach cost-effectiveness. Real-world studies showed high resource use and costs, particularly with hospitalizations and later treatment lines. Evidence on screening and prevention was limited, with one study suggesting that ultrasound surveillance may be cost-effective in a liver fluke-endemic region of Thailand. Discussion: The available economic evidence suggests that affordability and jurisdiction-specific value assessment are central to BTC policy decisions. Current prices for several immunotherapy and targeted agents limit cost-effectiveness in published models, while evidence on prevention, early detection, and care-pathway interventions remains sparse and context-specific. Full article

Patients with BRAF^V600E-mutated metastatic lung cancer benefit from both BRAF plus MEK inhibitors and immune checkpoint inhibitor (ICI)–chemotherapy. This study evaluated the cost-effectiveness of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors in these patients. This economic analysis, with a 15-year time horizon and an annual 3% discount, was conducted from the perspective of the healthcare sectors in Taiwan and the US. Simulated patients were entered into partitioned survival models upon initiation of first-line therapies. The model inputs were derived from the FRONT-BRAF study (progression-free/overall survival, adverse events, and subsequent therapies), insurance payments or retail prices (costs of drugs, physician visits, monitoring, adverse events, and end-of-life care), and a hospital cohort (health utility). Deterministic and probabilistic analyses were performed. The incremental cost-effectiveness ratios (ICERs) of ICI–chemotherapy compared with BRAF plus MEK inhibitors (Taiwan: $73,561/QALY; US: $290,279/QALY) exceeded the willingness-to-pay (WTP) thresholds (Taiwan: $70,000/QALY; US: $150,000/QALY). The drug costs of subsequent therapies and the utility values of the progressive-disease state were the major determinants of ICERs. In Taiwan, ICI–chemotherapy had a 41.0% probability of being cost-effective at the WTP threshold. ICI–chemotherapy had a higher probability of being cost-effective than BRAF plus MEK inhibitors when the WTP exceeded $300,000/QALY in the US. Our analysis suggests that, despite the longer survival of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors, ICI–chemotherapy is not a cost-effective strategy for patients with BRAF^V600E-mutated metastatic lung cancer. Full article

The paper investigates tourists’ willingness to pay (WTP) an increased tourist tax to support the development of accessible tourism. To achieve the research objective, a structured survey was conducted among 452 tourists who spent their holidays in the Ukrainian Carpathians. It has been confirmed that the WTP a higher tourist tax that varies significantly depending on the possible direction of its use. It has been established that in the context of a humanitarian crisis, social inclusion is a more powerful factor of tax loyalty than a traditional environmental programme. A statistically significant relationship was found between WTP an increased tourist tax for the development of accessible tourism and several factors, including respondents’ level of education, income level, frequency of tourist trips over the past five years, current trip expenditure, and perceived accessibility of infrastructure. Consumers’ willingness to voluntarily pay a tourist tax for a specific purpose may suggest that higher tax rates would be publicly acceptable, potentially generating financial resources to support the development of accessible tourism. Full article

This study investigates the psychological and contextual mechanisms through which consumers’ awareness of agriculture’s contribution to climate change translates into a willingness to pay (WTP) for low-carbon agricultural products. Drawing on data from Eurobarometer 93.2 (ZA7739; N = 24,193), the research applies a moderated mediation model (Hayes’ PROCESS Model 14) to examine the mediating role of support for mandatory environmental labelling and the moderating effect of residential context. The results indicate that climate change awareness is significantly and positively associated with WTP. Moreover, support for mandatory labelling partially mediates this relationship, suggesting that institutionalized transparency may serve as a key mechanism through which environmental concern becomes economically actionable. The findings further reveal that this indirect effect is moderated by the level of urbanization, being stronger in urban areas than in rural settings. This highlights the importance of socio-spatial context in shaping consumer responses to sustainability information. Overall, the study contributes to the literature on sustainable consumption by demonstrating that willingness to financially support low-carbon agriculture depends not only on environmental awareness but also on trust-enhancing policy instruments and contextual factors. The findings offer important implications for policymakers aiming to promote sustainable food systems through information-based regulation. Full article

This study examines the relationship between health consciousness, the components of the Theory of Planned Behaviour (TPB) and self-identity, as well as consumers’ willingness to pay more for Andean grains, which are recognised for their nutritional benefits and contribution to sustainable food systems. The study was conducted with 600 young university students living in Lima, Peru. Using Partial Least Squares Structural Equation Modelling (PLS-SEM), the findings revealed a positive association between health consciousness and attitude, subjective norms, perceived behavioural control, and self-identity related to healthy food consumption. Of the TPB components, self-identity was found to be the strongest predictor of willingness to pay more for Andean grains, followed by perceived behavioural control; attitude and subjective norms, however, showed no significant effect. These results suggest that the willingness to pay for sustainable heritage foods is driven more by identity-based motivations and perceived access conditions than by favourable evaluations or social pressure alone. The study extends the TPB by incorporating health consciousness as an antecedent variable and by highlighting the prominent role of self-identity in sustainable food choices within the context of an emerging economy. Furthermore, the findings provide practical insights for designing marketing strategies and public policies aimed at promoting healthy and sustainable food consumption. Full article

This study investigates asymmetric consumer responses to recycled thermoplastics, with a focus on the roles of eco-consciousness, sustainability knowledge, perceived concerns, trust, and value congruence. Using survey data from Hungarian consumers, the study applies linear and binary logistic regression analyses to examine how these factors influence brand perception, willingness to pay, and communication preferences. The results show that economic concerns act as a dominant barrier, significantly reducing both brand evaluations and willingness to pay, while functional concerns play a more limited role. Trust in sustainability communication and positive brand perception emerge as strong predictors of willingness to pay, with brand perception showing a stronger effect. Eco-consciousness consistently influences consumer responses, whereas sustainability knowledge demonstrates more selective and context-dependent effects. In addition, consumers show a clear preference for credible, evidence-based communication, while informal and promotional signals are less effective. Overall, the findings highlight the importance of reducing perceived risk, strengthening brand perception, and aligning sustainability communication with consumer expectations to support the adoption of recycled thermoplastics in the automotive industry. Full article

This study introduces a comprehensive framework for understanding sustainable online shopping preferences, validated using survey data collected in Serbia and Slovenia in 2025 (n = 572), thereby enhancing its generalizability. The primary aim of this research is to examine the extent to which specific environmental, social, and economic indicators influence decision-making processes for online purchasing and delivery. A detailed quantitative analysis was conducted using a structured questionnaire that included a wide range of variables related to online shopping behaviors and delivery preferences. The findings indicate that preferences for sustainability are inherently complex and multifaceted, shaped by critical factors such as environmental concerns, social responsibility, trust, skepticism towards sustainability claims, willingness to pay (WTP), and price sensitivity. Demographic variables, particularly gender and age, show consistent links to preferences for environmental considerations and corporate social responsibility (CSR), while income impacts trust-related behaviors and WTP. Furthermore, the analysis distinguishes between two distinct decision-making approaches: a value-driven sustainability cluster represented by EcoIndex, SocialIndex, and WTPIndex, and a cost-minimization strategy focused on price sensitivity (PriceIndex), with trust acting as a related yet separate factor (CredibilityIndex). Overall, this study emphasizes that a range of interconnected dimensions significantly shape sustainable online shopping preferences. The study was conducted in two developing European countries. Additionally, the findings highlight the need to address universal market barriers, such as price sensitivity, information asymmetry, and consumer skepticism. In a business context, they underscore the importance of adopting advanced analytical methods to enhance decision-making and optimize sustainable business strategies. Full article

Introduction: Competitive sport angling is a specialized form of recreational fishing in which participants compete in tournaments throughout the year to obtain annual rankings. In Portugal, competitive anglers may exhibit high levels of engagement and expenditure, yet the economic relevance of this activity remains poorly documented. Objective: This study aimed to assess the economic value of inland competitive angling competitions in Portugal. Methodology: Data on anglers’ annual expenditures were collected through a web-based questionnaire distributed in April 2025 by the Portuguese Federation of Sport Angling to 1,230 registered federated anglers. A total of 193 valid responses were obtained, including information on socio-demographic characteristics, angling modalities, and fishing locations, as well as expenditures on fishing equipment, travel, meals, accommodation, and willingness to pay (WTP) to ensure fish availability during competitions. Results: Extrapolation of the results to the national federated inland angler population suggests an estimated annual direct expenditure of approximately €6.7 million, ranging from €4.2 million to €9.2 million. Fishing equipment (e.g., rods, reels, boats, kayaks, and paniers) accounted for the largest share of expenditures, followed by travel, meals, and accommodation. Expenditure patterns varied according to age, angling modality, years of competitive experience, and participation in both inland and marine competitions. Most respondents (62.7%) reported being unwilling to pay additional amounts to guarantee fish availability, arguing that this responsibility should fall on the state and competition organizers given the fees already paid. Conclusions: Inland competitive sport angling appears to make a relevant contribution to economic activity associated with tourism and leisure services in Portugal and should therefore be considered in the management of inland water resources. Full article

This study examines how international tourists’ perceptions of environmental, social, and governance (ESG) practices influence their willingness to pay a premium for community-based homestays. Grounded in signaling theory, ESG perception is conceptualized as a credibility signal that reduces perceived uncertainty in community-based accommodation settings. Data were collected from 300 international tourists visiting Mae Kampong Village, Chiang Mai, Thailand, and analyzed using partial least squares structural equation modeling (PLS-SEM). To strengthen predictive assessment, the model was additionally evaluated using PLSpredict, Q²_predict, and the Cross-Validated Predictive Ability Test (CVPAT). The results indicate that ESG perception significantly enhances community sustainability image, trust, and booking intention. Trust partially mediates the relationships between ESG perception and both booking intention and willingness to pay a premium, while booking intention demonstrates the strongest effect on willingness to pay a premium. Community sustainability image does not directly influence booking intention but instead operates indirectly through trust. Environmental concern significantly influences willingness to pay a premium, although its moderating effect is not supported. The findings suggest that tourists in community-based homestay environments rely heavily on trust-based psychological assurance when making accommodation decisions. This study extends ESG tourism research into community-based accommodation contexts and highlights the importance of trust in high-uncertainty tourism environments. The findings also emphasize the importance of transparent ESG communication and trust-building strategies for strengthening sustainable tourism competitiveness. Full article