Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK.
Int J Technol Assess Health Care. 2012 Oct;28(4):407-14. doi: 10.1017/S0266462312000475. Epub 2012 Sep 21.
Reducing sexually transmitted infections (STI) and teenage pregnancy through effective health education is a high priority for health policy. Behavioral interventions which teach skills to practice safer sex may reduce the incidence of STIs. We evaluated the cost-effectiveness of school-based behavioral interventions in young people.
We developed an economic model to estimate the total number of STI cases averted, consequent gain in health related quality of life (HRQoL) and savings in medical costs, based on changes in sexual behavior. The parameters for the model were derived from a systematic literature search on the intervention effectiveness, epidemiology of STIs, sexual behavior and lifestyles, HRQoL and health service costs.
The costs of providing teacher-led and peer-led behavioral interventions were €5.16 and €18 per pupil, respectively. For a cohort of 1000 boys and 1000 girls aged 15 years, the model estimated that the behavioral interventions would avert two STI cases and save 0.35 Quality Adjusted Life Years (QALYs). Compared to standard education, the incremental cost-effectiveness of the teacher-led and peer-led interventions was €24,268 and €96,938 per QALY gained, respectively.
School-based behavioral interventions which provide information and teach young people sexual health skills can bring about improvements in knowledge and increased self-efficacy, though these may be limited in terms of impact on sexual behavior. There was uncertainty around the results due to the limited effect of the intervention on behavioral outcomes and paucity of data for other input parameters.
通过有效的健康教育降低性传播感染（STI）和青少年怀孕率是卫生政策的重中之重。教授安全性行为技能的行为干预措施可能会降低 STI 的发病率。我们评估了基于学校的行为干预措施对年轻人的成本效益。
我们开发了一个经济模型，根据性行为的变化来估计可以避免的 STI 病例数、相关健康相关生活质量（HRQoL）的增益以及医疗费用的节省。模型的参数源自对干预效果、STI 流行病学、性行为和生活方式、HRQoL 和卫生服务成本的系统文献检索。
提供教师主导和同伴主导的行为干预措施的成本分别为每个学生 5.16 欧元和 18 欧元。对于一个 15 岁的 1000 名男孩和 1000 名女孩的队列，该模型估计行为干预措施将避免 2 例 STI 病例，并节省 0.35 个质量调整生命年（QALY）。与标准教育相比，教师主导和同伴主导干预的增量成本效益分别为每个获得的 QALY 增加 24,268 欧元和 96,938 欧元。
提供信息并教授年轻人性健康技能的基于学校的行为干预措施可以改善知识和自我效能感，但这些可能在性行为方面的影响有限。由于干预对行为结果的影响有限以及其他输入参数的数据缺乏，结果存在不确定性。
