Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Prev Sci. 2019 Jul;20(5):655-664. doi: 10.1007/s11121-018-0970-x.
The costs associated with implementing evidence-based programs for pediatric obesity contribute to a lack of widespread adoption. This study examined the costs of preparing to implement the Family Check-Up 4 Health (FCU4Health), a family-centered behavioral program for the prevention of pediatric obesity and excess weight gain in primary care. Budget impact analysis was used to estimate the cost of preparing to implement FCU4Health (i.e., the activities to prepare for, but prior to, offering the service to families). Electronic cost capture methods were used to prospectively track personnel time associated with implementation preparation activities. We also estimated the cost of replicating these preparatory activities to inform future decisions to adopt the program and associated budgetary planning. The total cost of FCU4Health implementation preparation in three clinics and developing delivery materials and infrastructure was $181,768, for an average of $60,589 per clinic. Over two thirds of the total cost were personnel related, the largest of which was associated with the time spent developing automated fidelity coding for monitoring (20%), developing and tailoring clinical materials (16%), and training FCU4Health coordinators (15%). Due to these development costs associated with an initial implementation, that we anticipate would not be repeated in full, we estimated the cost to prepare FCU4Health for implementation in a future initiative will range from $15,195 to $17,912 per clinic. This study is a critical step towards equipping decision-makers with comprehensive short-term information about expected costs that are incurred immediately after choosing to adopt an evidence-based program.
实施基于证据的儿科肥胖症计划的相关成本导致其无法广泛采用。本研究考察了为实施家庭检查 4 健康（FCU4Health）做准备的成本，这是一个以家庭为中心的行为计划，用于预防初级保健中的儿童肥胖和体重过度增加。预算影响分析用于估计准备实施 FCU4Health 的成本（即，为向家庭提供服务之前做准备的活动）。电子成本捕获方法用于前瞻性地跟踪与实施准备活动相关的人员时间。我们还估计了复制这些预备活动的成本，以为未来采用该计划和相关预算规划提供信息。在三个诊所实施 FCU4Health 准备工作和开发交付材料和基础设施的总成本为 181768 美元，每个诊所的平均成本为 60589 美元。总成本的三分之二以上与人员有关，其中最大的部分与开发用于监测的自动化保真编码（20%）、开发和定制临床材料（16%）以及培训 FCU4Health 协调员（15%）有关。由于这些与初始实施相关的开发成本，我们预计不会全部重复，因此我们估计在未来的倡议中为实施 FCU4Health 做准备的成本将为每个诊所 15195 美元至 17912 美元。这项研究是朝着为决策者提供有关选择采用循证计划后立即产生的预期成本的全面短期信息迈出的关键一步。
