Department of Psychology.
Department of Medicine, Immunology and Rheumatology, Stanford University.
Health Psychol. 2019 Aug;38(8):689-700. doi: 10.1037/hea0000773.
This paper examines three distinct examples of interventions in nonclinical settings selected to highlight the challenges and opportunities for evaluating cost-effectiveness in the field of health psychology and behavioral medicine. Nonclinical settings are defined as those involving systems outside of traditional medical/clinical settings, and include interventions tested in clinical settings that can also be implemented in nonclinical settings. The examples in this paper reflect the use of a varying degree of existing cost-effectiveness data and previous health economic analyses. First, the Chronic Disease Self-Management Program model reflects an intervention protocol designed to increase patients' confidence and mastery in their ability to manage their conditions that has been shown to be cost effective for a variety of chronic disease conditions. Second, the cost and cost-effectiveness of tobacco quitlines (e.g., National Tobacco Quit Line) has been the subject of several preliminary cost-effectiveness examinations and has proven to have significant reach and impact on tobacco-related behaviors. Finally, environmental interventions for promoting walking and physical activity in community-based contexts (e.g., PATH trial) are presented and have been shown to be highly relevant for demonstrating cost-effectiveness. Overall, the disciplines of health psychology and behavioral medicine are in a unique position to develop, implement, and evaluate a broader range of interventions in more diverse environments than cost-effectiveness applications in more traditional, clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
本文考察了三个在非临床环境中进行的干预措施的例子，这些例子突出了在健康心理学和行为医学领域评估成本效益的挑战和机遇。非临床环境被定义为那些涉及传统医疗/临床环境以外的系统的环境，包括在临床环境中测试但也可以在非临床环境中实施的干预措施。本文中的例子反映了使用不同程度的现有成本效益数据和先前的健康经济分析。首先，慢性病自我管理计划模型反映了一种干预方案，旨在提高患者对自己管理疾病能力的信心和掌握程度，该方案已被证明对各种慢性病是具有成本效益的。其次，烟草戒烟热线（例如，国家烟草戒烟热线）的成本和成本效益已经成为几项初步成本效益研究的主题，并已被证明对与烟草相关的行为具有显著的影响和效果。最后，提出了在社区环境中促进步行和身体活动的环境干预措施，并已被证明在证明成本效益方面具有高度相关性。总的来说，健康心理学和行为医学这两个学科具有独特的优势，可以在比传统临床环境中更广泛的环境中开发、实施和评估更多样化的干预措施。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
