Deakin University, Geelong, Deakin Health Economics, Institute for Health Transformation, Geelong, Victoria, Australia
Deakin University, Geelong, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia.
BMJ Open. 2020 Aug 3;10(8):e038050. doi: 10.1136/bmjopen-2020-038050.
Limited evidence exists on the cost-effectiveness of interventions to prevent obesity and promote healthy body image in adolescents. The SHINE (Supporting Healthy Image, Nutrition and Exercise) study is a cluster randomised control trial (cRCT) aiming to deliver universal education about healthy nutrition and physical activity to adolescents, as well as targeted advice to young people with body image concerns who are at risk of developing disordered eating behaviours. This paper describes the methods for the economic evaluation of the SHINE cRCT, to determine whether the intervention is cost-effective as an obesity prevention measure.
A public payer perspective will be adopted, with intervention costs collected prospectively. Within-trial cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) will quantify the incremental costs and health gains of the intervention as compared with usual practice (ie, teacher-delivered curriculum). CEA will present results as cost per body mass index unit saved. CUA will present results as cost per quality-adjusted life year gained. A modelled CUA will extend the target population, time horizon and decision context to provide valuable information to policymakers on the potential for incremental cost offsets attributable to disease prevention arising from intervention. Intervention costs and effects will be extrapolated to the population of Australian adolescents in Grade 7 of secondary school (approximate age 13 years) and modelled over the cohort's lifetime. Modelled CUA results will be presented as health-adjusted life years saved and healthcare cost-savings of diseases averted. Incremental cost-effectiveness ratios will be calculated as the difference in costs between the intervention and comparator divided by the difference in benefit. Semi-structured interviews with key intervention stakeholders will explore the potential impact of scalability on cost-effectiveness. These data will be thematically analysed to inform sensitivity analysis of the base case economic evaluation, such that cost-effectiveness evidence is reflective of the potential for scalability.
Ethics approval was obtained from the Deakin University Human Research Ethics Committee (#2017-269) and the Victorian Department of Education and Training (#2018_003630). Study findings will be disseminated through peer-reviewed academic papers and participating schools will receive annual reports over the 3 years of data collection.
ACTRN 12618000330246; Pre-results.
关于预防肥胖和促进青少年健康体像的干预措施的成本效益，目前证据有限。SHINE（支持健康形象、营养和锻炼）研究是一项集群随机对照试验（cRCT），旨在向青少年提供关于健康营养和身体活动的普遍教育，以及向有体像问题风险且可能出现饮食失调行为的年轻人提供有针对性的建议。本文介绍了 SHINE cRCT 经济评估的方法，以确定该干预措施作为肥胖预防措施是否具有成本效益。
将采用公共支付者的视角，前瞻性收集干预成本。基于试验的成本效益分析（CEA）和成本效用分析（CUA）将量化干预措施与常规做法（即教师授课课程）相比的增量成本和健康收益。CEA 将以每单位体重指数节省的成本来表示结果。CUA 将以每获得一个质量调整生命年的成本来表示结果。基于模型的 CUA 将扩大目标人群、时间范围和决策背景，为决策者提供有关因干预而预防疾病所产生的增量成本抵消的潜在信息。干预成本和效果将外推到澳大利亚中学 7 年级（约 13 岁）的青少年人群，并在队列的一生中进行建模。基于模型的 CUA 结果将以节省的健康调整生命年和预防疾病的医疗保健成本节省表示。增量成本效益比将计算为干预措施和比较组之间的成本差异除以收益差异。对关键干预利益相关者的半结构化访谈将探讨可扩展性对成本效益的潜在影响。这些数据将进行主题分析，以告知对基础经济评估的敏感性分析，从而使成本效益证据反映出可扩展性的潜力。
迪肯大学人类研究伦理委员会（#2017-269）和维多利亚州教育部（#2018_003630）已批准该研究。研究结果将通过同行评审的学术论文进行传播，并且在数据收集的 3 年内，参与学校将每年收到报告。
ACTRN 12618000330246；预结果。
