了解儿科体重管理干预措施的实施成本：一项经济评估方案。

Understanding implementation costs of a pediatric weight management intervention: an economic evaluation protocol.

作者信息

Michaud Tzeyu L, Hill Jennie L, Heelan Kate A, Bartee R T, Abbey Bryce M, Malmkar Ali, Masker John, Golden Caitlin, Porter Gwenndolyn, Glasgow Russell E, Estabrooks Paul A

机构信息

Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.

Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Implement Sci Commun. 2022 Apr 5;3(1):37. doi: 10.1186/s43058-022-00287-1.

DOI:10.1186/s43058-022-00287-1

PMID:35382891

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8981827/

Abstract

BACKGROUND

Understanding the cost and/or cost-effectiveness of implementation strategies is crucial for organizations to make informed decisions about the resources needed to implement and sustain evidence-based interventions (EBIs). This economic evaluation protocol describes the methods and processes that will be used to assess costs and cost-effectiveness across implementation strategies used to improve the reach, adoption, implementation, and organizational maintenance of an evidence-based pediatric weight management intervention- Building Health Families (BHF).

METHODS

A within-trial cost and cost-effectiveness analysis (CEA) will be completed as part of a hybrid type III effectiveness-implementation trial (HEI) designed to examine the impact of an action Learning Collaborative (LC) strategy consisting of network weaving, consultee-centered training, goal-setting and feedback, and sustainability action planning to improve the adoption, implementation, organizational maintenance, and program reach of BHF in micropolitan and surrounding rural communities in the USA, over a 12-month period. We discuss key features of implementation strategy components and the associated cost collection and outcome measures and present brief examples on what will be included in the CEA for each discrete implementation strategy and how the results will be interpreted. The cost data will be collected by identifying implementation activities associated with each strategy and using a digital-based time tracking tool to capture the time associated with each activity. Costs will be assessed relative to the BHF program implementation and the multicomponent implementation strategy, included within and external to a LC designed to improve reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of BHF. The CEA results will be reported by RE-AIM outcomes, using the average cost-effectiveness ratio or incremental cost-effectiveness ratio. All the CEAs will be performed from the community perspective.

DISCUSSION

The proposed costing approach and economic evaluation framework for dissemination and implementation strategies and EBI implementation will contribute to the evolving but still scant literature on economic evaluation of implementation and strategies used and facilitate the comparative economic analysis.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04719442 . Registered on January 22, 2021.

摘要

背景

了解实施策略的成本和/或成本效益对于组织就是否需要投入资源来实施和维持循证干预措施（EBI）做出明智决策至关重要。本经济评估方案描述了将用于评估多种实施策略的成本和成本效益的方法和流程，这些策略旨在提高一项循证儿童体重管理干预措施——“构建健康家庭”（BHF）的覆盖范围、采用率、实施情况及在组织内的维持情况。

方法

作为一项混合型III期效果-实施试验（HEI）的一部分，将完成一项试验内成本和成本效益分析（CEA）。该HEI旨在检验一种行动学习协作（LC）策略的影响，该策略包括网络编织、以咨询对象为中心的培训、目标设定与反馈以及可持续性行动计划，以在12个月内提高BHF在美国小都市及周边农村社区的采用率、实施情况、在组织内的维持情况以及项目覆盖范围。我们讨论了实施策略组成部分的关键特征以及相关的成本收集和结果测量方法，并简要举例说明每个离散实施策略的CEA将包括哪些内容以及如何解读结果。成本数据将通过识别与每个策略相关的实施活动并使用基于数字的时间跟踪工具来记录与每个活动相关的时间来收集。将相对于BHF项目实施以及旨在提高BHF的覆盖范围、效果、采用率、实施情况和维持情况（RE-AIM）的LC内部和外部的多成分实施策略来评估成本。CEA结果将使用平均成本效益比或增量成本效益比按RE-AIM结果进行报告。所有CEA都将从社区角度进行。