Jacobs J, Nichols M, Ward N, Sultana M, Allender S, Brown V
Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Deakin Health Economics, Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Health Care Anal. 2025 Jun;33(2):151-172. doi: 10.1007/s10728-024-00495-x. Epub 2024 Oct 3.
Community-based interventions (CBIs) show promise as effective and cost-effective obesity prevention initiatives. CBIs are typically complex interventions, including multiple settings, strategies and stakeholders. Cost-effectiveness evidence, however, generally only considers a narrow range of costs and benefits associated with anthropometric outcomes. While it is recognised that the complexity of CBIs may result in broader non-health societal and community benefits, the identification, measurement, and quantification of these outcomes is limited. This study aimed to understand the perspectives of stakeholders on the broader benefits of CBIs and their measurement, as well as perceptions of CBI cost-effectiveness. Purposive sampling was used to recruit participants from three stakeholder groups (lead researchers, funders, and community stakeholders of CBIs). Online semi-structured interviews were conducted, taking a constructivist approach. Coding, theme development and analysis were based on published guidance for thematic analysis. Twenty-six stakeholders participated in the interviews (12 lead researchers; 7 funders; 6 community stakeholders). Six key themes emerged; (1) Impacts of CBIs (health impacts and broader impacts); (2) Broader benefits were important to stakeholders; (3) Measurement of benefits are challenging; (4) CBIs were considered cost-effective; (5) Framing CBIs for community engagement (6) Making equitable impacts and sustaining changes-successes and challenges. Across all stakeholders, broader benefits, particularly the establishment of networks and partnerships within communities, were seen as important outcomes of CBIs. Participants viewed the CBI approach to obesity prevention as cost-effective, however, there were challenges in measuring, quantifying and valuing broader benefits. Development of tools to measure and quantify broader benefits would allow for more comprehensive evaluation of the cost-effectiveness of CBIs for obesity prevention.
基于社区的干预措施（CBIs）有望成为有效且具成本效益的肥胖预防举措。CBIs通常是复杂的干预措施，包括多个环境、策略和利益相关者。然而，成本效益证据一般仅考虑与人体测量结果相关的有限范围的成本和效益。虽然人们认识到CBIs的复杂性可能会带来更广泛的非健康社会和社区效益，但对这些结果的识别、测量和量化是有限的。本研究旨在了解利益相关者对CBIs更广泛效益及其测量的看法，以及对CBI成本效益的看法。采用目的抽样法从三个利益相关者群体（主要研究人员、资助者和CBIs的社区利益相关者）中招募参与者。采用建构主义方法进行在线半结构化访谈。编码、主题开发和分析基于已发表的主题分析指南。26名利益相关者参与了访谈（12名主要研究人员；7名资助者；6名社区利益相关者）。出现了六个关键主题：（1）CBIs的影响（健康影响和更广泛的影响）；（2）更广泛的效益对利益相关者很重要；（3）效益的测量具有挑战性；（4）CBIs被认为具有成本效益；（5）构建CBIs以促进社区参与（6）产生公平影响并维持变化——成功与挑战。在所有利益相关者中，更广泛的效益，特别是社区内网络和伙伴关系的建立，被视为CBIs的重要成果。参与者认为CBI预防肥胖的方法具有成本效益，然而，在测量、量化和评估更广泛的效益方面存在挑战。开发测量和量化更广泛效益的工具将有助于更全面地评估CBIs预防肥胖的成本效益。
