支持卫生专业人员实施身体活动促进的成本效益：PROMOTE-PA有效性-实施混合试验的试验内和模型经济评估方案

Cost-effectiveness of support for health professionals to implement physical activity promotion: a protocol for within-trial and modelled economic evaluations of the PROMOTE-PA effectiveness-implementation hybrid trial.

作者信息

Wang Belinda, Sherrington Catherine, Baldwin Jennifer N, Hassett Leanne, Purcell Kate, Savage Roslyn, Tiedemann Anne, Chagpar Sakina, Cheung Daniel, Noetel Michael, Clutterbuck Georgina, Howard Kirsten, Pinheiro Marina

机构信息

School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia

Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2025 Apr 5;15(4):e098452. doi: 10.1136/bmjopen-2024-098452.

DOI:10.1136/bmjopen-2024-098452

PMID:40187775

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11973784/

Abstract

INTRODUCTION

Physical activity has important benefits for the prevention and management of chronic diseases and healthy ageing. Health professionals have valuable opportunities to promote physical activity to a large group of people across the lifespan. Promotion of Physical Activity by Health Professionals is a hybrid type 1 effectiveness-implementation cluster randomised trial designed to evaluate the impact of physical activity promotion by health professionals (n=30 clusters) on physical activity participation in their patients (n=720). To inform the future implementation of this programme, we will be conducting a within-trial and modelled economic evaluation.

METHODS AND ANALYSIS

We will conduct a cost-effectiveness and cost-utility analysis from the perspective of the healthcare, aged care and disability funder. The time horizon will be 6 months for the within-trial analysis and 2 years for the modelled analysis. Data on intervention costs will be collected using trial records. Data on healthcare utilisation will be collected using data linkage. Incremental cost-effectiveness ratios (ICERs) will be reported for physical activity and quality-adjusted life years outcomes. Bootstrapping will be used to explore uncertainty around the ICERs and estimate 95% CIs. Results will be presented on a cost-effectiveness plane. The probability that the intervention would be cost-effective at varying willingness-to-pay thresholds will be presented using a cost-effectiveness acceptability curve.

ETHICS AND DISSEMINATION

Ethics approval was obtained through Sydney Local Health District (RPAH zone) Ethics Review Committee (X23-0197). The findings of this study will be disseminated through peer-reviewed journal articles and conference presentations.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry: ACTRN12623000920695.

摘要

引言

体育活动对慢性病的预防与管理以及健康老龄化具有重要益处。健康专业人员有宝贵机会在人的整个生命周期内向大量人群推广体育活动。《健康专业人员对体育活动的推广》是一项1型混合有效性-实施整群随机试验，旨在评估健康专业人员（30个整群）对其患者（720名）体育活动参与情况的体育活动推广影响。为指导该项目未来的实施，我们将进行试验内和模型化经济评估。

方法与分析

我们将从医疗保健、老年护理和残疾资助者的角度进行成本效益和成本效用分析。试验内分析的时间范围为6个月，模型化分析为2年。干预成本数据将通过试验记录收集。医疗保健利用数据将通过数据链接收集。将报告体育活动和质量调整生命年结果的增量成本效益比（ICER）。将使用自抽样法探讨ICER周围的不确定性并估计95%置信区间。结果将呈现在成本效益平面上。将使用成本效益可接受性曲线呈现干预在不同支付意愿阈值下具有成本效益的概率。