| 1. |
- Feldman, Inna, Docent, 1951-, et al.
(författare)
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Economic Evaluations of Public Health Interventions to Improve Mental Health and Prevent Suicidal Thoughts and Behaviours : A Systematic Literature Review.
- 2021
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Ingår i: Administration and Policy in Mental Health and Mental Health Services Research. - : Springer Nature. - 0894-587X .- 1573-3289. ; 48:2, s. 299-315
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Tidskriftsartikel (refereegranskat)abstract
- To review the literature on economic evaluations of public health interventions targeting prevention of mental health problems and suicide, to support evidence based societal resource allocation. A systematic review of economic evaluations within mental health and suicide prevention was conducted including studies published between January 2000 and November 2018. The studies were identified through Medline, PsychINFO, Web of Science, the National Health Service Economic Evaluation Database and Health Technology Assessment. The quality of relevant studies and the transferability of their results were assessed using a criterion set out by the Swedish Agency for Health Technology Assessment. Nineteen studies of moderate to high quality were included in this review, which evaluated 18 interventions in mental health and four interventions in suicide prevention. Fourteen (63%) of all interventions were cost-effective based on the conclusions from original papers. None of the studies that evaluated suicide prevention was of high quality. The interventions largely focused on psychological interventions at school, the workplace and within elderly care as well as screening and brief interventions in primary care. Nine studies (around 50% of included articles) had a high potential for transferability to the Swedish context. Public health interventions aiming to improve mental health have a high potential to be economically beneficial to society, but high-quality evidence on the cost-effectiveness of suicide prevention is limited.
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| 2. |
- Fäldt, Anna, 1975-, et al.
(författare)
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Family-Based Intervention for Substance Using Parents : Experiences and Resource Use
- 2023
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Ingår i: Research on social work practice. - : Sage Publications. - 1049-7315 .- 1552-7581. ; 33:7, s. 810-821
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The study aimed to assess families? resource use and to explore parents? experiences of the Sofia model, a family-based intervention for parents with substance use disorder (SUD). Methods: Interviews were conducted with 14 parents. Data were analyzed with qualitative content analysis. The resource use assessment was estimated based on data for 40 families referred to the Sofia model and 30 reference families. Results: Parents described difficulties accessing family support and differences in received services in the Sofia model. The intervention lacked focus on the children. Families? communication regarding substance use did not increase. Resource use estimations indicated larger use of services by families in the Sofie model, but little co-parent and child-specific support. Conclusions: The intervention failed its aim to focus on the children, and enhance communication about SUD. Parents voiced a need for more long-term comprehensive support for their children and themselves.
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| 3. |
- Gebreslassie, Mihretab, et al.
(författare)
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Economic evaluations of public health interventions for physical activity and healthy diet : A systematic review
- 2020
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Ingår i: Preventive Medicine. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0091-7435 .- 1096-0260. ; 136
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Forskningsöversikt (refereegranskat)abstract
- Physical inactivity and unhealthy dietary habits are associated with an increased disease and economic burden. The aim of this systematic review was to identify economic evaluations of public health interventions targeting physical activity and healthy diet, and assess the quality and transferability of the findings to the Swedish context. A search of published economic evaluations was conducted through electronic databases including PubMed, Web of Science, PsycINFO, National Health Service Economic Evaluation Databases (NHS EED) and the Health Technology Assessment Database (HTA). An additional search was done using references of relevant systematic reviews and websites of relevant organizations were checked to find grey literature. Quality and transferability of the economic evaluations were appraised using a quality assessment tool developed by the Swedish Agency for Health Technology Assessment. Thirty-two economic evaluations, rated as moderate or high quality, of 178 interventions were included; thirteen studies targeting physical activity, thirteen targeting healthy diet and six targeting both. The interventions varied in terms of their content, setting, mode of delivery and target populations. A majority of the economic evaluations reported that the interventions were likely to be cost-effective; however, considerable variations in the methodological and reporting qualities were observed. Only half of the economic evaluations were rated to have a high probability of transferring to the Swedish context. Public health interventions targeting physical activity and dietary habits have a high potential to be cost-effective. However, decision makers should consider the variation in quality and transferability of the available evidence.
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| 4. |
- Nystrand, Camilla, et al.
(författare)
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A systematic review of economic evaluations of public health interventions targeting alcohol, tobacco, illicit drug use and problematic gambling : Using a case study to assess transferability.
- 2021
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 125:1, s. 54-74
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To identify and assess the cost-effectiveness of public health interventions targeting the use of alcohol, illicit drugs and tobacco, as well as problematic gambling behavior (ANDTS), and consider whether the results from these evaluations are transferable to the Swedish setting.METHODS: A systematic review of economic evaluations within the area of ANDTS was conducted including studies published between January 2000 and November 2018, identified through Medline, PsychINFO, Web of Science, the National Health Service Economic Evaluation Database and Health Technology Assessment. The quality of relevant studies and the possibilities of transferring results were assessed using criteria set out by the Swedish Agency for Health Technology Assessment.RESULTS: Out of 54 relevant studies, 39 were of moderate to high quality and included in the review, however none for problematic gambling. Eighty-one out of a total of 91 interventions were cost-effective. The interventions largely focusing on taxed-based policies or screening and brief interventions. Thirteen of these studies were deemed to have high potential for transferability, with effect estimates considered relevant, and with good feasibility for implementation in Sweden.CONCLUSIONS: Interventions targeting alcohol- and illicit-drug use and tobacco use are cost-effective approaches, and results may be transferred to the Swedish setting. Caution must be taken regarding cost estimates and the quality of the evidence which the studies are based upon.
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| 5. |
- Nystrand, Camilla, et al.
(författare)
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Adding the Coping Power Programme to parent management training : the cost‑effectiveness of stacking interventions for children with disruptive behaviour disorders
- 2020
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Nature. - 1018-8827 .- 1435-165X. ; 30, s. 1603-1614
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Tidskriftsartikel (refereegranskat)abstract
- Parent management training (PMT) programmes and child cognitive behavioural therapy are recommended approaches for treatment of oppositional defiant disorder in children, and combining these may be effective. However, little is known regarding the economic efficiency of this additive effect. A within-trial cost-effectiveness analysis was carried out in Sweden including 120 children aged 8–12 who screened positive for disruptive behaviour disorders, within a psychiatric care setting, and their parents. They were randomly assigned to either the Swedish group-based PMT Comet, or to an enhanced version, where an additional child component was provided, the Coping Power Programme (CPP). Child behaviour problems as well as healthcare and educational resource use were measured at baseline, post-test and at two-year follow-up. A net benefit regression framework was used to estimate differences in costs and health outcomes between the two intervention arms during the two-year period. Comet with CPP cost on average 820 EURO more per family than Comet only. At the 2-year follow-up, there were 37% recovered cases of ODD in Comet with CPP, in comparison to 26% in the Comet only arm. At a willingness-to-pay of approximately 62,300 EURO per recovered case of ODD, Comet with CPP yielded positive net benefits, in comparison to Comet only. Offering children the CPP simultaneously as their parents receive PMT, in comparison to only providing PMT, yields clinically relevant gains. Despite the relatively small cost for CPP, investment in combining PMT and CPP should be guided by resource prioritisation. Trial registration number: ISRCTN10834473, date of registration: 23/12/2015
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| 6. |
- Nystrand, Camilla, et al.
(författare)
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Cost-effectiveness analysis of parenting interventions for the prevention of behaviour problems in children
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Behavior problems are common among children and place a high disease and financial burden on individuals and society. Parenting interventions are commonly used to prevent such problems, but little is known about their possible longer-term economic benefits. This study modelled the longer-term cost-effectiveness of five parenting interventions delivered in a Swedish context: Comet, Connect, the Incredible Years (IY), COPE, bibliotherapy, and a waitlist control, for the prevention of persistent behavior problems.METHODS: A decision analytic model was developed and used to forecast the cost per averted disability-adjusted life-year (DALY) by each parenting intervention and the waitlist control, for children aged 5-12 years. Age-specific cohorts were modelled until the age of 18. Educational and health care sector costs related to behavior problems were included. Active interventions were compared to the waitlist control as well as to each other.RESULTS: Intervention costs ranged between US$ 14 (bibliotherapy) to US$ 1,300 (IY) per child, with effects of up to 0.23 averted DALYs per child (IY). All parenting interventions were cost-effective at a threshold of US$ 15,000 per DALY in relation to the waitlist control. COPE and bibliotherapy strongly dominated the other options, and an additional US$ 2,629 would have to be invested in COPE to avert one extra DALY, in comparison to bibliotherapy.CONCLUSIONS: Parenting interventions are cost-effective in the longer run in comparison to a waitlist control. Bibliotherapy or COPE are the most efficient options when comparing interventions to one another. Optimal decision for investment should to be based on budget considerations and priority settings.
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| 7. |
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| 8. |
- Nystrand, Camilla, et al.
(författare)
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Cost-Offset Analysis Of Social And Emotional Learning Programs For The Prevention Of Externalizing Behavior Problems : An Economic Modeling Study
- 2017
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Ingår i: Value in Health. - : Elsevier BV. - 1098-3015 .- 1524-4733. ; 20:5, s. A297-A297
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: Externalizing behavior problems are common among children,and place a high disease and financial burden on individuals and society. Social and Emotional Learning (SEL) programs are commonly used to prevent such problems, but little is known about their possible longer-term cost-offsets. This study estimates the costs and longer term savings of the two evidence based SEL programs currently available in Sweden, Good Behavior Game and Second Step, for the reduction of externalizing behavior problems in children.METHODS: A population-based Markov model was developed to estimate the cost-savings of the two SEL programs compared to a no intervention scenario, achieved by a reduction in clinical cases of attention-deficit/hyperactivity disorder (ADHD), Conduct disorder (CD) and comorbid ADHD/CD. Epidemiological data were collected from the 2015 Global Burden of Disease Study. Intervention effectiveness parameters were estimated from a meta-analysis of relevant studies, where effects assumed to reduce to zero after one year. This study adopted a limited societal perspective including costs accruing to the healthcare and education sectors while intervention costs were based on intervention descriptions. The target population was a cohort of 8-10-year-old healthy children in the 2015 Swedish population followed through to the age of 15 years, assuming 100% intervention coverage. Multivariate probabilistic and univariate sensitivity analyses were conducted to test model assumptions.RESULTS: Intervention cost per child amounted to 70 USD and total cost-savings per child over the modeling period were estimated at 330 USD. The cost-offset relationship for prevention was 1.49, implying that for 1 USD invested, 1.49 USD can be gained over the modeling period.CONCLUSIONS: Our results suggest that these two evidence based SEL programs are likely to yield cost-savings to society. Further research is needed to investigate cost-savings accruing to other sectors of the society, as well as the cost-effectiveness of such interventions.
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| 9. |
- Nystrand, Camilla, et al.
(författare)
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Economic Return on Investment of Parent Training Programmes for the Prevention of Child Externalising Behaviour Problems
- 2020
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Ingår i: Administration and Policy in Mental Health and Mental Health Services Research. - : Springer Science and Business Media LLC. - 0894-587X .- 1573-3289. ; 47:2, s. 300-315
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Tidskriftsartikel (refereegranskat)abstract
- Economic models to inform decision-making are gaining popularity, especially for preventive interventions. However, there are few estimates of the long-term returns to parenting interventions used to prevent mental health problems in children. Using data from a randomised controlled trial evaluating five indicated parenting interventions for parents of children aged 5-12, we modeled the economic returns resulting from reduced costs in the health care and education sector, and increased long-term productivity in a Swedish setting. Analyses done on the original trial population, and on various sized local community populations indicated positive benefit-cost ratios. Even smaller local authorities would financially break-even, thus interventions were of good value-for-money. Benefit-cost analyses of such interventions may improve the basis for resource allocation within local decision-making.
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| 10. |
- Nystrand, Camilla, et al.
(författare)
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Indicated Parenting Interventions and Long Term Outcomes : A Health Economic Modeling Study
- 2018
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Ingår i: Value in Health. - : Elsevier. - 1098-3015 .- 1524-4733. ; 21, s. S76-S76
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Konferensbidrag (refereegranskat)abstract
- Economic evaluations of early interventions for children are augmenting in numbers and a larger focus is put on the longer-term economic returns. However, little is known about the labour market returns from preventive parenting programs. This study estimates the benefits and costs of five parenting interventions: Comet, Connect, the Incredible Years (IY), Cope and bibliotherapy, compared to a waitlist control, for the prevention of persistent externalizing behavior problems in children.
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