Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children?: a register-based retrospective observational study

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Häggström, JennyUmeå universitet,Statistik,Umeå SIMSAM Lab,Umeå University, Umeå School of Business and Economics, Department of Statistics (author)

Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children? : a register-based retrospective observational study

Article/chapterEnglish2017

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2017-09-21
BMJ Publishing Group Ltd,2017
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:umu-139899
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-139899URI
https://doi.org/10.1136/bmjopen-2017-016732DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-337760URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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OBJECTIVES: This study investigates the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention, compared with care-as-usual, over the periods of pregnancy, delivery and the child's first 2 years of life.METHOD: We adopted a register-based retrospective observational design using existing data sources with respect to both exposures and outcomes. Health outcomes and costs were compared between geographical areas that received care-as-usual (non-Salut area) and areas where the programme was implemented (Salut area). We included mothers and their children from both the Salut and non-Salut areas if: (1) the child was born 2002-2004 (premeasure period) or (2) the child was born 2006-2008 (postmeasure period). The effectiveness study adopted two strategies: (1) a matched difference-in-difference analysis using data from all participants and (2) a longitudinal analysis restricted to mothers who had given birth twice, that is, both in the premeasure and postmeasure periods. The economic evaluation was performed from a healthcare and a limited societal perspective. Outcomes were clustered during pregnancy, delivery and birth and the child's first 2 years.RESULTS: Difference-in-difference analyses did not yield any significant effect on the outcomes. Longitudinal analyses resulted in significant positive improvement in Apgar scores, reflecting the newborn's physical condition, with more children having a normal Apgar score (1 min +3%, 5 min +1%). The cost of the programme was international dollar (INT$)308/child. From both costing perspectives, the programme yielded higher effects and lower costs than care-as-usual, being thus cost-saving (probability of around 50%).CONCLUSIONS: Our findings suggest that the Salut Programme is an effective universal intervention to improve maternal and child health, and it may be good value for money; however, there is large uncertainty around the cost estimates.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
Child Health
Cost-effectiveness
Health Promotion
Intervention Effectiveness
Maternal Health
Universal Intervention

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Sampaio, Filipa,PhD,1985-Uppsala universitet,Socialmedicin/CHAP(Swepub:uu)filsa251 (author)
Eurenius, EvaUmeå universitet,Epidemiologi och global hälsa,Umeå SIMSAM Lab,Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health(Swepub:umu)evaeus87 (author)
Pulkki-Brännström, Anni-MariaUmeå universitet,Epidemiologi och global hälsa,Umeå SIMSAM Lab,Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health(Swepub:umu)anpu0004 (author)
Ivarsson, AnneliUmeå universitet,Epidemiologi och global hälsa,Umeå SIMSAM Lab,Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health(Swepub:umu)aniv0001 (author)
Lindkvist, MarieUmeå universitet,Statistik,Epidemiologi och global hälsa,Umeå University, Umeå School of Business and Economics, Department of Statistics; Umeå University, Department of Public Health and Clinical Medicine, Epidemiology and Global Health(Swepub:umu)mali0004 (author)
Feldman, Inna,Docent,1951-Uppsala universitet,Socialmedicin/CHAP(Swepub:uu)ife21721 (author)
Umeå universitetStatistik (creator_code:org_t)

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