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Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions
BACKGROUND: Cost-effectiveness analyses of behavioral interventions typically use a dichotomous outcome criterion. However, achieving behavioral change is a complex process involving several steps towards a change in behavior. Delayed effects may occur after an intervention period ends, which can le...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579467/ https://www.ncbi.nlm.nih.gov/pubmed/22223124 http://dx.doi.org/10.1007/s10198-011-0371-6 |
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author | Prenger, Rilana Pieterse, Marcel E. Braakman-Jansen, Louise M. A. van der Palen, Job Christenhusz, Lieke C. A. Seydel, Erwin R. |
author_facet | Prenger, Rilana Pieterse, Marcel E. Braakman-Jansen, Louise M. A. van der Palen, Job Christenhusz, Lieke C. A. Seydel, Erwin R. |
author_sort | Prenger, Rilana |
collection | PubMed |
description | BACKGROUND: Cost-effectiveness analyses of behavioral interventions typically use a dichotomous outcome criterion. However, achieving behavioral change is a complex process involving several steps towards a change in behavior. Delayed effects may occur after an intervention period ends, which can lead to underestimation of these interventions. To account for such delayed effects, intermediate outcomes of behavioral change may be used in cost-effectiveness analyses. The aim of this study is to model cognitive parameters of behavioral change into a cost-effectiveness model of a behavioral intervention. METHODS: The cost-effectiveness analysis (CEA) of an existing dataset from an RCT in which an high-intensity smoking cessation intervention was compared with a medium-intensity intervention, was re-analyzed by modeling the stages of change of the Transtheoretical Model of behavioral change. Probabilities were obtained from the dataset and literature and a sensitivity analysis was performed. RESULTS: In the original CEA over the first 12 months, the high-intensity intervention dominated in approximately 58% of the cases. After modeling the cognitive parameters to a future 2nd year of follow-up, this was the case in approximately 79%. CONCLUSION: This study showed that modeling of future behavioral change in CEA of a behavioral intervention further strengthened the results of the standard CEA. Ultimately, modeling future behavioral change could have important consequences for health policy development in general and the adoption of behavioral interventions in particular. |
format | Online Article Text |
id | pubmed-3579467 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-35794672013-02-26 Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions Prenger, Rilana Pieterse, Marcel E. Braakman-Jansen, Louise M. A. van der Palen, Job Christenhusz, Lieke C. A. Seydel, Erwin R. Eur J Health Econ Original Paper BACKGROUND: Cost-effectiveness analyses of behavioral interventions typically use a dichotomous outcome criterion. However, achieving behavioral change is a complex process involving several steps towards a change in behavior. Delayed effects may occur after an intervention period ends, which can lead to underestimation of these interventions. To account for such delayed effects, intermediate outcomes of behavioral change may be used in cost-effectiveness analyses. The aim of this study is to model cognitive parameters of behavioral change into a cost-effectiveness model of a behavioral intervention. METHODS: The cost-effectiveness analysis (CEA) of an existing dataset from an RCT in which an high-intensity smoking cessation intervention was compared with a medium-intensity intervention, was re-analyzed by modeling the stages of change of the Transtheoretical Model of behavioral change. Probabilities were obtained from the dataset and literature and a sensitivity analysis was performed. RESULTS: In the original CEA over the first 12 months, the high-intensity intervention dominated in approximately 58% of the cases. After modeling the cognitive parameters to a future 2nd year of follow-up, this was the case in approximately 79%. CONCLUSION: This study showed that modeling of future behavioral change in CEA of a behavioral intervention further strengthened the results of the standard CEA. Ultimately, modeling future behavioral change could have important consequences for health policy development in general and the adoption of behavioral interventions in particular. Springer-Verlag 2012-01-06 2013 /pmc/articles/PMC3579467/ /pubmed/22223124 http://dx.doi.org/10.1007/s10198-011-0371-6 Text en © The Author(s) 2012 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Paper Prenger, Rilana Pieterse, Marcel E. Braakman-Jansen, Louise M. A. van der Palen, Job Christenhusz, Lieke C. A. Seydel, Erwin R. Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title | Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title_full | Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title_fullStr | Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title_full_unstemmed | Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title_short | Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
title_sort | moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579467/ https://www.ncbi.nlm.nih.gov/pubmed/22223124 http://dx.doi.org/10.1007/s10198-011-0371-6 |
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