Cost-Effectiveness of Facilitated Access to a Self-Management Website, Compared to Usual Care, for Patients With Type 2 Diabetes (HeLP-Diabetes): Randomized Controlled Trial

Journal of Medical Internet Research, Journal Year: 2018, Volume and Issue: 20(6), P. e201 - e201

Published: June 8, 2018

Background: Type 2 diabetes mellitus is one of the most common long-term conditions, and costs health services approximately 10% their total budget. Active self-management by patients improves outcomes reduces service costs. While existing evidence suggested that uptake education was low, development internet-based technology might improve situation.

Language: Английский

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On spillovers in economic evaluations: definition, mapping review and research agenda

The European Journal of Health Economics, Journal Year: 2024, Volume and Issue: 25(7), P. 1239 - 1260

Published: Jan. 23, 2024

Abstract An important issue in economic evaluations is determining whether all relevant impacts are considered, given the perspective chosen for analysis. Acknowledging that patients not isolated individuals has implications this context. Increasingly, term “spillovers” used to label consequences of health interventions on others. However, a clear definition spillovers lacking, and as result, scope concept remains unclear. In study, we aim clarify by proposing applicable evaluations. To illustrate definition, highlight diversity potential through an expanded impact inventory conduct mapping review outlines evidence base different types spillovers. context interventions, define from intervention parties or entities other than users under evaluation . This encompasses broader range costs effects, beyond informal caregivers family members. The enables systematic approach identifying interventions. shows relevance context-specific. Some regularly included evaluations, although always recognised such, while others not. A consistent use “spillovers”, improved measurement these increased transparency reporting them still necessary. end, propose research agenda.

Language: Английский

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Planning, implementation, evaluation, and sustainment of digital health interventions for adolescent substance use prevention: a systematic review of influencing factors based on the RE-AIM framework

Health Education Research, Journal Year: 2025, Volume and Issue: 40(3)

Published: Jan. 1, 2025

Abstract School-based health interventions can help prevent adolescent substance use, but their success depends on various factors affecting planning and evaluation. This study examines the that facilitate or hinder of school-based digital interventions. A systematic review was conducted in September–October 2024, following PRISMA guidelines, using PubMed, Scopus, Web Science, CINAHL, PsycINFO databases. From a total 2530 studies, after removing duplicates screening titles abstracts, 51 full-text articles were assessed 12 met inclusion criteria. Data extracted an adapted tool for reviews applying RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. The methodological quality with Joanna Briggs Institute tools. studies included cluster-randomized controlled trials, quasi-experimental designs, one cross-sectional study, primarily targeting adolescents aged 11.9–17.4 years, sample sizes ranging from 90 to nearly 5000 participants. Most implemented schools USA, Europe, Taiwan, balanced gender distribution. Many reported reach effectiveness reducing particularly alcohol. However, adoption implementation influencing school participation less frequently addressed, maintenance not mentioned. To maximize impact, future efforts should focus enhancing sustainment by leveraging emerging technologies personalization.

Language: Английский

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A Web-Based, Computer-Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized Controlled Trial

Journal of Medical Internet Research, Journal Year: 2019, Volume and Issue: 22(1), P. e15438 - e15438

Published: Oct. 19, 2019

Alcohol consumption, including binge drinking (BD) and heavy episodic (HED), is one of the leading risk factors among Spanish adolescents to significant social, health, economic consequences. Reduction BD HED in can be achieved using Web-based, computer-tailored (CT) interventions, providing highly personalized feedback that adapted a person's individual characteristics needs. Randomized controlled trials assessing effects tailored reduction programs are scarce.The aim this study was test effectiveness CT intervention Alerta Alcohol, aimed at prevention adolescents. As secondary outcome, on HED, weekly any consumption were also assessed. The adherence process evaluation assessed.A cluster randomized trial conducted 15 schools developed. Each school into either an experimental condition (EC) (N=742) or control (CC) (N=505). Finally, 351 participants for EC 261 CC included analysis (N=612). Baseline assessment took place January February 2017. Demographic variables alcohol use assessed baseline. Follow-up 4 months later May June Participants compared according their randomization group (EC versus CC). After baseline assessment, started intervention, which consisted short stories about BD, based I-Change Model behavior change. only received questionnaire. Effects three-level mixed logistic regression linear consumption.In total, 1247 participated 612 follow-up assessment; attrition rate 50.92%. effective reducing adolescents; odds nine times (P=.04). No found consumption. Process evaluations revealed satisfied with program (68.8%), would again (52.9%), recommend it someone else (62.8%). Females non-binge drinkers showed better responses evaluation.Our regarding but not It may limiting prevent easier context than carry out further steps, such as other patterns Hence, additional actions needed accomplish these latter goals, community approaches policy denormalizing adolescents.ClinicalTrials.gov NCT03288896; https://clinicaltrials.gov/ct2/show/NCT03288896.RR2-10.1186/s12889-018-5346-4.

Language: Английский

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A web-based self-management programme for people with type 2 diabetes: the HeLP-Diabetes research programme including RCT

Programme Grants for Applied Research, Journal Year: 2018, Volume and Issue: 6(5), P. 1 - 242

Published: Sept. 1, 2018

Background In the UK, 6% of UK population have diabetes mellitus, 90% whom type 2 mellitus (T2DM). Diabetes accounts for 10% NHS expenditure (£14B annually). Good self-management may improve health outcomes. policy is to refer all people with T2DM structured education, on diagnosis, their skills, annual reinforcement thereafter. However, uptake remains low (5.6% in 2014–15). Almost education group based, which not suit who work, family or other caring commitments simply do like group-based formats. Moreover, patient needs vary time and a single session at diagnosis unlikely meet these evolving needs. A web-based programme increase uptake. Objectives Our aim was develop, evaluate implement any stage illness journey, goal improving access to, of, support, thereby outcomes cost-effective manner. Specific objectives were (1) develop an evidence-based theoretically informed that acceptable patients health-care professionals (HCPs) could be readily implemented within routine care, (2) determine clinical effectiveness cost-effectiveness compared usual care (3) how best integrate into care. Design There five linked work packages (WPs). WP determined requirements B HCP programme. C developed user-tested Healthy Living People (HeLP-Diabetes) D individually randomised controlled trial primary economic analysis. E used mixed-methods case-study design study potential implementing HeLP-Diabetes practice. Setting English Participants (WPs A, E) HCPs B, E). Intervention The programme; stages using participatory principles. Main outcome measures WPs provided data user ‘wants needs’, including factors would accessibility itself. (WP D) had two measures: glycated haemoglobin (HbA 1c ) level mellitus-related distress, as measured Problem Areas (PAID) scale. implementation adoption commissioning group, general practice levels identification key barriers facilitators. Results Data from supported our holistic approach addressed areas (medical, emotional role management). voiced concerns about linkage electronic medical records (EMRs) supporting use C. recruited target ( n = 374), achieved follow-up rates over 80% intention-to-treat analysis showed there additional improvement HbA 12 months intervention [mean difference –0.24%, 95% confidence interval (CI) –0.44% –0.049%]. no overall PAID score (mean –1.5 points, CI –3.9 0.9 points). within-trial found incremental costs lower than control –£111, –£384 £136) quality-adjusted life-years (QALYs) higher 0.02 QALYs, 0.000 0.044 QALYs), meaning dominated group. E, we successfully General practices registering better registered wider demographic those relying self-registration. Some reluctant this, they did see it part professional role. Limitations We unable link EMRs effects users study. Conclusions effective support implementable Future research team will explore following future work: support; digital educational pathway newly diagnosed people; prevention national Trial registration Research Ethics Committee reference number 10/H0722/86 A–C; 12/LO/1571 Clinical Network/National Institute Health (NIHR) Portfolio 13563 D; 13/EM/0033 E. addition, D, International Standard Randomised Controlled Register ISRCTN02123133. Funding details This project funded by NIHR Programme Grants Applied published full ; Vol. 6, No. 5. See Journals Library website further information.

Language: Английский

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Design, implementation and evaluation of a web-based computer-tailored intervention to prevent binge drinking in adolescents: study protocol

BMC Public Health, Journal Year: 2018, Volume and Issue: 18(1)

Published: April 4, 2018

Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation evaluation of first web-based computer tailored intervention aimed at prevention binge drinking Spanish adolescents. The Alerta Alcohol program based on I-Change Model. First, feedback from focus Delphi groups are used for cultural adaptation to obtain further information items be included program. A pilot study then conducted assess feasibility identify strengths weaknesses. Second, Cluster Randomized Controlled Trial test effectiveness students aged 16 18 years. performed high schools Andalusia (southern Spain), which randomized either experimental or control condition (EC CC). EC receives intervention, consists four sessions school (baseline questionnaire, two three scenarios: home, celebrations, public places, final evaluation). provided answers related their views each scenario; this provide specific regarding knowledge, risk perception, self-esteem, attitude, social influence, self-efficacy. In addition, booster given home reinforce previous messages. CC just completes baseline questionnaires they allowed receive as well (as waiting list). Evaluation takes place after months. primary endpoint within 30 days prior alcohol use week. It expected reduce prevalence by 10%. Follow up analyses carried out determine differences according compliance (quality implementation). results applicable may incorporate improvements practice Healthcare Education Systems. If proves effective, regional eventual national should considered. registration number (ClinicalTrials.gov): NCT03288896 . was retrospectively registered 19/09/2017.

Language: Английский

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Econometric Issues in Prospective Economic Evaluations Alongside Clinical Trials: Combining the Nonparametric Bootstrap With Methods That Address Missing Data

Epidemiologic Reviews, Journal Year: 2022, Volume and Issue: 44(1), P. 67 - 77

Published: Jan. 1, 2022

Abstract Prospective economic evaluations conducted alongside clinical trials have become an increasingly popular approach in evaluating the cost-effectiveness of a public health initiative or treatment intervention. These types studies provide improved internal validity and accuracy cost effectiveness estimates interventions and, compared with simulation decision-analytic models, advantage jointly observing economics outcomes trial participants. However, missing data due to incomplete response patient attrition, sampling uncertainty are common concerns econometric analysis trials. Missing particular problem for comparative substance use disorder interventions. Multiple imputation inverse probability weighting 2 widely recommended methods address bias, nonparametric bootstrap is predicted mean between Although these been studied extensively by themselves, little known about how appropriately combine them potential pitfalls advantages different approaches. We review statistical used 29 intervention identified from 4 published systematic reviews targeted search literature. evaluate each study addressed whether was used, were combined, conclude recommendations future research.

Language: Английский

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Cost‐effectiveness and cost‐utility analyses of a web‐based computer‐tailored intervention for prevention of binge drinking among Spanish adolescents

Alcohol Clinical and Experimental Research, Journal Year: 2023, Volume and Issue: 47(2), P. 319 - 335

Published: Feb. 1, 2023

Abstract Background Binge drinking (BD) among adolescents is a public health concern worldwide. This study assessed the cost‐effectiveness and cost‐utility of web‐based computer‐tailored intervention to prevent BD in adolescence. Methods The sample was drawn from evaluating Alerta Alcohol program. population consisted 15 19 years age. Data were recorded at baseline (January February 2016) after 4 months (May June 2017) used estimate costs outcomes, as measured by number occasions quality‐adjusted life (QALYs). Incremental ratios calculated National Health Service (NHS) societal perspectives for time horizon months. A multivariate deterministic sensitivity analysis best/worst scenarios subgroups account uncertainty. Results cost reducing one per month €16.63 NHS perspective, which perspective resulted savings €7986.37. From an incremental €71.05 QALY gained this dominant, resulting €34,126.64 comparison with control group. Subgroup analyses showed that dominant girls both individuals 17 or older perspective. Conclusions Computer‐tailored feedback cost‐effective way reduce increase QALYs adolescents. However, long‐term follow‐up needed evaluate more fully changes health‐related quality life.

Language: Английский

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Computer-Based Prevention and Intervention to Reduce Substance Use in Youth

Current Addiction Reports, Journal Year: 2017, Volume and Issue: 4(4), P. 410 - 421

Published: Sept. 25, 2017

Language: Английский

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Fostering Engagement in Health Behavior Change: Iterative Development of an Interactive Narrative Environment to Enhance Adolescent Preventive Health Services

Journal of Adolescent Health, Journal Year: 2020, Volume and Issue: 67(2), P. S34 - S44

Published: July 24, 2020

Language: Английский

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