Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

Mitchell, P. M.; Husbands, Samantha; Byford, Sarah; Kinghorn, Philip; Bailey, Cara; Peters, Tim J.; Coast, Joanna

doi:10.1002/hec.4363

Cited by 11 publications

(8 citation statements)

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“…A comparison of capability wellbeing with measures of health status and subjective wellbeing during the COVID-19 pandemic may also be useful to help decision-makers choose appropriate tools to aid their decision-making on the quality of life impacts across the general population during pandemics and social restrictions. We would also recommend future general population analysis to account for the impact on children and young people’s capabilities, with measures in this area currently under development [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Estimating loss in capability wellbeing in the first year of the COVID-19 pandemic: a cross-sectional study of the general adult population in the UK, Australia and the Netherlands

et al. 2022

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Objectives To estimate capability wellbeing lost from the general adult populations in the UK, Australia and the Netherlands in the first year of the COVID-19 pandemic and the associated social restrictions, including lockdowns. Design Cross-sectional with recalled timepoints. Setting Online panels in the UK, Australia and the Netherlands conducted in February 2021 (data collected 26 January–2 March 2021). Participants Representative general adult (≥ 18 years old) population samples in the UK (n = 1,017), Australia (n = 1,011) and the Netherlands (n = 1,017) Main outcome measure Participants completed the ICECAP-A capability wellbeing measure in February 2021, and for two recalled timepoints during the initial lockdowns in April 2020 and in February 2020 (prior to COVID-19 restrictions in all three countries). ICECAP-A scores on a 0–1 no capability–full capability scale were calculated for each timepoint. Societal willingness to pay estimates for a year of full capability (YFC) was used to place a monetary value associated with change in capability per person and per country. Paired t tests were used to compare changes in ICECAP-A and YFC from pre- to post-COVID-19-related restrictions in each country. Results Mean (standard deviation) loss of capability wellbeing during the initial lockdown was 0.100 (0.17) in the UK, 0.074 (0.17) in Australia and 0.049 (0.12) in the Netherlands. In February 2021, losses compared to pre-lockdown were 0.043 (0.14) in the UK, 0.022 (0.13) in Australia and 0.006 (0.11) in the Netherlands. In monetary terms, these losses were equivalent to £14.8 billion, AUD$8.6 billion and €2.1 billion lost per month in April 2020 and £6.4 billion, A$2.6 billion and €260 million per month in February 2021 for the UK, Australia and the Netherlands, respectively. Conclusions There were substantial losses in capability wellbeing in the first year of the COVID-19 pandemic. Future research is required to understand the specific impact of particular COVID-19 restrictions on people’s capabilities.

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Section: Discussionmentioning

confidence: 99%

Estimating loss in capability wellbeing in the first year of the COVID-19 pandemic: a cross-sectional study of the general adult population in the UK, Australia and the Netherlands

et al. 2022

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“…As a challenge to the QALY used by NICE, there is a programme of work developing in the capability paradigm of outcome measurement in health economics. This centers around a framework based on conceiving capabilities as evolving across the life-course (10). Concerning children and young people, the term well-being capability is used.…”

Section: Current Use Of a Life-course Approach To Well-being And Well...mentioning

confidence: 99%

“…The capability movement in outcome measurement in health economics is addressing the challenge of measuring outcomes within a life-course model. This approach allows for the development of an economic evaluation framework that places different capabilities at the center of attention depending on where an individual is at in their life-course trajectory (10). A recent paper by Deidda et al (39) is a good example of a cost-effectiveness analysis of a public health prevention interventionwhich used both QALYs and well-being capabilities in the area of reducing sedentary behavior across four European countries.…”

Section: Current Use Of a Life-course Approach To Well-being And Well...mentioning

confidence: 99%

“…Second, the paper contrasts this with advances in the capability paradigm, based on Sen's contribution in development economics (22). The capability movement in health economics is producing life-course stage specific measures focusing on capabilities rather than qualityadjusted life years (QALYs) (10). Third, the paper illustrates Edwards .…”

Section: Introductionmentioning

confidence: 97%

“…In an education context it has been used to carefully distinguish between how we help children in "being well" in the present and in well-becoming in shaping their future "being" and hence opportunities. In the field of health economics, the only place we have found reference to it is in the development of capability measures through the life-course (10). In mainstream economics, the financial benefits of investing in well-becoming are found in the work of James Heckman, a Chicago Nobel Prize-winning economist (11).…”

Section: Introductionmentioning

confidence: 99%

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Well-being and well-becoming through the life-course in public health economics research and policy: A new infographic

Edwards

2022

Front. Public Health

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BackgroundThe term “well-becoming” is not new, but is not routinely used in our everyday language or in research in public health economics. It has been applied in early years research. Well-becoming can be thought of as our multitude of life-journeys toward meaning and purposefulness.ObjectiveTo develop a new infographic in the spirit of the Dahlgren and Whitehead rainbow infographic of social determinants of health. The purpose being to redefine well-being as a process of growth through life, articulated as well-becoming.MethodsA rapid review of life-course stage appropriate models of well-being was undertaken with stages of the life-course as defined as: preconception and birth; early years; adolescence; working, parenting and caring; older age, and death. Infographics in this area were identified and the information above was used to design a new infographic with the concept of well-being and well-becoming at its center.ResultsA new infographic reflecting an underlying concept of “the wheel of life” is presented. It shows movement through the life-course at its center, with concentric rings summarizing personal, local, and national and global factors that have an impact on well-being and well-becoming of individuals through the life-course. Of note, is the inclusion of death, which is a topic often avoided. Prepared during 2021–22, the infographic reflects the role of pandemic and war within the national and global ring of influential factors. I reflect on three ways in which health economists are currently using a life-course approach and the concept of well-becoming in the economic evaluation of individual programs and at a population level of government policy.ConclusionMoving from solely focusing on a concept of well-being to a concept of well-being and well-becoming acknowledges the influence that socioeconomic and other conditions in a particular life-course stage have on subsequent life-course stages, and the cost-effectiveness of intervening across the life-course.

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Is well-becoming important for children and young people? Evidence from in-depth interviews with children and young people and their parents

Husbands,

Mitchell,

Kinghorn

et al. 2024

Qual Life Res

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Purpose This study explores how important well-becoming factors appear to be to children during childhood. We define well-becoming as the indicators which predict children and young people’s future wellbeing and opportunities. The priority for this work was to explore whether well-becoming might be an important factor to include in outcome measures for children and young people. The inclusion of well-becoming indicators could ensure that opportunities to invest in promoting wellbeing in children’s futures are not missed. Methods In-depth, qualitative interviews (N = 70) were undertaken with children and young people aged 6–15 years and their parents. Analysis used constant comparison and framework methods to investigate whether well-becoming factors were considered important by informants to children and young people’s current wellbeing. Results The findings of the interviews suggested that children and young people and their parents are concerned with future well-becoming now, as factors such as future achievement, financial security, health, independence, identity, and relationships were identified as key to future quality of life. Informants suggested that they considered it important during childhood to aspire towards positive outcomes in children and young people’s futures. Conclusion The study findings, taken alongside relevant literature, have generated evidence to support the notion that future well-becoming is important to current wellbeing. We have drawn on our own work in capability wellbeing measure development to demonstrate how we have incorporated a well-becoming attribute into our measures. The inclusion of well-becoming indicators in measures could aid investment in interventions which more directly improve well-becoming outcomes for children and young people.

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Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

Cited by 11 publications

References 137 publications

Estimating loss in capability wellbeing in the first year of the COVID-19 pandemic: a cross-sectional study of the general adult population in the UK, Australia and the Netherlands

Estimating loss in capability wellbeing in the first year of the COVID-19 pandemic: a cross-sectional study of the general adult population in the UK, Australia and the Netherlands

Well-being and well-becoming through the life-course in public health economics research and policy: A new infographic

Is well-becoming important for children and young people? Evidence from in-depth interviews with children and young people and their parents

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