Costs of development and maintenance of an internet program for teens with type 1 diabetes

Abstract

Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths’ many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5–1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense.

Online Health Information-Seeking Behavior and Confidence in Filling Out Online Forms Among Latinos: A Cross-Sectional Analysis of the California Health Interview Survey, 2011-2012

“…Online interventions are viewed as a low-cost platform to deliver health information and interventions [ 38 , 39 ], but our findings show Latinos, particularly foreign-born Latinos, may not benefit from this shift to online delivery of health-related content and care. Our findings regarding a gap in Internet use and online health information-seeking behavior between non-Hispanic whites and Latinos are consistent with previous literature showing a disparity in Internet usage for online health information-seeking behavior in the general US population [ 15 , 18 , 19 ].…”

Using Social Media as a Research Tool for a Bespoke Web-Based Platform for Stakeholders of Children With Congenital Anomalies: Development Study

“…The development of a web-based network is expensive, as it requires ongoing administrative support [ 41 ]. Coordinating, reviewing, translating, and responding to posts and connecting to the internet requires considerable investment in time and expertise.…”

A systematic review of community‐based interventions for the treatment of adolescents with overweight and obesity

“…Online programs can be self‐paced or have group components which aim to build community and empower peer‐learning; however, there are generally higher levels of attrition or dropout, and hence a risk that participants may not be exposed to the program or intervention . Consequently, participant engagement may limit the cost‐effectiveness of such a program, particularly as online programs can be costly to develop due to outsourcing costs such as specialized technological expertise for online platform or app development, and ongoing maintenance and improvement . Additionally, reliable and high speed internet or hardware such as tablets, computers or smartphones may not be universally available or attainable for all participants, which is likely to most affect those with greater social disadvantage .…”