Economic evaluations of public health implementation-interventions: a systematic review and guideline for practice

Reeves, Penny; Edmunds, Kim; Searles, Andrew; Wiggers, John

doi:10.1016/j.puhe.2019.01.012

Cited by 69 publications

(101 citation statements)

References 30 publications

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“…Likewise, if an implementation effort is not adequately financed, it is unlikely to be sustained [2]. Although cost has been identified as a key implementation outcome, it is not frequently evaluated within implementation studies [2][3][4][5]. In order for decision makers to determine if they are going to implement an EBP and the associated strategies to implement it, information on cost is needed.…”

Section: Introductionmentioning

confidence: 99%

Collaborating with health economists to advance implementation science: a qualitative study

Barnett

Dopp

Klein

et al. 2020

Implement Sci Commun

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Background Implementation research infrequently addresses economic factors, despite the importance of understanding the costs of implementing evidence-based practices (EBPs). Though partnerships with health economists have the potential to increase attention to economic factors within implementation science, barriers to forming these collaborations have been noted. This study investigated the experiences of health economists and implementation researchers who have partnered across disciplines to inform strategies to increase such collaborations. Methods A purposeful sampling approach was used to identify eight health economists and eight implementation researchers with experience participating in cross-disciplinary research. We used semi-structured interviews to gather information about participants’ experiences with collaborative research. Thematic analysis was conducted to identify core themes related to facilitators and barriers to collaborations. Results Health economists and implementation researchers voiced different perspectives on collaborative research, highlighting the importance of increasing cross-disciplinary understanding. Implementation researchers described a need to measure costs in implementation studies, whereas many health economists described that they seek to collaborate on projects that extend beyond conducting cost analyses. Researchers in both disciplines articulated motivations for collaborative research and identified strategies that promote successful collaboration, with varying degrees of convergence across these themes. Shared motivations included improving methodological rigor of research and making a real-world impact. Strategies to improve collaboration included starting partnerships early in the study design period, having a shared interest, and including health economists in the larger scope of the research. Conclusions Health economists and implementation researchers both conduct research with significant policy implications and have the potential to inform one another’s work in ways that might more rapidly advance the uptake of EBPs. Collaborative research between health economists and implementation science has the potential to advance the field; however, researchers will need to work to bridge disciplinary differences. By beginning to develop strong working relationships; increasing their understanding of one another’s disciplinary culture, methodology, and language; and increasing the role economists have within research design and execution, both implementation researchers and health economists can support successful collaborations and robust and informative research.

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Section: Introductionmentioning

confidence: 99%

Collaborating with health economists to advance implementation science: a qualitative study

Barnett

Dopp

Klein

et al. 2020

Implement Sci Commun

View full text Add to dashboard Cite

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“…There is dearth of economic evaluations of approaches to improve and sustain the implementation of public health interventions across a range of settings (25). Speci cally, there are no comparable economic evaluations of implementation-interventions in this setting focussed on childhood obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Recent systematic reviews have shown that economic evaluation is rarely applied to public health implementation-interventions and the generation of economic evidence has been identi ed as a priority for the eld of implementation research (13,25,26). Investment in implementation has an opportunity cost.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines.

Reeves

Edmunds

Szewczyk

et al. 2020

Preprint

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Abstract Background Despite the known benefits of healthy eating in childhood, few Australian childcare services provide food that is consistent with dietary guidelines. The effectiveness of a web-based menu planning intervention to increase childcare service provision of healthy foods, and decrease provision of discretionary foods in long daycare centres in Australia was assessed in a randomised controlled trial. Here we consider the costs, consequences, cost-effectiveness and budget impact of the intervention using data collected within the trial. Methods The prospective trial-based economic evaluation involved 54 childcare services across New South Wales (NSW), Australia. Services were randomised to a 12-month intervention or usual care. The intervention involved access to a web-based menu planning and decision support tool, and online resources. Effectiveness measures included: mean number of food groups, overall menu and individual food group compliance with dietary guidelines, and mean servings of food groups at 12 months. Costs (reported in $AUD, 2017/18) were evaluated from both health sector and societal perspectives. The direct cost to support uptake of the intervention was calculated, as were costs to each childcare centres. The incremental cost of the intervention was calculated as the net difference in the cost to undertake menu planning and review plus the direct cost of the intervention. Incremental cost–effectiveness ratios (ICERs) including uncertainty intervals, were estimated for differences in costs and effects between intervention and control groups. A relative value index was calculated to determine overall value for money. Results Over the 12 months of the trial, we calculated a difference in cost between usual practice and intervention groups of -$482 (95% UI -$859, -$56). While the measured increase in menu and food group compliance within the trial did not reach statistical significance, there were significant improvements in mean servings of fruit and discretionary food, represented in the cost-consequence analysis. The calculated relative value index of 1.1 suggests that the intervention returns acceptable value for money for the outcomes generated. Conclusion Compared to usual practice, web-based programs may offer an efficient and sustainable alternative for childcare centres to improve the provision of healthy foods to children in their care. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000974404

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“…Testing the cost-effectiveness of an IS that has been shown to have superior effectiveness, relative to an active-control IS, is termed IR testing an upper right quadrant (URQ) hypothesis. It is considered a priority testable hypothesis for IR as knowing the effectiveness of an intervention/strategy is not su cient for many potential users, especially decision makers who need to know whether the bene ts from the intervention/strategy are commensurate with its costs (i.e., whether it delivers value), [35][36][37][38] Further, noting that economic evaluation of implementation strategies "has been neglected," Foy et al encouraged IR with an economic evaluation component. 22 Building upon Garner et al (2012), 31 which found pay-for-performance to be an effective IS for improving the implementation and effectiveness of A-CRA in a superiority trial, Garner et al (2018) 39 provide an example of IR testing an URQ hypothesis.…”

Section: Three Priority Aims For Implementation Researchmentioning

confidence: 99%

Priority domains, aims, and testable hypotheses for implementation research: Protocol for a scoping review and evidence map

Garner

Kirk

2020

Preprint

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Background: The challenge of implementing evidence-based innovations within practice settings is a significant public health issue the field of implementation research (IR) is focused on addressing. Significant amounts of funding, time, and effort have been invested in IR to date, yet there remains significant room for advancement, especially regarding IR’s development of scientific theories as defined by the National Academy of Sciences (i.e., a comprehensive explanation of the relationship between variables that is supported by a vast body of evidence). Research priority setting (i.e., promoting consensus about areas where research effort will have wide benefits to society) is a key approach to helping accelerate research advancements. Thus, building upon existing IR, general principles of data reduction, and a general framework for moderated mediation, this article identifies four priority domains, three priority aims, and four testable hypotheses for IR, which we organize in the priority aims and testable hypotheses (PATH) diagram..Methods: The objective of this scoping review is to map the extent to which IR has examined the identified PATH priorities to date. Because Implementation Science is the leading journal for publishing IR and receives over 800 submissions annually, our sample will include IR (specifically, original research articles and short reports) published in Implementation Science between its inception in 2006 and December 2019. The protocol for the current scoping review and evidence map has been developed in accordance with the approach developed by Arksey & O’Malley and advanced by Levac, Colquhoun, and O’Brien. Because scoping reviews seek to provide an overview of the identified evidence base rather than synthesize findings from across studies, we plan to use our data-charting form to provide a descriptive overview of implementation research to-date and summarize the research via one or more summary tables. We will use the PATH diagram to organize a map of the evidence to date.Discussion: This scoping review and evidence map is intended to help accelerate IR focused on suggested priority aims and testable hypotheses, which in turn will accelerate IR’s development of National Academy of Sciences-defined scientific theories and, subsequently, improvements in public health.Systematic review registration: Open Science Framework: https://osf.io/3vhuj/

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Economic evaluations of public health implementation-interventions: a systematic review and guideline for practice

Cited by 69 publications

References 30 publications

Collaborating with health economists to advance implementation science: a qualitative study

Collaborating with health economists to advance implementation science: a qualitative study

Economic evaluation of a web-based menu planning intervention to improve childcare service adherence with dietary guidelines.

Priority domains, aims, and testable hypotheses for implementation research: Protocol for a scoping review and evidence map

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