The cost-effectiveness of a theory-based online health behaviour intervention for new university students: an economic evaluation

BMC Public Health

Tracy Epton¹  Paul Norman¹  Chloe Thomas²  Mark Strong²  Alan Brennan²  Jen Kruger² 

[1] Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP, United Kingdom;School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, United Kingdom

关键词: Costs;    University;    Students;    Young people;    Economic model;    Economic evaluation;    Cost-effectiveness;    Health behaviour;    Smoking;    Exercise;    Fruit and vegetables;    Alcohol;   

Others  :  1126541
DOI  :  10.1186/1471-2458-14-1011

 received in 2014-01-31, accepted in 2014-09-08,  发布年份 2014

【 摘 要 】

Background

Too many young people engage in unhealthy behaviours such as eating unhealthily, being physically inactive, binge drinking and smoking. This study aimed to estimate the short-term and long-term cost-effectiveness of a theory-based online health behaviour intervention (“U@Uni”) in comparison with control in young people starting university.

Methods

A costing analysis was conducted to estimate the full cost of U@Uni and the cost of U@Uni roll-out. The short-term cost-effectiveness of U@Uni was estimated using statistical analysis of 6-month cost and health-related quality of life data from the U@Uni randomised controlled trial. An economic modelling analysis combined evidence from the trial with published evidence of the effect of health behaviours on mortality risk and general population data on health behaviours, to estimate the lifetime cost-effectiveness of U@Uni in terms of incremental cost per QALY. Costs and effects were discounted at 1.5% per annum. A full probabilistic sensitivity analysis was conducted to account for uncertainty in model inputs and provide an estimate of the value of information for groups of important parameters.

Results

To implement U@Uni for the randomised controlled trial was estimated to cost £292 per participant, whereas roll-out to another university was estimated to cost £19.71, both giving a QALY gain of 0.0128 per participant. The short-term (6-month) analysis suggested that U@Uni would not be cost-effective at a willingness-to-pay threshold of £20,000 per QALY (incremental cost per QALY gained = £243,926). When a lifetime horizon was adopted the results suggest that the full implementation of U@Uni is unlikely to be cost-effective, whereas the roll-out of U@Uni to another university is extremely likely to be cost-effective. The value of information analysis suggests that the most important drivers of decision uncertainty are uncertainties in the effect of U@Uni on health behaviours.

Conclusions

The study provides the first estimate of the costs and cost-effectiveness of an online health behaviour intervention targeted at new university students. The results suggest that the roll-out, but not the full implementation, of U@Uni would be a cost-effective decision for the UK Department of Health, given a lifetime perspective and a willingness-to pay threshold of £20,000 per QALY.

Trial registration

Current Controlled Trials ISRCTN67684181.

【 授权许可】

   
2014 Kruger et al.; licensee BioMed Central Ltd.

【 图 表 】

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