TY - JOUR
T1 - Cost-effectiveness of preventing child internalising problems
T2 - Results from the translational trial of Cool Little Kids at school entry
AU - Chatterton, Mary Lou
AU - Bayer, Jordana K.
AU - Engel, Lidia
AU - Rapee, Ronald M.
AU - Beatson, Ruth
AU - Hiscock, Harriet
AU - Bretherton, Lesley
AU - Wake, Melissa
AU - Mihalopoulos, Cathrine
N1 - Funding Information:
The funding for this trial came from the National Health and Medical Research Council (NHMRC) ( APP607302 ). Cathrine Mihalopoulos was funded by a NHMRC Early Career Fellowship during the conduct of this trial ( APP1035887 ). Jordana Bayer was funded by an Australian Rotary Health fellowship in mental illness to conduct the trial. Melissa Wake was funded by NHMRC Senior Research Fellowship 1046518 and Principal Research Fellowship 1160906 and Cure Kids New Zealand . Research at the Murdoch Children’s Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program .
Funding Information:
The authors thank the preschool services and families in the Victorian cities of Banyule, Boroondara, Frankston, Kingston, Knox, Maroondah, Whitehorse and Wyndham who took part in this research. They thank Joyce Cleary (Victorian Department of Education and Early Child Development) for her support in contacting preschool services. We also acknowledge and thank Alexandra Perry, Megan Mathers, Kate Beasley, Cassima Beechey, Timothy Grant-Taylor and Chelsea Cornell who were research assistants during the trial and Tamsyn Gilbertson who was a postgraduate clinical psychology candidate during the trial. The funding for this trial came from the National Health and Medical Research Council (NHMRC) (APP607302). Cathrine Mihalopoulos was funded by a NHMRC Early Career Fellowship during the conduct of this trial (APP1035887). Jordana Bayer was funded by an Australian Rotary Health fellowship in mental illness to conduct the trial. Melissa Wake was funded by NHMRC Senior Research Fellowship1046518 and Principal Research Fellowship1160906 and Cure Kids New Zealand. Research at the Murdoch Children's Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/3
Y1 - 2020/3
N2 - Objective: A translational trial evaluated the effectiveness of screening for inhibited childhood temperament, followed by a preventive parenting program -Cool Little Kids. This study determined the cost-effectiveness from societal and health sector perspectives using trial data. Method: Resources to deliver the screening and parenting sessions were determined from study records. Parents completed a questionnaire reporting resources used at one-year follow-up. Standard Australian unit costs were applied. Clinical outcomes for children and parental quality adjusted life-years (QALYs) were used to calculate incremental cost-effectiveness ratios (ICERs). Results: Total societal costs were lower, but non-significant for the intervention compared to the control group (mean difference -$500 p = 0.937). Total health sector costs were significantly greater (mean difference $1,956; p = 0.015). The intervention led to significantly fewer internalising symptoms (Strengths and Difficulties Questionnaire (SDQ)-emotional difficulties adjusted mean difference −0.5; p = 0.006), fewer children with SDQ-emotional symptoms in the abnormal range (24.2 % vs. 33.0 % p =.014) and fewer with diagnosed anxiety (44.2 % vs. 50.2 % p = 0.427). From the societal perspective, the intervention would likely be cost-effective. Health sector ICERs were $1,171/SDQ-emotional symptom decrease, $51/abnormal SDQ avoided and $77/anxiety case avoided. Conclusions: This economic analysis alongside an implementation study provides an early indication that Cool Little Kids may be cost-effective.
AB - Objective: A translational trial evaluated the effectiveness of screening for inhibited childhood temperament, followed by a preventive parenting program -Cool Little Kids. This study determined the cost-effectiveness from societal and health sector perspectives using trial data. Method: Resources to deliver the screening and parenting sessions were determined from study records. Parents completed a questionnaire reporting resources used at one-year follow-up. Standard Australian unit costs were applied. Clinical outcomes for children and parental quality adjusted life-years (QALYs) were used to calculate incremental cost-effectiveness ratios (ICERs). Results: Total societal costs were lower, but non-significant for the intervention compared to the control group (mean difference -$500 p = 0.937). Total health sector costs were significantly greater (mean difference $1,956; p = 0.015). The intervention led to significantly fewer internalising symptoms (Strengths and Difficulties Questionnaire (SDQ)-emotional difficulties adjusted mean difference −0.5; p = 0.006), fewer children with SDQ-emotional symptoms in the abnormal range (24.2 % vs. 33.0 % p =.014) and fewer with diagnosed anxiety (44.2 % vs. 50.2 % p = 0.427). From the societal perspective, the intervention would likely be cost-effective. Health sector ICERs were $1,171/SDQ-emotional symptom decrease, $51/abnormal SDQ avoided and $77/anxiety case avoided. Conclusions: This economic analysis alongside an implementation study provides an early indication that Cool Little Kids may be cost-effective.
KW - Child, anxiety disorders
KW - Cost-effectiveness
KW - Prevention
KW - Randomised controlled trial
KW - Translation
UR - https://www.scopus.com/pages/publications/85078676179
U2 - 10.1016/j.janxdis.2020.102191
DO - 10.1016/j.janxdis.2020.102191
M3 - Article
C2 - 32014832
AN - SCOPUS:85078676179
SN - 0887-6185
VL - 70
JO - Journal of Anxiety Disorders
JF - Journal of Anxiety Disorders
M1 - 102191
ER -
SDG 3 Good Health and Well-being