Dataset Information

Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position?

ABSTRACT:

Objective

This study aimed to determine whether the cost-effectiveness of an infant sleep intervention from the Prevention of Overweight in Infancy (POI) trial was influenced by socioeconomic position (SEP).

Methods

An SEP-specific economic evaluation of the sleep intervention was conducted. SEP-specific intervention costs and effects at age 5 years, derived from the trial data, were applied to a representative cohort of 4,898 4- to 5-year-old Australian children. Quality-adjusted life years and health care costs were simulated until age 17 years using a purpose-built SEP-specific model. Incremental cost-effectiveness ratios and acceptability curves were derived for each SEP group.

Results

The incremental cost-effectiveness ratios, in Australian dollars per quality-adjusted life year gained, were smaller in the low- ($23,010) and mid-SEP ($18,206) groups compared with the high-SEP group ($31,981). The probability that the intervention was cost-effective was very high in the low- and mid-SEP groups (92%-100%) and moderately high in the high-SEP group (79%).

Conclusions

An infant sleep intervention is more cost-effective in low- and mid-SEP groups compared with high-SEP groups. Targeting this intervention to low-SEP groups would not require trade-offs between efficiency and equity.

SUBMITTER: Killedar A

PROVIDER: S-EPMC10947595 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position?

Killedar Anagha A Lung Thomas T Taylor Rachael W RW Taylor Barry J BJ Hayes Alison A

Obesity (Silver Spring, Md.) 20221205 1

<h4>Objective</h4>This study aimed to determine whether the cost-effectiveness of an infant sleep intervention from the Prevention of Overweight in Infancy (POI) trial was influenced by socioeconomic position (SEP).<h4>Methods</h4>An SEP-specific economic evaluation of the sleep intervention was conducted. SEP-specific intervention costs and effects at age 5 years, derived from the trial data, were applied to a representative cohort of 4,898 4- to 5-year-old Australian children. Quality-adjusted ...[more]

PMID: 36471911

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Project description:BackgroundChildhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 5-19 years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal.MethodsWe will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 8-12 years and 600 parents will be recruited during 3 consecutive editions (1st - 2019/2020; 2nd - 2020/2021; 3rd - 2021/2022) of 10 months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups.DiscussionThere is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status.Trial registrationISRCTN Registry: ISRCRN12682870 . Registered 9 July 2020. Retrospectively registered. Protocol version: 30 April 2021, version 5.

Project description:ObjectiveTo demonstrate how distributional cost-effectiveness analyses of childhood obesity interventions could be conducted and presented for decision makers.MethodsWe conducted modelled distributional cost-effectiveness analyses of three obesity interventions in children: an infant sleep intervention (POI-Sleep), a combined infant sleep, food, activity and breastfeeding intervention (POI-Combo) and a clinician-led treatment for primary school-aged children with overweight and obesity (High Five for Kids). For each intervention, costs and socioeconomic position (SEP)-specific effect sizes were applied to an Australian child cohort (n = 4898). Using a purpose-built microsimulation model we simulated SEP-specific body mass index (BMI) trajectories, healthcare costs and quality-adjusted life years (QALYs) from age 4 to 17 years for control and intervention cohorts. We examined the distribution of each health outcome across SEP and determined the net health benefit and equity impact accounting for opportunity costs and uncertainty due to individual-level heterogeneity. Finally, we conducted scenario analyses to test the effect of assumptions about health system marginal productivity, the distribution of opportunity costs and SEP-specific effect sizes. The results of the primary analyses, uncertainty analyses and scenario analyses were presented on an efficiency-equity impact plane.ResultsAccounting for uncertainty, POI-Sleep and High Five for Kids were found to be 'win-win' interventions, with a 67% and 100% probability, respectively, of generating a net health benefit and positive equity impact compared with control. POI-Combo was found to be a 'lose-lose' intervention, with a 91% probability of producing a net health loss and a negative equity impact compared with control. Scenario analyses indicated that SEP-specific effect sizes were highly influential on equity impact estimates for POI-Combo and High Five for Kids, while health system marginal productivity and opportunity cost distribution assumptions primarily influenced the net health benefit and equity impact of POI-Combo.ConclusionsThese analyses demonstrated that distributional cost-effectiveness analyses using a fit-for-purpose model are appropriate for differentiating and communicating the efficiency and equity impacts of childhood obesity interventions.

Dataset Information

Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position?

Objective

Methods

Results

Conclusions

Publications

Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position?

Similar Datasets

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