Dataset Information

Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum.

ABSTRACT:

Background

School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness.

Objective

Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum.

Methods

A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n?=?2676 children) were randomised to receive PATHS, and 22 schools (n?=?2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation.

Results

The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009-0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI -?14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher's salary costs.

Conclusion

The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources.

Trial registration number

ISRCTN85087674.

SUBMITTER: Turner AJ

PROVIDER: S-EPMC7085485 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum.

Turner Alex J AJ Sutton Matt M Harrison Mark M Hennessey Alexandra A Humphrey Neil N

Applied health economics and health policy 20200401 2

<h4>Background</h4>School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness.<h4>Objective</h4>Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum.<h4>Methods</h4>A prospective economic evaluation was conducted alongside a cluster-randomised control ...[more]

PMID: 31347016

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Project description:The preschool edition of Promoting Alternative THinking Strategies (PATHS®) is a school-based, teacher implemented universal intervention developed in the United States designed to promote social emotional competence (SEC) in children as a foundation for improved mental health. PATHS is delivered as a curriculum and it is based on theories and research regarding SEC, brain development, and optimal school environments. A majority of children in Sweden attend preschool, which is government-subsidized and follows a national curriculum focusing on both academic and social emotional learning. However, there is not so much focus on formal instruction nor manual-based lessons. The purpose of this study was to assess the short-term (pre- to post-test) effects of PATHS in the Swedish preschool setting. Using a two-wave cluster randomized trial with multi-method and informant assessment (N = 285 4 and 5-year-old Swedish children; n = 145 wait-list control; n = 140 intervention; K = 26 preschools; k = 13 intervention; k = 13 control) we assessed changes in child emotional knowledge, emotional awareness, social problem solving, prosocial play, inhibitory control, and working memory using structural equation modeling (SEM). We included schools with at least one classroom of 4-5-year-old children from three municipalities. We excluded open preschools, parent cooperative preschools, and family day homes. After random assignment, schools were informed of condition assignment. Research team members were not blind to assignment. We hypothesized that relative to children in control schools, children in intervention schools would evidence improvements in social emotional competence as well as other outcomes. Children in PATHS, relative to children in the control, evidenced improvements in working memory and prosocial play, but also showed an increase in hyperactive behaviors. Girls in PATHS, relative to girls in the control, showed improvement in emotional knowledge and reduced anxiety. These results are considered in light of efforts to promote positive development and mental health. The trial registration number at ClinicalTrials.gov is NCT04512157. Main funding was from Swedish Council for Working Life and Social Research, the Swedish Research Council, Formas, and VINNOVA (dnr: 259-2012-71).

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Dataset Information

Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum.

Background

Objective

Methods

Results

Conclusion

Trial registration number

Publications

Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum.

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