Understanding implementation costs of a pediatric weight management intervention: an economic evaluation protocol

Tzeyu L Michaud; Jennie L Hill; Kate A Heelan; R T Bartee; Bryce M Abbey; Ali Malmkar; John Masker; Caitlin Golden; Gwenndolyn Porter; Russell E Glasgow; Paul A Estabrooks

doi:10.1186/s43058-022-00287-1

Understanding implementation costs of a pediatric weight management intervention: an economic evaluation protocol

Implement Sci Commun. 2022 Apr 5;3(1):37. doi: 10.1186/s43058-022-00287-1.

Authors

Tzeyu L Michaud^{1

2}, Jennie L Hill³, Kate A Heelan⁴, R T Bartee⁴, Bryce M Abbey⁴, Ali Malmkar⁴, John Masker⁴, Caitlin Golden⁵, Gwenndolyn Porter⁵, Russell E Glasgow⁶, Paul A Estabrooks⁷

Affiliations

¹ Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA. tzeyu.michaud@unmc.edu.
² Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. tzeyu.michaud@unmc.edu.
³ Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
⁴ Kinesiology and Sport Sciences Department, University of Nebraska at Kearney, Kearney, NE, USA.
⁵ Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
⁶ Department of Family Medicine and Adult and Child Outcomes and Delivery Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
⁷ Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA.

Abstract

Background: Understanding the cost and/or cost-effectiveness of implementation strategies is crucial for organizations to make informed decisions about the resources needed to implement and sustain evidence-based interventions (EBIs). This economic evaluation protocol describes the methods and processes that will be used to assess costs and cost-effectiveness across implementation strategies used to improve the reach, adoption, implementation, and organizational maintenance of an evidence-based pediatric weight management intervention- Building Health Families (BHF).

Methods: A within-trial cost and cost-effectiveness analysis (CEA) will be completed as part of a hybrid type III effectiveness-implementation trial (HEI) designed to examine the impact of an action Learning Collaborative (LC) strategy consisting of network weaving, consultee-centered training, goal-setting and feedback, and sustainability action planning to improve the adoption, implementation, organizational maintenance, and program reach of BHF in micropolitan and surrounding rural communities in the USA, over a 12-month period. We discuss key features of implementation strategy components and the associated cost collection and outcome measures and present brief examples on what will be included in the CEA for each discrete implementation strategy and how the results will be interpreted. The cost data will be collected by identifying implementation activities associated with each strategy and using a digital-based time tracking tool to capture the time associated with each activity. Costs will be assessed relative to the BHF program implementation and the multicomponent implementation strategy, included within and external to a LC designed to improve reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of BHF. The CEA results will be reported by RE-AIM outcomes, using the average cost-effectiveness ratio or incremental cost-effectiveness ratio. All the CEAs will be performed from the community perspective.

Discussion: The proposed costing approach and economic evaluation framework for dissemination and implementation strategies and EBI implementation will contribute to the evolving but still scant literature on economic evaluation of implementation and strategies used and facilitate the comparative economic analysis.

Trial registration: ClinicalTrials.gov NCT04719442 . Registered on January 22, 2021.

Keywords: Activity-based costing; Childhood obesity; Dissemination; Implementation strategy; RE-AIM.

Associated data

ClinicalTrials.gov/NCT04719442

Abstract

Associated data

Grants and funding