scholarly journals Qualitative Research to Inform Economic Modelling: Older People’s Views on Implementing the Nice Falls Prevention Guideline in English Community Context.

2021 ◽  
Author(s):  
Joseph Kwon ◽  
Yujin Lee ◽  
Tracey Young ◽  
Hazel Squires ◽  
Janet Harris
Keyword(s):  
Public Health ◽  
Qualitative Research ◽  
Economic Evaluation ◽  
Priority Setting ◽  
Older Persons ◽  
Qualitative Data ◽  
Falls Prevention ◽  
Conceptual Modelling ◽  
Economic Modelling ◽  
Community Based

Abstract Background: High prevalence of falls among older persons makes falls prevention a public health priority. Yet community-based falls prevention face complexity in implementation and any commissioning strategy should be subject to rigorous economic evaluation to ensure cost-effective use of scarce healthcare resources. The study aims to capture the subjective views of older people in Sheffield on implementing the National Institute for Health and Care Excellence (NICE) guideline on community-based falls prevention and explore how the qualitative data can be used to inform commissioning strategies and the conceptual modelling of falls prevention economic evaluation. Methods: Focus group and interview participants (n=27) were recruited from Sheffield, England, and comprised falls prevention service users and eligible non-users of varying falls risks. Topics concerned key components of the NICE-recommended falls prevention pathway, including falls risk screening, multifactorial risk assessment and treatment uptake and adherence. Views on other topics concerning falls were also invited. Framework analysis was applied for data analysis, involving data familiarisation, identifying themes, indexing, charting and mapping and interpretation. The qualitative data were mapped to three frameworks: (1) facilitators and barriers to implementing the NICE-recommended pathway and contextual factors; (2) intervention-related causal mechanisms for formulating commissioning strategies spanning context, priority setting, need, supply and demand; and (3) methodological and evaluative challenges for public health economic modelling. Results: Two cross-component factors were identified: health motives of older persons; and professional competence. Participants highlighted the need for intersectoral approaches and prioritising the vulnerable groups. The local commissioning strategy should consider the socioeconomic, linguistic, geographical, legal and cultural contexts, priority setting challenges, supply-side mechanisms spanning provider, organisation, funding and policy (including intersectoral) and health and non-health demand motives. Methodological and evaluative challenges identified included: incorporating wider costs and effects; considering dynamic complexity in ageing process; considering social determinants of health; and conducting equity analyses. Conclusions: Holistic qualitative research can inform how commissioned falls prevention pathways can be feasible and effective. Qualitative data can inform commissioning strategies and conceptual modelling for economic evaluation of falls prevention and other geriatric interventions. This would improve the structural validity of quantitative models used to inform geriatric public health policies.

scholarly journals Qualitative research to inform economic modelling: a case study in older people’s views on implementing the NICE falls prevention guideline

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Kwon ◽  
Yujin Lee ◽  
Tracey Young ◽  
Hazel Squires ◽  
Janet Harris
Keyword(s):  
Public Health ◽  
Qualitative Research ◽  
Economic Evaluation ◽  
Priority Setting ◽  
Older Persons ◽  
Qualitative Data ◽  
Falls Prevention ◽  
Conceptual Modelling ◽  
Economic Modelling ◽  
Community Based

Abstract Background High prevalence of falls among older persons makes falls prevention a public health priority. Yet community-based falls prevention face complexity in implementation and any commissioning strategy should be subject to economic evaluation to ensure cost-effective use of healthcare resources. The study aims to capture the views of older people on implementing the National Institute for Health and Care Excellence (NICE) guideline on community-based falls prevention and explore how the qualitative data can be used to inform commissioning strategies and conceptual modelling of falls prevention economic evaluation in the local area of Sheffield. Methods Focus group and interview participants (n = 27) were recruited from Sheffield, England, and comprised falls prevention service users and eligible non-users of varying falls risks. Topics concerned key components of the NICE-recommended falls prevention pathway, including falls risk screening, multifactorial risk assessment and treatment uptake and adherence. Views on other topics concerning falls prevention were also invited. Framework analysis was applied for data analysis, involving data familiarisation, identifying themes, indexing, charting and mapping and interpretation. The qualitative data were mapped to three frameworks: (1) facilitators and barriers to implementing the NICE-recommended pathway and contextual factors; (2) intervention-related causal mechanisms for formulating commissioning strategies spanning context, priority setting, need, supply and demand; and (3) methodological and evaluative challenges for public health economic modelling. Results Two cross-component factors were identified: health motives of older persons; and professional competence. Participants highlighted the need for intersectoral approaches and prioritising the vulnerable groups. The local commissioning strategy should consider the socioeconomic, linguistic, geographical, legal and cultural contexts, priority setting challenges, supply-side mechanisms spanning provider, organisation, funding and policy (including intersectoral) and health and non-health demand motives. Methodological and evaluative challenges identified included: incorporating non-health outcomes and societal intervention costs; considering dynamic complexity; considering social determinants of health; and conducting equity analyses. Conclusions Holistic qualitative research can inform how commissioned falls prevention pathways can be feasible and effective. Qualitative data can inform commissioning strategies and conceptual modelling for economic evaluations of falls prevention and other geriatric interventions. This would improve the structural validity of quantitative models used to inform geriatric public health policies.

scholarly journals Economic evaluation of ‘Men on the Move’, a ‘real world’ community-based physical activity programme for men

2020 ◽  
Author(s):  
Liam Kelly ◽  
Michael Harrison ◽  
Noel Richardson ◽  
Paula Carroll ◽  
Tom Egan ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Health Benefits ◽  
Cost Effective ◽  
Health Improvement ◽  
Community Based ◽  
Life Years ◽  
The Impact

Abstract Background Physical activity (PA) interventions capable of producing health benefits cost effectively are a public health priority across the Western world. ‘Men on the Move’ (MOM), a community-based PA intervention for men, demonstrated significant health benefits up to 52-weeks (W) post-baseline. This article details the economic evaluation of MOM with a view to determining its cost-effectiveness as a public health intervention to be rolled out nationally in Ireland. Methods Cost-effectiveness was determined by comparing the costs (direct and indirect) of the programme to its benefits, which were captured as the impact on quality-adjusted life-years (QALYs). For the benefits, cost–utility analysis was conducted by retrospectively adapting various health-related measures of participants to generate health states using Brazier et al.’s (2002) short form-6D algorithm. This in turn allowed for ‘utility measures’ to be generated, from which QALYs were derived. Results Findings show MOM to be cost-effective in supporting an ‘at risk’ cohort of men achieves significant improvements in aerobic fitness, weight loss and waist reduction. The total cost per participant (€125.82 for each of the 501 intervention participants), the QALYs gained (11.98 post-12-W intervention, or 5.3% health improvement per participant) and estimated QALYs ratio costs of €3723 represents a cost-effective improvement when compared to known QALY guidelines. Conclusions The analysis shows that the cost per QALY achieved by MOM is significantly less than the existing benchmarks of £20 000 and €45 000 in the UK and Ireland respectively, demonstrating MOM to be cost-effective.

Applied Health Economics for Public Health Practice and Research

2019 ◽  
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Health Economics ◽  
Case Studies ◽  
Population Health ◽  
Evidence Synthesis ◽  
Health Interventions ◽  
Public Healthcare ◽  
Economic Modelling ◽  
Public Health Interventions

Public health has been described as the organized activities of society to improve and protect the health of the population. Health economics applied to public health is the study of how we allocate our scarce societal resources to meet our public health wants and needs in the best way possible. This book presents current thinking on health economics methodology and application to the evaluation of public health interventions (PHIs). It is for health economists working in higher education and public healthcare systems, challenged with the economic evaluation of PHIs, when they have been used to applying health economics and the methods of economic evaluation to narrower clinical interventions in primary or secondary care settings. This book will also be of interest to public health practitioners wanting to incorporate health economics into their daily work. This book covers the history of economics of public health and the economic rationale for government investment in prevention; principles of health economics including scarcity, choice, and opportunity cost; evidence synthesis; key methods of economic evaluation with accompanying case studies; economic modelling of public health interventions; return on investment analysis with national and international case studies; and application of programme budgeting and marginal analysis (PBMA) to the prioritization of PHIs. It concludes with priorities for research in the field of public health economics, spanning an acknowledgement of the role played by the natural environment in promoting better health, through to precision public health, recognizing the role of genetics, the environment, and socioeconomic status in determining population health.

scholarly journals Economic Evaluation of Community-Based Falls Prevention Interventions: A Systematic Methodological Overview of Systematic Reviews

2021 ◽  
Author(s):  
Joseph Kwon ◽  
Hazel Squires ◽  
Matt Franklin ◽  
Yujin Lee ◽  
Tracey Young
Keyword(s):  
Economic Evaluation ◽  
Systematic Reviews ◽  
Health Economic Evaluation ◽  
Reporting Quality ◽  
Falls Prevention ◽  
Decision Models ◽  
Economic Evaluations ◽  
Community Based ◽  
Dynamic Complexity ◽  
Environmental Interventions

Abstract Background: Falls impose significant health and economic burdens on older people, making their prevention a priority for care decision-makers. The volume of falls prevention economic evaluations has increased, the findings from which have been synthesised by systematic reviews (SRs) with pre-specified criteria (e.g., objectives, eligibility, data extraction). Such SRs can inform commissioning and design of future evaluations, particularly decision models; however, their findings can be biased and partial dependent on their pre-specified criteria. This study aims to conduct a systematic overview (SO) to: (1) systematically identify SRs of community-based falls prevention economic evaluations; (2) describe the methodology and findings of SRs; (3) critically appraise the methodology of SRs; and (4) suggest commissioning recommendations based on SO findings. Methods: The SO followed the PRISMA guideline and the Cochrane guideline on SO, covering the period 2003-2020. Identified SRs’ aims, search strategies and results, extracted data fields, quality assessment methods and results, and commissioning and research recommendations were synthesised. The comprehensiveness of previous SRs’ data synthesis was judged against criteria drawn from expert guideline and academic literature on falls prevention/public health economic evaluation. Outcomes of general population, lifetime decision models were re-analysed to inform commissioning recommendations. The SO protocol is registered in the Prospective Register of Systematic Reviews (CRD42021234379).Results: Seven SRs were identified, which extracted 8 to 33 data fields from 44 relevant economic evaluations. Four economic evaluation methodological/reporting quality checklists were used; three SRs narratively synthesised methodological features to varying extent and focus. SRs generally did not appraise decision modelling features, including methods for characterising dynamic complexity of falls risk and intervention need. Their commissioning recommendations were based mainly on cost-per-unit ratios (e.g., incremental cost-effectiveness ratios) and neglected aggregate impact. There is model-based evidence of multifactorial and environmental interventions, home assessment and modification and Tai Chi being cost-effective but also the risk that they exacerbate social inequities of health. Conclusions: Current SRs of falls prevention economic evaluations do not holistically inform commissioning and evaluation design. Accounting for broader decisional factors including intervention reach and capacity constraints and a broader grasp of methodological nuances of economic evaluations, particularly decision models, are needed.

scholarly journals A review of public health economic modelling in the National Institute for Health and Care Excellence (NICE)

2020 ◽  
Vol 3 ◽  
pp. 30
Author(s):  
Brian P. Reddy ◽  
Stephen J. Walters ◽  
Praveen Thokala ◽  
Alejandra Duenas ◽  
Michael P. Kelly
Keyword(s):  
Public Health ◽  
Health Economic ◽  
Economic Evaluation ◽  
Economic Models ◽  
Cost Utility ◽  
Economic Modelling ◽  
Reference Case ◽  
Evaluation Approach ◽  
The Given ◽  
Evaluation Techniques

Background: The National Institute for Health and Care Excellence (NICE) use economic modelling to inform judgements whenever further insight is required for decision-making. Doing so for public health guidance poses several challenges. The study’s objective was to investigate the level of heterogeneity in NICE’s public health economic models with regards to economic evaluation techniques, perspectives on outcomes and the measurement of non-health benefits. Methods: A review of all economic modelling reports published by NICE’s Centre for Public Health (CPH) as part of their guidance. Results: The review identified 56 eligible pieces of public health over the relevant period. Of these, 43 used economic modelling and 13 used no formal economic model. In total 61 economic models were used. Though the CPH specifies a reference case, in practice there is a large amount of variability from one model to the next. The most common perspective used for evaluations was that of the National Health Service (NHS); the most common economic evaluation approach was cost-utility analysis (CUA). 23 of the 56 topics used other combinations of perspective and technique, which allowed them to incorporate non-health effects, such as productivity, the effect on taxes raised and benefits spending, costs to the criminal justice sector, the effect on educational attainment and general wellbeing. Conclusions: NICE regularly updates its reference case, and non-CUA evaluation techniques have become more prominent in recent years. The results highlight the genuine advantages of having a variety of economic evaluation techniques available, which can be matched with the given topic. While it is always necessary to be wary of the possibility of gamesmanship and cherry picking, there is a surprising alignment between many approaches in certain circumstances.

Qualitative methods

2013 ◽  
pp. 90-99
Author(s):  
Sara Mallinson ◽  
Jennie Popay ◽  
Gareth Williams
Keyword(s):  
Public Health ◽  
Qualitative Research ◽  
Qualitative Methods ◽  
Qualitative Data ◽  
Research Question ◽  
Common Features ◽  
Analysis Process ◽  
Different Types ◽  
Key Issues ◽  
Key Features

After reading this chapter you should be able to introduce key features of qualitative research, outline how different qualitative methods can be used to answer different types of research question, describe some of the most widely used qualitative methods, explain key issues in the analysis of qualitative data and common features of the analysis process, and outline the importance of qualitative research in a public health context.

Risk Attitudes and Behavior Among Norwegian Adolescents

2005 ◽  
Vol 10 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Hilde Iversen ◽  
Torbjørn Rundmo ◽  
Hroar Klempe
Keyword(s):  
Public Health ◽  
Traffic Safety ◽  
Behavior Modification ◽  
Health Programs ◽  
Risk Attitudes ◽  
Community Based ◽  
Public Health Programs ◽  
The Core ◽  
And Behavior ◽  
Attitudes And Behavior

Abstract. The core aim of the present study is to compare the effects of a safety campaign and a behavior modification program on traffic safety. As is the case in community-based health promotion, the present study's approach of the attitude campaign was based on active participation of the group of recipients. One of the reasons why many attitude campaigns conducted previously have failed may be that they have been society-based public health programs. Both the interventions were carried out simultaneously among students aged 18-19 years in two Norwegian high schools (n = 342). At the first high school the intervention was behavior modification, at the second school a community-based attitude campaign was carried out. Baseline and posttest data on attitudes toward traffic safety and self-reported risk behavior were collected. The results showed that there was a significant total effect of the interventions although the effect depended on the type of intervention. There were significant differences in attitude and behavior only in the sample where the attitude campaign was carried out and no significant changes were found in the group of recipients of behavior modification.

DAMPAK PENGELOLAAN SAMPAH PADA KESEHATAN MASYARAKAT DI TPA

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Emilda Emilda
Keyword(s):  
Public Health ◽  
Hand Hygiene ◽  
Waste Management ◽  
Qualitative Data ◽  
Water Storage ◽  
Health Impact ◽  
Clean Water ◽  
The People ◽  
Clean Environment ◽  
The Impact

The limitations of waste management in the Cipayung Landfill (TPA) causing a buildup of garbage up to more than 30 meters. This condition has a health impact on people in Cipayung Village. This study aims to analyze the impact of waste management at Cipayung Landfill on public health in Cipayung Village, Depok City. The research is descriptive qualitative. Data obtained by purposive sampling. Data was collected by interviews, observation and documentation. Based on interviews with 30 respondents, it was found that the most common diseases were diarrhea, then other types of stomach ailments, subsequent itching on the skin and coughing. This is presumably because the environmental conditions in the form of unhealthy air and water and clean and healthy living behaviors (PHBS) have not become the habit of the people. The results indicated that there were no respondents who had implemented all of these criteria. In general respondents have implemented  3 criteria, namely maintaining hair hygiene, maintaining skin cleanliness, and maintaining hand hygiene. While maintaining clean water storage is the most often overlooked behavior. To minimize this health impact, improvements in waste management in Cipayung landfill are needed along with continuous socialization and education to develop PHBS habits and the importance of maintaining a clean environment.

E-Voting Kepala Desa dan Modal Sosial

2019 ◽  
Vol 2 (6) ◽  
pp. 759
Author(s):  
Khaulah Afifah ◽  
Lala M Kolopaking ◽  
Zessy Ardinal Barlan
Keyword(s):  
Social Capital ◽  
Random Sampling ◽  
Qualitative Data ◽  
Sampling Technique ◽  
Cost Effective ◽  
Simple Random Sampling ◽  
Community Based ◽  
Time Saving ◽  
The Social ◽  
Voting System

Head of a village election with e-voting system is a new thing for community The success level of e-voting system can be reached by fulfil several principles in order to the implementation going effective and the result of the election can be accepted by all. The objectives of this research is to analyze the relation between the success level of e-voting system with social capital of the community. This research is carried out with the quantitative approach and supported by qualitative data. This research takes 60 respondents using simple random sampling technique. The results showed that the success level of e-voting has a correlation with the level of social capital of the community. Based on the field study, the social capital of the community is classified as high. The high social capital makes the implementation of e-voting successful and the success level is also high, because in the election ten years ago occurred a conflict. The community considers e-voting easier and more practical, cost effective and time-saving, and the results of e-voting are also reliable. A practical and fast of e-voting system can be a solution especially for “rural-urban” community who are busy or work outside the village.Keywords: E-voting, the success level of the system, social capital Pemilihan kepala desa dengan sistem e-voting merupakan hal yang baru bagi masyarakat. Keberhasilan penerapan sistem e-voting dilihat dari terpenuhinya beberapa prinsip agar penerapannya berlangsung efektif dan hasilnya dapat diterima oleh seluruh masyarakat. Penelitian ini bertujuan untuk menganalisis hubungan tingkat keberhasilan sistem e-voting dalam pemilihan kepala desa dengan tingkat modal sosial masyarakat. Bentuk penelitian ini adalah penelitian kuantitatif yang didukung oleh analisis data kualitatif. Penelitian ini mengambil enam puluh responden dengan teknik simple random sampling. Hasil penelitian menunjukkan bahwa tingkat keberhasilan e-voting memiliki hubungan dengan tingkat modal sosial masyarakat. Berdasarkan kajian di lapang, modal sosial masyarakat tergolong tinggi. Tingginya modal sosial tersebut membuat pelaksanaan e-voting berhasil dan tingkat keberhasilannya juga tergolong tinggi karena pada pemilihan sepuluh tahun silam sempat terjadi konflik. Masyarakat menganggap sistem evoting lebih mudah dan praktis, hemat dalam segi biaya dan waktu, serta hasil dari pemilihan juga dapat dipertanggungjawabkan. Sistem e-voting yang praktis dan cepat dapat menjadi solusi khususnya bagi masyarakat daerah “desa-kota” yang memiliki kesibukan atau pekerjaan di luar desa.Kata Kunci: E-voting, keberhasilan sistem, modal sosial. 

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