儿童焦虑和抑郁预防策略的成本效益分析:卫生服务视角。

IF 4.6 3区 医学 Q1 PEDIATRICS
Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer
{"title":"儿童焦虑和抑郁预防策略的成本效益分析:卫生服务视角。","authors":"Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer","doi":"10.1186/s13034-025-00962-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.</p><p><strong>Methods: </strong>This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.</p><p><strong>Results: </strong>For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.</p><p><strong>Discussion: </strong>In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.</p><p><strong>Conclusion: </strong>The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. Trial registration number Clinical Trials NCT04263558 (Feb 11, 20, Jan 25. 21).</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"19 1","pages":"107"},"PeriodicalIF":4.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486731/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness analysis of preventive strategies for child anxiety and depression: a health service perspective.\",\"authors\":\"Kristin D Martinsen, Eline Aas, Jo Magne Ingul, Carina Lisøy, Frode Adolfsen, Lene-Mari Rasmussen, Tore Wentzel-Larsen, Simon-Peter Neumer\",\"doi\":\"10.1186/s13034-025-00962-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.</p><p><strong>Methods: </strong>This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.</p><p><strong>Results: </strong>For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.</p><p><strong>Discussion: </strong>In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.</p><p><strong>Conclusion: </strong>The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. Trial registration number Clinical Trials NCT04263558 (Feb 11, 20, Jan 25. 21).</p>\",\"PeriodicalId\":9934,\"journal\":{\"name\":\"Child and Adolescent Psychiatry and Mental Health\",\"volume\":\"19 1\",\"pages\":\"107\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486731/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Child and Adolescent Psychiatry and Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13034-025-00962-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child and Adolescent Psychiatry and Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13034-025-00962-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

摘要

背景:心理健康问题的日益流行带来了经济和社会挑战,青少年焦虑和抑郁是主要原因。虽然加强预防措施对于减轻这些疾病的影响至关重要,但资源有限,需要仔细确定干预措施的优先次序。这强调需要进行成本效益研究,以便为资源分配和决策提供信息。方法:本研究利用了一项采用MOST框架的试验数据,以优化针对表现出焦虑和抑郁症状的青少年的目标群体CBT干预。使用检查干预成本、儿童心理健康结果:焦虑和抑郁症状以及质量调整生命年(QALYs)的真实世界数据来评估实验策略的成本效益。研究考察了三个干预因素:交付形式(16节课vs. 8节课+ 8个基于网络的课)、家长参与(5节课vs.家长宣传册)和测量反馈系统(MFS)(反馈vs.无反馈),产生了8种干预策略。这项研究包括701名8至12岁的儿童,他们来自挪威39个城市的52所公立学校。结果:对于抑郁症状和qaly,具有成本效益的策略包括长时间面对面治疗,父母低参与且无反馈,以及混合形式(面对面+网络治疗),父母低参与且无反馈。对于抑郁症状,父母参与和无反馈的混合形式是可行的策略。对于焦虑症状,具有成本效益的策略包括低父母参与和反馈的长时间面对面版本,以及低父母参与和反馈的混合格式。讨论:在资源受限的环境中,最少资源密集的策略可以确保以最小的成本减少症状。父母参与是一个可行的替代条件下,中间资源,平衡成本和临床效益。当症状减轻是优先考虑的,而费用是次要的,长时间的面对面形式,低家长参与和没有反馈可能是可取的。结论:该研究突出了成本控制、覆盖范围和干预效果之间的权衡。决策者在做决定时必须权衡成本和减轻症状的预期水平。试验注册号临床试验NCT04263558(2月11日,20日,1月25日)。21)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-effectiveness analysis of preventive strategies for child anxiety and depression: a health service perspective.

Background: The rising prevalence of mental health problems presents economic and social challenges with youth anxiety and depression as major contributors. While strengthening preventive measures is essential to mitigate the impacts of these conditions, limited resources necessitate careful prioritization of interventions. This underscores the need for cost-effectiveness studies to inform resource allocation and decision-making.

Methods: This study utilized data from a trial employing the MOST framework to optimize a targeted group CBT intervention for youths exhibiting anxiety and depressive symptoms. Experimental strategies were evaluated for cost-effectiveness using real-world data examining intervention costs, child mental health outcomes: anxious and depressive symptoms and quality-adjusted life-years (QALYs). Three intervention factors were examined: delivery format (16 sessions vs. 8 sessions + 8 web-based sessions), parental involvement (five sessions vs. parental brochure), and measurement feedback system (MFS) (feedback vs. no feedback), producing eight intervention strategies. The study included 701 children aged 8 to 12, recruited from 52 public schools in 39 municipalities in Norway. Statistical analysis was conducted using R.

Results: For depressive symptoms and QALYs, cost-effective strategies included the long in-person version with low parental involvement and no feedback, and the hybrid format (in-person + web-based sessions) with low parental involvement and no feedback. For depressive symptoms, the hybrid format with parental involvement and no feedback was a feasible strategy. For anxiety symptoms, cost-effective strategies involved the long in-person version with low parental involvement and feedback, and the hybrid format with low parental involvement and feedback.

Discussion: In resource-constrained environments, the least resource-intensive strategies can ensure symptom reduction at minimal cost. Parental involvement is a viable alternative under conditions of intermediate resources, balancing costs, and clinical benefits. When symptom reduction is prioritized, and cost is secondary, the long in-person format with low parental involvement and no feedback may be preferable.

Conclusion: The study highlights trade-offs between cost containment, reach, and intervention effectiveness. Policymakers must weigh costs against desired levels of symptom reduction when making decisions. Trial registration number Clinical Trials NCT04263558 (Feb 11, 20, Jan 25. 21).

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Child and Adolescent Psychiatry and Mental Health
Child and Adolescent Psychiatry and Mental Health PEDIATRICSPSYCHIATRY-PSYCHIATRY
CiteScore
7.00
自引率
3.60%
发文量
84
审稿时长
16 weeks
期刊介绍: Child and Adolescent Psychiatry and Mental Health, the official journal of the International Association for Child and Adolescent Psychiatry and Allied Professions, is an open access, online journal that provides an international platform for rapid and comprehensive scientific communication on child and adolescent mental health across different cultural backgrounds. CAPMH serves as a scientifically rigorous and broadly open forum for both interdisciplinary and cross-cultural exchange of research information, involving psychiatrists, paediatricians, psychologists, neuroscientists, and allied disciplines. The journal focusses on improving the knowledge base for the diagnosis, prognosis and treatment of mental health conditions in children and adolescents, and aims to integrate basic science, clinical research and the practical implementation of research findings. In addition, aspects which are still underrepresented in the traditional journals such as neurobiology and neuropsychology of psychiatric disorders in childhood and adolescence are considered.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信