An economic model of school-based behavioral interventions to prevent sexually transmitted infections

Article

Cooper, Keith, Shepherd, Jonathan, Picot, Jo, Jones, Jeremy, Kavanagh, Josephine, Harden, A., Barnett-Page, Elaine, Clegg, Andrew, Hartwell, Debbie, Frampton, Geoff and Price, Alison 2012. An economic model of school-based behavioral interventions to prevent sexually transmitted infections. International Journal of Technology Assessment in Health Care. 28 (04), pp. 407-414.
AuthorsCooper, Keith, Shepherd, Jonathan, Picot, Jo, Jones, Jeremy, Kavanagh, Josephine, Harden, A., Barnett-Page, Elaine, Clegg, Andrew, Hartwell, Debbie, Frampton, Geoff and Price, Alison
Abstract

Objectives: Reducing sexually transmitted infections (STI) and teenage pregnancy through effective health education is a high priority for health policy. Behavioral interventions which teach skills to practice safer sex may reduce the incidence of STIs. We evaluated the cost-effectiveness of school-based behavioral interventions in young people.

Methods: We developed an economic model to estimate the total number of STI cases averted, consequent gain in health related quality of life (HRQoL) and savings in medical costs, based on changes in sexual behavior. The parameters for the model were derived from a systematic literature search on the intervention effectiveness, epidemiology of STIs, sexual behavior and lifestyles, HRQoL and health service costs.

Results: The costs of providing teacher-led and peer-led behavioral interventions were €5.16 and €18 per pupil, respectively. For a cohort of 1000 boys and 1000 girls aged 15 years, the model estimated that the behavioral interventions would avert two STI cases and save 0.35 Quality Adjusted Life Years (QALYs). Compared to standard education, the incremental cost-effectiveness of the teacher-led and peer-led interventions was €24,268 and €96,938 per QALY gained, respectively.

Conclusions: School-based behavioral interventions which provide information and teach young people sexual health skills can bring about improvements in knowledge and increased self-efficacy, though these may be limited in terms of impact on sexual behavior. There was uncertainty around the results due to the limited effect of the intervention on behavioral outcomes and paucity of data for other input parameters.

Keywordscost effectiveness; models; sexually transmitted infections
JournalInternational Journal of Technology Assessment in Health Care
Journal citation28 (04), pp. 407-414
ISSN1471-6348
0266-4623
Year2012
PublisherCambridge University Press
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CC BY-NC-SA
Web address (URL)http://dx.doi.org/10.1017/S0266462312000475
Publication dates
PrintOct 2012
Publication process dates
Deposited18 Sep 2013
Copyright information© Cambridge University Press 2012 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use
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