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Cost-utility analysis of a dance intervention for adolescent girls with internalizing problems
Department of Community Medicine and Public health, Örebro County Council, Örebro, Sweden.ORCID iD: 0000-0001-8433-6529
Örebro University Hospital. Department of Community Medicine and Public health.ORCID iD: 0000-0001-5585-1783
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Health Care Sciences.ORCID iD: 0000-0003-2411-1795
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Community Medicine and Public health.
2013 (English)In: Cost Effectiveness and Resource Allocation, ISSN 1478-7547, E-ISSN 1478-7547, Vol. 11, no 1, 4- p.Article in journal (Refereed) Published
Abstract [en]

Background: The increasing prevalence of psychological health problems among adolescent girls is alarming. Knowledge of beneficial effects of physical activity on psychological health is widespread. Dance is a popular formof exercise that could be a protective factor in preventing and treating symptoms of depression. The aim of thisstudy was to assess the cost-effectiveness of a dance intervention in addition to usual school health services foradolescent girls with internalizing problems, compared with usual school health services alone.

Methods: A cost-utility analysis from a societal perspective based on a randomized controlled intervention trial wasperformed. The setting was a city in central Sweden with a population of 130 000. A total of 112 adolescent girls, 13–18 years old, with internalizing problems participated in the study. They were randomly assigned to intervention (n =59) or control (n = 53) group. The intervention comprised dance twice weekly during eight months in addition to usualschool health services. Costs for the stakeholder of the intervention, treatment effect and healthcare costs wereconsidered. Gained quality-adjusted life-years (QALYs) were used to measure the effects. Quality of life was measuredwith the Health Utility Index Mark 3. Cost-effectiveness ratios were based on the changes in QALYs and net costs forthe intervention group compared with the control group. Likelihood of cost-effectiveness was calculated.

Results: At 20 months, quality of life had increased by 0.08 units more in the intervention group than in the controlgroup (P = .04), translating to 0.10 gained QALYs. The incremental cost-effectiveness ratio was USD $3,830 per QALYand the likelihood of cost-effectiveness was 95%.

Conclusions: Intervention with dance twice weekly in addition to usual school health services may be consideredcost-effective compared with usual school health services alone, for adolescent girls with internalizing problems.

Place, publisher, year, edition, pages
2013. Vol. 11, no 1, 4- p.
Keyword [en]
Internalizing problems, Adolescent girls, Physical activity, Dance, Cost-utility analysis
National Category
Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Business Studies
Identifiers
URN: urn:nbn:se:oru:diva-38723DOI: 10.1186/1478-7547-11-4PubMedID: 23425608Scopus ID: 2-s2.0-84873979104OAI: oai:DiVA.org:oru-38723DiVA: diva2:764195
Note

Trial registration:

Name of the trial registry: “Influencing Adolescent Girls’ With Creative Dance Twice Weekly”

Trial registration number: NCT01523561

Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2017-10-18Bibliographically approved
In thesis
1. Dance Intervention for Adolescent Girls with Internalizing Problems: Effects and Experiences
Open this publication in new window or tab >>Dance Intervention for Adolescent Girls with Internalizing Problems: Effects and Experiences
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Globally, psychological health problems are currently among the most serious public health challenges. Adolescent girls suffer from internalizing problems, such as somatic symptoms and mental health problems, at higher rates than in decades. By age 15, over 50 % of all girls experience multiple health complaints more than once a week and one in five girls reports fair or poor health.

The overall aim of this study was to investigate the effects of and experiences with an after-school dance intervention for adolescent girls with internalizing problems. The intervention comprised dance that focused on resources twice weekly for 8 months. Specifically, this thesis aimed to: I) investigate the effects on self-rated health (SRH), adherence and over-all experience; II) evaluate the effects on somatic symptoms, emotional distress and use of medication; III) explore the experiences of those participating in the intervention; and IV) assess the cost-effectiveness.

A total of 112 girls aged 13 to 18 years were included in a randomized controlled trial. The dance intervention group comprised 59 girls, and the control group 53. In paper I, the dance group showed increased SRH scores compared to the control group (p = .02). Girls in the intervention group showed high adherence and a positive overall experience. In paper II, the dance group exhibited a decrease in somatic symptoms (p = .021), emotional distress (p = .023) and use of medication (p = .020) compared to the control group. In paper III, a strategic sample of 24 girls was interviewed. Qualitative content analysis was performed, and five generic categories emerged. Two were “An Oasis from Stress” and “Supportive Togetherness”, which was shown to represent the fundamental basis and setting of the intervention. The main category, participants’ central experience, was understood as “Finding embodied self-trust that opens new doors”. Paper IV revealed that, due to decreased number of visits to the school nurse and an increase in health related quality of life; the intervention was considered to be cost-effective (combined with the usual school health services). In summary, the results of this thesis show that this dance intervention for adolescent girls with internalizing problems generated positive health effects and proved to be cost-effective. For this target group, a non-judgmental environment and supportive togetherness proved to be of importance for participation. The results of this study may provide practical information for school health care staff and caregivers in designing future interventions.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. 129 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 144
Keyword
Adolescent Health, Body Awareness, Cost Effectiveness, Dance, Enjoyment, Physical Activity, Randomized Controlled Trial, Self-rated Health
National Category
Nursing Other Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-48178 (URN)978-91-7529-140-6 (ISBN)
Public defence
2016-05-20, Universitetssjukhuset, Wilandersalen, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-02-10 Created: 2016-02-10 Last updated: 2017-10-17Bibliographically approved

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