رسالة جامعية
Examining Methods Used to Evaluate the Cost-Effectiveness of Childhood Obesity Interventions
| العنوان: | Examining Methods Used to Evaluate the Cost-Effectiveness of Childhood Obesity Interventions |
|---|---|
| المؤلفون: | Wright, Davene |
| مرشدي الرسالة: | Prosser, Lisa Alison, Kim, Jane Jooyun |
| بيانات النشر: | Harvard University, 2013. |
| سنة النشر: | 2013 |
| المجموعة: | Harvard University |
| Original Material: | Wright, Davene. 2012. Examining Methods Used to Evaluate the Cost-Effectiveness of Childhood Obesity Interventions. Doctoral dissertation, Harvard University. |
| مصطلحات موضوعية: | childhood obesity, cost-effectiveness, economic evaluation, health economics, obesity, pediatric health, public health, economics, medicine |
| الوصف: | This dissertation examines methods used to evaluate the cost-effectiveness of childhood obesity interventions in order to help decision-makers prioritize among competing health programs using standardized outcomes. Chapter 1 generates inputs for use in cost-effectiveness analyses (CEAs) of childhood obesity interventions. In Chapter 1.1, I use data from the Medical Expenditure Panel Survey to predict expenditures associated with obesity in childhood and adolescence. I found that obese children and adolescents have significantly different expenditures than their normal weight counterparts. I conclude that exclusion of obesity-related medical expenditures can potentially undervalue the cost-effectiveness of interventions. In Chapter 1.2, I use data from the Study of Early Child Care and Youth Development to examine the longitudinal trajectory of child weight. I derived probabilities of transitioning between weight classes that can be used in a decision-analytic model to extrapolate the effectiveness of childhood obesity interventions beyond childhood. I found that deviating from CDC BMI reference categories can more accurately capture the risk of future obesity. In Chapter 2, I evaluate the cost-effectiveness of a primary care-based obesity prevention program, High Five for Kids. Over two years, High Five for Kids was low-cost, but only marginally effective in reducing BMI. I used a decision analytic simulation model to extrapolate trial outcomes over a 10-year horizon, and found that in the long-term, primary care based obesity prevention was likely to be cost-effective relative to usual care. I also found that key methodological considerations can meaningfully influence the cost-effectiveness of childhood obesity interventions. In Chapter 3, I develop an agent-based model to explore the dynamics of the potential spread of obesity within families. I found that the “contagion” of obesity could result in significant collateral weight loss in family members not targeted in an intervention. As a result, CEAs may underestimate the benefits of obesity interventions. Moreover, I found that unless interventions are targeted toward all obese children in a family, the contagion of obesity can hinder weight loss in intervention targets. This model can be leveraged as a tool to optimize family-based obesity intervention strategies and inform randomized controlled obesity prevention trials. |
| Original Identifier: | oai:dash.harvard.edu:1/10288417 |
| نوع الوثيقة: | Thesis or Dissertation |
| الإتاحة: | http://dissertations.umi.com/gsas.harvard:10266Test http://nrs.harvard.edu/urn-3:HUL.InstRepos:10288417Test |
| حقوق: | closed access |
| رقم الانضمام: | edsndl.harvard.edu.oai.dash.harvard.edu.1.10288417 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| الوصف غير متاح. |