Measuring the Costs of Outreach Motivational Interviewing for Smoking Cessation and Relapse Prevention Among Low-Income Pregnant Women

BMC Pregnancy and Childbirth, Vol. 9, 2009

11 Pages Posted: 9 Apr 2008 Last revised: 16 Oct 2009

See all articles by Jennifer Prah Ruger

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine

Karen M. Emmons

Harvard University - T.H. Chan School of Public Health; Kaiser Permanente

Margaret H. Kearney

University of Rochester - School of Nursing

Milton Weinstein

Harvard University

Abstract

Background: Economic theory provides the philosophical foundation for valuing costs in judging medical and public health interventions. When evaluating smoking cessation interventions, accurate data on costs are essential for understanding resource consumption. Smoking cessation interventions, for which prior data on resource costs are typically not available, present special challenges. We develop a micro-costing methodology for estimating the real resource costs of outreach motivational interviewing (MI) for smoking cessation and relapse prevention among low-income pregnant women and report results from a randomized controlled trial (RCT) employing the methodology. Methodological standards in cost analysis are necessary for comparison and uniformity in analysis across interventions. Estimating the costs of outreach programs is critical for understanding the economics of reaching underserved and hard-to-reach populations.

Methods: Randomized controlled trial (1997-2000) collecting primary cost data for intervention. A sample of 302 low-income pregnant women was recruited from multiple obstetrical sites in the Boston metropolitan area. MI delivered by outreach health nurses vs. usual care (UC), with economic costs as the main outcome measures.

Results: The total cost of the MI intervention for 156 participants was $48,672 or $312 per participant. The total cost of $311.8 per participant for the MI intervention compared with a cost of $4.82 per participant for usual care, a difference of $307 ([CI], $289.2 to $322.8). The total fixed costs of the MI were $3,930 and the total variable costs of the MI were $44,710. The total expected program costs for delivering MI to 500 participants would be 147,430, assuming no economies of scale in program delivery. The main cost components of outreach MI were intervention delivery, travel time, scheduling, and training.

Conclusion: Grounded in economic theory, this methodology systematically identifies and measures resource utilization, using a process tracking system and calculates both component-specific and total costs of outreach MI. The methodology could help improve collection of accurate data on costs and estimates of the real resource costs of interventions alongside clinical trials and improve the validity and reliability of estimates of resource costs for interventions targeted at underserved and hard-to-reach populations.

Keywords: smoking cessation, relapse prevention, low-income, pregnancy micro-costing, measuring costs, primary cost data, motivational interviewing, U.S. Panel on Cost-Effectiveness in Health and Medicine

JEL Classification: I11, I12

Suggested Citation

Prah Ruger, Jennifer and Emmons, Karen M. and Kearney, Margaret H. and Weinstein, Milton, Measuring the Costs of Outreach Motivational Interviewing for Smoking Cessation and Relapse Prevention Among Low-Income Pregnant Women. BMC Pregnancy and Childbirth, Vol. 9, 2009 . Available at SSRN: https://ssrn.com/abstract=1117649

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

Karen M. Emmons

Harvard University - T.H. Chan School of Public Health ( email )

677 Huntington Avenue
Boston, MA MA 02115
United States

Kaiser Permanente ( email )

CA
United States

Margaret H. Kearney

University of Rochester - School of Nursing ( email )

Helen Wood Hall
601 Elmwood Ave
Rochester, NY 14642
United States

Milton Weinstein

Harvard University ( email )

1875 Cambridge Street
Cambridge, MA 02138
United States

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
98
Abstract Views
1,078
rank
281,777
PlumX Metrics