Estimating The Costs And Cost-effectiveness Of Promoting Mammography Screening Among US-based Latinas

Authors

Yamilé Molina, University of Illinois at ChicagoFollow
Catherine M. Pichardo, University of Illinois at ChicagoFollow
Donald L. Patrick, University of WashingtonFollow
Scott D. Ramsey, Fred Hutchinson Cancer Research CenterFollow
Sonia Bishop, Fred Hutchinson Cancer Research CenterFollow
Shirley A.A. Beresford PhD, University of WashingtonFollow
Gloria Coronado, Kaiser Permanente Center for Health ResearchFollow

Keywords

cost-effectiveness analysis; community health workers; mammography disparities; Latinas

Disciplines

Community Health and Preventive Medicine

Abstract

Purpose: We characterize the costs and cost-effectiveness of a community health worker (CHW)-based intervention to promote screening mammography among US-based non-adherent Latinas.

Methods: The parent study was a randomized controlled trial for 536 Latinas aged 42-74 years old who had sought care within a safety net health center in Western Washington. Participants were block-randomized within clinic to the control arm (usual care) or intervention arm (CHW-led motivational interviewing intervention). We used the perspective of the organization implementing promotional activities to characterize costs and cost-effectiveness. Cost data were categorized as program set-up and maintenance (initial training, booster/annual training) program implementation (administrative activities, intervention delivery); and, overhead/miscellaneous expenses. Cost-effectiveness was calculated as the incremental cost of screening for each additional woman screened between the intervention and control arms.

Results: The respective costs per participant for standard care and the intervention arm were $69.96 and $300.99. There were no study arm differences in 1-year QALYs among women who completed a 12-month follow-up survey (intervention= 0.8827, standard care = 0.8841). Most costs pertained to program implementation and administrative activities specifically. The incremental cost per additional woman screened was $2,595.32.

Conclusions: Our findings are within the ranges of costs and cost-effectiveness for other CHW programs to promote screening mammography among underserved populations. Our strong study design and focus on non-adherent women provides important strengths to this body of work, especially give implementation and dissemination science efforts regarding CHW-based health promotion for health disparity populations.

Recommended Citation

Molina, Yamilé; Pichardo, Catherine M.; Patrick, Donald L.; Ramsey, Scott D.; Bishop, Sonia; Beresford, Shirley A.A. PhD; and Coronado, Gloria (2018) "Estimating The Costs And Cost-effectiveness Of Promoting Mammography Screening Among US-based Latinas," Journal of Health Disparities Research and Practice: Vol. 12: Iss. 6, Article 10.
Available at: https://digitalscholarship.unlv.edu/jhdrp/vol12/iss6/10