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