A mixed methods partner-focused cost and budget impact analysis to deploy implementation strategies for school-based prevention Article Swipe
Andria B. Eisman
,
Jacob Whitman
,
Lawrence A. Palinkas
,
Judy Fridline
,
Christina Harvey
,
Amy M. Kilbourne
,
David W. Hutton
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1186/s43058-023-00511-6
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1186/s43058-023-00511-6
Background Obtaining information on implementation strategy costs and local budget impacts from multiple perspectives is essential to data-driven decision-making about resource allocation for successful evidence-based intervention delivery. This mixed methods study determines the costs and priorities of deploying Enhanced Replicating Effective Programs (REP) to implement the Michigan Model for Health™, a universal school-based prevention intervention, from key shareholder perspectives. Methods Our study included teachers in 8 high schools across 3 Michigan counties as part of a pilot cluster randomized trial. We used activity-based costing, mapping key Enhanced REP activities across implementation phases. We included multiple perspectives, including state agencies, regional education service agencies, lead organization, and implementers. We also conducted a budget impact analysis (BIA, assessing the potential financial impact of adopting Enhanced REP) and a scenario analysis to estimate replication and account for cost variability. We used an experimental embedded mixed methods approach, conducting semi-structured interviews and collecting field notes during the trial to expand and explain the cost data and the implications of costs across relevant perspectives. Results Based on trial results, we estimate costs for deploying Enhanced REP are $11,903/school, with an estimated range between $8263/school and $15,201/school. We estimate that adding four additional schools, consistent with the pilot, would cost $8659/school. Qualitative results indicated misalignment in school and teacher priorities in some cases. Implementation activities, including training and implementation facilitation with the health coordinator, were sometimes in addition to regular teaching responsibilities. The extent to which this occurred was partly due to leadership priorities (e.g., sticking to the district PD schedule) and organizational priorities (e.g., budget). Conclusions Previous research findings indicate that, from a societal perspective, universal prevention is an excellent return on investment. However, notable misalignment in cost burden and priorities exists across shareholder groups. Our results indicate significant personal time costs by teachers when engaging in implementation strategy activities that impose an opportunity cost. Additional strategies are needed to improve the alignment of costs and benefits to enhance the success and sustainability of implementation. We focus on those perspectives informed by the analysis and discuss opportunities to expand a multi-level focus and create greater alignment across perspectives. Trial registration ClinicalTrials.gov NCT04752189. Registered on 12 February 2021.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1186/s43058-023-00511-6
- https://implementationsciencecomms.biomedcentral.com/counter/pdf/10.1186/s43058-023-00511-6
- OA Status
- gold
- Cited By
- 3
- References
- 58
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388540353
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388540353Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1186/s43058-023-00511-6Digital Object Identifier
- Title
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A mixed methods partner-focused cost and budget impact analysis to deploy implementation strategies for school-based preventionWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-11-09Full publication date if available
- Authors
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Andria B. Eisman, Jacob Whitman, Lawrence A. Palinkas, Judy Fridline, Christina Harvey, Amy M. Kilbourne, David W. HuttonList of authors in order
- Landing page
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https://doi.org/10.1186/s43058-023-00511-6Publisher landing page
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https://implementationsciencecomms.biomedcentral.com/counter/pdf/10.1186/s43058-023-00511-6Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://implementationsciencecomms.biomedcentral.com/counter/pdf/10.1186/s43058-023-00511-6Direct OA link when available
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Activity-based costing, Intervention (counseling), Cluster randomised controlled trial, Resource (disambiguation), Process management, Business, Computer science, Medicine, Accounting, Nursing, Computer networkTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 3Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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