Cost-effectiveness of peer-delivered physical activity promotion and maintenance programs for initially sedentary breast cancer survivors.
Cost-effectiveness of peer-delivered physical activity promotion and maintenance programs for initially sedentary breast cancer survivors.
复制标题
同伴为最初久坐的乳腺癌幸存者提供的身体活动促进和维持计划的成本效益。
DOI：
10.1093/tbm/ibad026
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发表时间：
2023
影响因子：
3.6
通讯作者：
Pinto,BernardineM
中科院分区：
文献类型：
--
作者：
Chen,BrianK;Dunsiger,ShiraI;Pinto,BernardineM
体力活动(PA)对癌症幸存者的生存和健康益处的证据得到了很好的记录。然而，在癌症幸存者中维持PA一直是一项挑战。评价同伴支持在乳腺癌幸存者中鼓励维持中等到剧烈的体力活动(MVPA)的成本效益。参与者在最初采用阶段后6个月被随机分为REACH Plus消息(每周短信/电子邮件)、REACH Plus电话(每月电话)或REACH Plus(自我监控干预)。我们用质量调整年(QALY)和自我报告的MVPA计算增量成本-效果比(ICER)，从支付者一年的预算和社会角度出发。通过培训师和同伴教练的时间记录收集干预成本，通过调查从参与者那里收集参与者成本。在我们的敏感性分析中，我们通过自举成本和效果来构建成本-效果平面和可接受曲线。通过Reach Plus，提供同行教练每周信息的干预措施，每QALY获得的ICER为14,446美元，MVPA每天额外一分钟的ICER为0.95美元。当决策者愿意支付大约每QALY 25,000美元和每增加一分钟MVPA 10美元时，Reach Plus消息的成本效益概率分别为49.8%和78.5%。Reach Plus Phone需要每月定制电话呼叫，其成本高于Reach Plus Message，但一年后的QALY和自我报告的MVPA较低。Reach Plus Message可能是一种可行且具有成本效益的干预策略，可以在乳腺癌幸存者中维持MVPA。
The evidence for the survival and health benefits of physical activity (PA) among cancer survivors is well documented. However, it has been challenging to maintain PA among cancer survivors. To evaluate the cost-effectiveness of peer support to encourage maintenance of moderate-to-vigorous physical activity (MVPA) among breast cancer survivors. Participants were randomized into Reach Plus Message (weekly text/email messages), Reach Plus Phone (monthly phone calls) or Reach Plus (a self-monitoring intervention) over 6 months after an initial adoption phase. We calculated the incremental cost-effectiveness ratios (ICER) in terms of quality-adjusted years life years (QALYs) and self-reported MVPA, from the payer’s budgetary and societal perspectives over 1 year. Intervention costs were collected via time logs from the trainers and peer coaches, and participant costs from the participants via surveys. For our sensitivity analyses, we bootstrapped costs and effects to construct cost-effectiveness planes and acceptability curves. The intervention that provides weekly messages from peer coaches has an ICER of $14,446 per QALY gained and $0.95 per extra minute of MVPA per day over Reach Plus. Reach Plus Message has a 49.8% and 78.5% probability of cost-effectiveness respectively when decision makers are willing to pay approximately $25,000 per QALY and $10 per additional minute of MVPA. Reach Plus Phone, which requires tailored monthly telephone calls, costs more than Reach Plus Message but yields less QALY and self-reported MVPA at 1 year. Reach Plus Message may be a viable and cost-effective intervention strategy to maintain MVPA among breast cancer survivors.