Incredible Years Wales:
The Welsh Centre for Promoting
the Incredible Years Programmes
Title:
“An
economic evaluation of the Incredible Years BASIC Parenting Programme”
Presented
by: Rhiannon Tudor-Edwards, University of Wales, Bangor.
Authors:
Rhiannon Tudor-Edwards & Alan Kelleher, Centre for
Economics of Health, University of Wales, Bangor.
Abstract:
Conduct disorder is estimated to affect 10% of children
in the UK and the US and has both short and long term cost implications for
families, public services and society. This paper reports on the relative cost-effectiveness
of the Incredible Years BASIC Parenting Programme when compared, in a randomised
controlled trial, with six-month waiting list control families. The programme
was delivered, by Sure Start staff in community settings, to the parents of
children designated as at high risk of conduct disorder living in Sure Start
areas in north Wales, mid Wales and Borders. The health economic component involved
an incremental cost-effectiveness analysis.
One hundred and sixteen children aged 36-59 months, and displaying early signs
of conduct disorder as measured by the problem and intensity scores of the Eyberg
Child Behaviour Index (ECBI), were recruited by health visitors. Participants
were randomised to either a group receiving the BASIC parenting programme or
to a six-month waiting-list control. The primary outcome measure was the incremental
cost per unit of improvement on the intensity score of the ECBI.
Results
An ICER point estimate of £23 per one point improvement on the intensity
score of the Eyberg Child Behaviour Index (95% confidence interval -£1
- £51) was calculated. With a Cost-Effectiveness Acceptability Curve (CEAC)
cost ceiling set at £45 there is a 93.9% chance of the intervention being
cost-effective. The mean cost per child of attending the parenting group was
£654 (SD = £213.18) (n=73). Dividing the sample into relatively
mild, moderate and severe groups, based on Eyberg intensity scores at baseline,
the intervention appeared more cost-effective for those children with more intense
conduct disorders.
Conclusion
The Incredible Years Parent programme improves child behaviour as measured by
the intensity and problem scores of the ECBI at a small additional cost, indeed
at more severe levels of conduct disorder the extra cost may be very small indeed.
The parenting programme's modest cost and strong clinical effect suggest that
it represents good value for money for public spending.