Abstract
BackgroundAttention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context.MethodWe investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models.ResultsThe relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole.ConclusionThe study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0908-y) contains supplementary material, which is available to authorized users.
Highlights
Attention is increasing on the consideration of broader non-health outcomes in economic evaluations
In an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole
Goebbels et al [12], for example, used interviews and focus groups to explore what broader outcomes are relevant from the perspective of participants in a lifestyle behavior change program, who were at risk for diabetes and cardiovascular disease
Summary
Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. Goebbels et al [12], for example, used interviews and focus groups to explore what broader outcomes are relevant from the perspective of participants in a lifestyle behavior change program, who were at risk for diabetes and cardiovascular disease. They identified non-health outcomes such as body satisfaction, stress reduction and relaxation, endurance, social interaction, feeling of control, overcoming addiction, feeling fresh and clean, and effort of making behavioral changes. Despite the increasing attention and evidence for the importance of broader outcomes in the aforementioned literature, economic evaluations (of health promotion programs) hardly include any outcomes that go beyond health [17]
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