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Monashefsky A, Alon D, Baranowski T, Barreira TV, Chiu KA, Fleischman A, Green MC, Huang S, Samuels RC, Sousa CV, Thompson D, Lu AS. How much did it cost to develop and implement an eHealth intervention for a minority children population that overlapped with the COVID-19 pandemic? Contemp Clin Trials 2023; 125:107044. [PMID: 36473682 PMCID: PMC9721158 DOI: 10.1016/j.cct.2022.107044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/14/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions. OBJECTIVES We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19. METHODS We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs. RESULTS The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant completing the RCT (79 participants/237 visits) was $24,403 (Direct: $15,543; Indirect: $8860). Due to no-shows and cancellations (198 visits) and dropouts before study completion (61 visits; 56 participants), 496 visits had to be scheduled to ensure complete data collection on 79 participants. If all 496 visits were from participants completing the three-visit protocol, that would correspond to 165 participants, bringing the average cost per participant down to $11,684 (Direct: $7442; Indirect: $4242). Of the subcategories, intervention material development accounted for the largest portion, followed by personnel salaries. While the direct COVID-19-specific cost constituted <1% of the entire budget, the indirect effects were much larger and significantly impacted the trial. CONCLUSION RCTs typically involve significant resources, even more so during a pandemic. Future eHealth intervention investigators should budget and plan accordingly to prepare for unexpected costs such as recruitment challenges to increase flexibility while maximizing the intervention efficacy.
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Affiliation(s)
- Alexandra Monashefsky
- Precision Link Biobank, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States
| | - Dar Alon
- Harvard T.H Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Tom Baranowski
- Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, United States
| | - Tiago V Barreira
- Exercise Science Department, Syracuse University, 820 Commstock Ave, Syracuse, NY 13244, United States
| | - Kelly A Chiu
- Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02130, United States
| | - Amy Fleischman
- Harvard Medical School, Optimal Wellness for Life Clinic, Boston Children's Hospital, Boston, MA 02115, United States
| | - Melanie C Green
- Department of Communication, University at Buffalo, 359 Baldy Hall, Buffalo, NY 14260, United States
| | - Shirley Huang
- Tufts University School of Medicine, Tufts Medical Center, Boston, MA 02111, United States
| | - Ronald C Samuels
- Children's Hospital of Montefiore and Einstein Medical School, 3411 Wayne Ave, Bronx, NY, 10467, United States
| | - Caio Victor Sousa
- Health and Human Sciences Department, Loyola Marymount University, 1 LMU Drive, MS 8888, Los Angeles, CA 90045, United States
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, United States
| | - Amy S Lu
- Health Technology Lab, Department of Communication Studies, College of Arts, Media, and Design, Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave, Boston, MA 02115, United States.
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Monashefsky A, Alon D, Baran A, Borah R, Lee K, McGarrity E, Menon H, Sousa C, Swaminathan N, Lu AS. Running an active gaming-based randomized controlled trial during the COVID-19 pandemic: Challenges, solutions and lessons learned. PUBLIC HEALTH IN PRACTICE 2022; 3:100259. [PMID: 35502216 PMCID: PMC9044649 DOI: 10.1016/j.puhip.2022.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/08/2022] [Accepted: 04/16/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives The COVID-19 pandemic has created significant obstacles for clinical trials and human subject research. This paper discusses the challenges our study team encountered while implementing an eHealth intervention during the pandemic, including: increased dropout, cancellation and rescheduling rates, increased mailing returns and delays, social distancing impediments, COVID-19 positive team members, and restricted training access. Study design This is a short paper on research protocol for a six-month randomized controlled single-blind trial. Methods N/A. Results In response to these challenges, we changed the study protocol. We included multimodal communication models, amplified recruitment efforts, expanded our population's age range, increasingly utilized tracking labels, utilized external space for extra participants, and transitioned to a virtual RA training format. Conclusions Sharing our experience and the adaptations required to run a clinical trial during the pandemic should provide useful and practical knowledge for institutions, funding agencies, and researchers. We believe that the lessons learned here would be applicable to future clinical trial research after the pandemic as well.
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