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Weber P, Birkholz L, Straub R, Kohler S, Helsper N, Dippon L, Pfeifer K, Rütten A, Semrau J. The Limitations and Potentials of Evaluating Economic Aspects of Community-Based Health Promotion: A Critical Review. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:165-179. [PMID: 38190019 PMCID: PMC10864521 DOI: 10.1007/s40258-023-00864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
Community-based health promotion (CBHP) interventions are promising approaches to address public health problems; however, their economic evaluation presents unique challenges. This review aims to explore the opportunities and limitations of evaluating economic aspects of CBHP, focusing on the assessment of intervention costs and outcomes, and the consideration of political-level changes and health equity. A systematic search of the PubMed, Web of Science and PsycInfo databases identified 24 CBHP interventions, the majority of which targeted disadvantaged communities. Only five interventions included a detailed cost/resource assessment. Outcomes at the operational level were mainly quantitative, related to sociodemographics and environment or health status, while outcomes at the political level were often qualitative, related to public policy, capacity building or networks/collaboration. The study highlights the limitations of traditional health economic evaluation methods in capturing the complexity of CBHP interventions. It proposes the use of cost-consequence analysis (CCA) as a more comprehensive approach, offering a flexible and multifaceted assessment of costs and outcomes. However, challenges remain in the measurement and valuation of outcomes, equity considerations, intersectoral costs and attribution of effects. While CCA is a promising starting point, further research and methodological advancements are needed to refine its application and improve decision making in CBHP.
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Affiliation(s)
- Philipp Weber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany.
| | - Leonie Birkholz
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Riccarda Straub
- School of Business, Economics and Society, Chair of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Lange Gasse 20, 90403, Nuremberg, Germany
| | - Simone Kohler
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Natalie Helsper
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Lea Dippon
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Jana Semrau
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
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Gelius PC, Jansen M, King AC. Cooperative planning and its utilization in German physical activity promotion: a brief introduction. Health Promot Int 2021; 36:ii1-ii7. [PMID: 34905606 PMCID: PMC8670624 DOI: 10.1093/heapro/daab170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Peter C Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maria Jansen
- Department of Health Services Research, Universiteit Maastricht, Maastricht, The Netherlands
| | - Abby C King
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
- Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
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