An economic evaluation of an online computer-tailored smoking cessation intervention that includes message frame-tailoring: A randomized controlled trial

• Published in: PLOS digital health Vol. 1; no. 9; p. e0000094
• Main Authors: Altendorf, Maria B, van Weert, Julia C M, Hoving, Ciska, Smit, Eline S
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-09-2022; Public Library of Science (PLoS)
• Subjects: Abstinence; Biology and Life Sciences; Clinical trials; Computer and Information Sciences; Consumer Price Index; Cost analysis; Engineering and Technology; Health care expenditures; Intervention; Medicine and Health Sciences; Nicotine; Quality of life; Questionnaires; Research and Analysis Methods; Sensitivity analysis; Smoking; Smoking cessation; Social networks; Social Sciences; Software
• ISSN: 2767-3170; 2767-3170
• DOI: 10.1371/journal.pdig.0000094

Evidence of economic evaluations of behaviour change interventions is scarce, but needed to guide policy makers' decision-making. This study economically evaluated 4 versions of an innovative online computer-tailored smoking cessation intervention. The economic evaluation from a societal perspective was embedded in a randomized controlled trial among 532 smokers using a 2 (message frame-tailoring, i.e. how messages are presented: autonomy-supportive vs controlling) x 2 (content-tailoring, i.e. what content is presented: tailored vs. generic) design. Both kinds of tailoring, content-tailoring and message frame-tailoring, were based on a set of questions asked at baseline. Self-reported costs, prolonged smoking abstinence (cost-effectiveness) and quality of life (cost-utility) were assessed during a 6-month-follow-up. For cost-effectiveness analysis, costs per abstinent smoker were calculated. For cost-utility analysis, costs per QALY (i.e. quality-adjusted life year) gained were calculated. A willingness-to-pay (WTP) threshold of €20.000 was used. Bootstrapping and sensitivity analysis were conducted. Cost-effectiveness analysis showed that up to a WTP of €2.000, the combination of message frame- and content-tailoring dominated all study groups. From a WTP of €2.005, the content-tailored group dominated all study groups. Cost-utility analysis revealed that the combination of message frame-tailoring and content-tailoring had the highest probability of being the most efficient study group at all levels of the WTP. The combination of message frame-tailoring and content-tailoring in online smoking cessation programmes seemed to have high potential for cost-effectiveness (smoking abstinence) and cost-utility (quality of life), thus providing good value for money. Yet, when the WTP for each abstinent smoker is high (i.e., €2.005 or higher), the addition of message frame-tailoring might not be worth the effort and content-tailoring only is preferred.