IDEAS home Printed from https://ideas.repec.org/a/eee/epplan/v55y2016icp46-54.html

Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis

Author

Listed:
  • Mac Giolla Phadraig, Caoimhin
  • Nunn, June
  • Guerin, Suzanne
  • Normand, Charles

Abstract

Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000–€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison between programs. Suggestions to reduce cost are presented.

Suggested Citation

  • Mac Giolla Phadraig, Caoimhin & Nunn, June & Guerin, Suzanne & Normand, Charles, 2016. "Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis," Evaluation and Program Planning, Elsevier, vol. 55(C), pages 46-54.
    • Handle: RePEc:eee:epplan:v:55:y:2016:i:c:p:46-54
    DOI: 10.1016/j.evalprogplan.2015.12.003
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0149718915001317
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.evalprogplan.2015.12.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Claxton, Karl, 1999. "The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies," Journal of Health Economics, Elsevier, vol. 18(3), pages 341-364, June.
    2. Weatherly, Helen & Drummond, Michael & Claxton, Karl & Cookson, Richard & Ferguson, Brian & Godfrey, Christine & Rice, Nigel & Sculpher, Mark & Sowden, Amanda, 2009. "Methods for assessing the cost-effectiveness of public health interventions: Key challenges and recommendations," Health Policy, Elsevier, vol. 93(2-3), pages 85-92, December.
    3. Binkley, Catherine J. & Johnson, Knowlton W. & Abadi, Melissa & Thompson, Kirsten & Shamblen, Stephen R. & Young, Linda & Zaksek, Brigit, 2014. "Improving the oral health of residents with intellectual and developmental disabilities: An oral health strategy and pilot study," Evaluation and Program Planning, Elsevier, vol. 47(C), pages 54-63.
    4. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Teasdale, Rebecca M. & Strasser, Mikayla & Moore, Ceily & Graham, Kara E., 2023. "Evaluative criteria in practice: Findings from an analysis of evaluations published in Evaluation and Program Planning," Evaluation and Program Planning, Elsevier, vol. 97(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Maria Andersson & Ola Eriksson & Chris Von Borgstede, 2012. "The Effects of Environmental Management Systems on Source Separation in the Work and Home Settings," Sustainability, MDPI, vol. 4(6), pages 1-17, June.
    2. Colin C Williams, 2021. "Tackling Undeclared Self-Employment in South-East Europe: from Deterrents to Preventative Policy Measures," Economic Alternatives, University of National and World Economy, Sofia, Bulgaria, issue 2, pages 280-298, July.
    3. Chia-chen Wang & Chin-ta Chen & Shu-chen Yang & Cheng-kiang Farn, 2009. "Pirate or Buy? The Moderating Effect of Idolatry," Journal of Business Ethics, Springer, vol. 90(1), pages 81-93, November.
    4. Tran Huy Phuong & Thanh Trung Hieu, 2015. "Predictors of Entrepreneurial Intentions of Undergraduate Students in Vietnam: An Empirical Study," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 5(8), pages 46-55, August.
    5. Mustapha Bachiri, 2016. "Determinants of Students’ Entrepreneurial Intentions: Evidence from Moroccan University," International Business Research, Canadian Center of Science and Education, vol. 9(11), pages 83-89, November.
    6. Hyun Hye Kim & EunKyoung Han, 2020. "The Application of the Theory of Planned Behavior to Identify Determinants of Donation Intention: Towards the Comparative Examination of Positive and Negative Reputations of Nonprofit Organizations CEO," Sustainability, MDPI, vol. 12(21), pages 1-19, November.
    7. Corinne Mulley & Liang Ma, 2018. "How the longer term success of a social marketing program is influenced by socio-demographics and the built environment," Transportation, Springer, vol. 45(2), pages 291-309, March.
    8. Clara Cardone-Riportella & María José Casasola-Martinez & Isabel Feito-Ruiz, 2014. "Do Entrepreneurs Come From Venus Or Mars? Impact Of Postgraduate Studies: Gender And Family Business Background," Working Papers 14.04, Universidad Pablo de Olavide, Department of Financial Economics and Accounting (former Department of Business Administration), revised Sep 2014.
    9. Peng Cheng & Zhe Ouyang & Yang Liu, 0. "The effect of information overload on the intention of consumers to adopt electric vehicles," Transportation, Springer, vol. 0, pages 1-20.
    10. Abayomi Samuel Oyekale, 2015. "Factors Explaining Households’ Cash Payment for Solid Waste Disposal and Recycling Behaviors in South Africa," Sustainability, MDPI, vol. 7(12), pages 1-18, November.
    11. Dyfrig Hughes & Joanna Charles & Dalia Dawoud & Rhiannon Tudor Edwards & Emily Holmes & Carys Jones & Paul Parham & Catrin Plumpton & Colin Ridyard & Huw Lloyd-Williams & Eifiona Wood & Seow Tien Yeo, 2016. "Conducting Economic Evaluations Alongside Randomised Trials: Current Methodological Issues and Novel Approaches," PharmacoEconomics, Springer, vol. 34(5), pages 447-461, May.
    12. Francisco Díez-Martín & Alicia Blanco-González & Camilo Prado-Román, 2016. "Explaining nation-wide differences in entrepreneurial activity: a legitimacy perspective," International Entrepreneurship and Management Journal, Springer, vol. 12(4), pages 1079-1102, December.
    13. Ruijie Zhu & Guojing Zhao & Zehai Long & Yangjie Huang & Zhaoxin Huang, 2022. "Entrepreneurship or Employment? A Survey of College Students’ Sustainable Entrepreneurial Intentions," Sustainability, MDPI, vol. 14(9), pages 1-15, May.
    14. Alsalem, Amani & Fry, Marie-Louise & Thaichon, Park, 2020. "To donate or to waste it: Understanding posthumous organ donation attitude," Australasian marketing journal, Elsevier, vol. 28(3), pages 87-97.
    15. Pan, Jing Yu & Liu, Dahai, 2022. "Mask-wearing intentions on airplanes during COVID-19 – Application of theory of planned behavior model," Transport Policy, Elsevier, vol. 119(C), pages 32-44.
    16. Byrka, Katarzyna & Jȩdrzejewski, Arkadiusz & Sznajd-Weron, Katarzyna & Weron, Rafał, 2016. "Difficulty is critical: The importance of social factors in modeling diffusion of green products and practices," Renewable and Sustainable Energy Reviews, Elsevier, vol. 62(C), pages 723-735.
    17. Zhang, Kai & Cheng, Xiaoting, 2025. "Determinants of consumers’ intentions to use smart home devices from the perspective of perceived value: A mixed SEM, NCA, and fsQCA study," Journal of Retailing and Consumer Services, Elsevier, vol. 87(C).
    18. Zampetakis, Leonidas A. & Kafetsios, Konstantinos & Moustakis, Vassilis, 2017. "Using emotional persuasion for changing attitudes towards entrepreneurship: An interpersonal perspective," Journal of Business Venturing Insights, Elsevier, vol. 7(C), pages 50-54.
    19. Minh-Tri Ha, 2021. "Optimizing Green Brand Equity: The Integrated Branding and Behavioral Perspectives," SAGE Open, , vol. 11(3), pages 21582440211, July.
    20. Mohammed Akhmaaj, Asmaeil Ali & Sharif, Mohamed Omar, 2024. "The effects of planned behavior model constructs and technology acceptance model constructs on online purchasing behavior: An empirical study on internet users in the Libya city of Tripoli," Technology in Society, Elsevier, vol. 79(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:epplan:v:55:y:2016:i:c:p:46-54. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/evalprogplan .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.