Effectiveness and Cost-effectiveness of School-based Dissemination Strategies of an Internet-based Program for the Prevention and Early Intervention in Eating Disorders: A Randomized Trial
- 829 Downloads
Only little is known about costs and effects (i.e., success) of dissemination strategies, although cost-effective dissemination strategies are crucial for the transfer of interventions into routine care. This study investigates the effects and cost-effectiveness of five school-based dissemination strategies for an Internet-based intervention for the prevention and early intervention of eating disorders. Three-hundred ninety-five schools were randomly assigned to one of five dissemination strategies. Strategies varied with respect to intensity from only sending advertisement materials and asking the school to distribute them among students to organizing presentations and workshops at schools. Effects were defined as the number of page visits, the number of screenings conducted, and the number of registrations to the Internet-based intervention. More expensive strategies proved to be more cost-effective. Cost per page visit ranged from 2.83€ (introductory presentation plus workshop) to 20.37€ (dissemination by student representatives/peers). Costs per screening ranged from 3.30€ (introductory presentation plus workshop) to 75.66€ (dissemination by student representatives/peers), and costs per registration ranged from 6.86€ (introductory presentation plus workshop) to 431.10€ (advertisement materials only). Dissemination of an Internet-based intervention for prevention and early intervention is challenging and expensive. More intense, expensive strategies with personal contact proved to be more cost-effective. The combination of an introductory presentation on eating disorders and a workshop in the high school was most effective and had the best cost-effectiveness ratio. The sole distribution of advertisement materials attracted hardly any participants to the Internet-based program.
KeywordsDissemination Prevention Internet-based Cost-effectiveness Eating disorders
Compliance with Ethical Standards
This work was supported by the project ProYouth which received funding from the European Union, in the framework of the Health Programme (PROYOUTH 20101209).
Conflict of Interest
The authors declare that they have no competing interests.
The efficacy study was approved by the Ethics Committee of the Medical Faculty of the University of Heidelberg (S-236/2008). According to the Ethics Committee, separate approval for the dissemination of the program was not needed.
All participants registering to the ProYouth program provide informed consent online. For the present study, no personal data were gathered, i.e., only anonymous data were used.
- Bauer, S., Papezova, H., Chereches, R., Caselli, G., McLoughlin, O., Szumska, I., van Furth, E., Ozer, F., & Moessner, M. (2013). Advances in the prevention and early intervention of eating disorders: The potential of Internet-delivered approaches. Mental Health & Prevention, 1, 26–32.CrossRefGoogle Scholar
- Frantz, I., Stemmler, M., Hahlweg, K., Plück, J., & Heinrichs, N. (2015). Experiences in disseminating evidence-based prevention programs in a real-world setting. Prevention Science. Advance online publication. Retrieved from http://link.springer.com/article/10.1007/s11121-015-0554-y
- Glasgow, R. E., Vinson, C., Chambers, D., Khoury, M. J., Kaplan, R. M., & Hunter, C. (2012). National Institutes of health approaches to dissemination and implementation science: Current and future directions. American Journal of Public Health, 102, 1274–1281.CrossRefPubMedPubMedCentralGoogle Scholar
- Graham, A. L., Milner, P., Saul, J. E., & Pfaff, L. (2008). Online advertising as a public health and recruitment tool: Comparison of different media campaigns to increase demand for smoking cessation interventions. Journal of Medical Internet Research, 10, e50.CrossRefPubMedPubMedCentralGoogle Scholar
- Graham, A. L., Fang, Y., Moreno, J. L., Streiff, S. L., Villegas, J., Munoz, R. F., Tercyak, K. P., Mandelblatt, J. S., & Vallone, D. M. (2012). Online advertising to reach and recruit Latino smokers to an internet cessation program: Impact and costs. Journal of Medical Internet Research, 14, e116.CrossRefPubMedPubMedCentralGoogle Scholar
- Lindenberg, K., & Kordy, H. (2015). Wirksamkeit eines gestuften, Internet-vermittelten Ansatzes zur Prävention von Essstörungen bei Schülern der 7.bis 10.Klasse [Efficacy of a stepped, Internet-delivered approach for the prevention of eating disorders in high school]. Kindheit und Entwicklung, 24, 55–63.CrossRefGoogle Scholar
- Minarik, C., Moessner, M., Ozer, F., & Bauer, S. (2013). Implementierung und Dissemination eines internetbasierten Programms zur Prävention und frühen Intervention bei Essstörungen [Implementation and Dissemination of an Internet-based Program for Prevention and Early Intervention in Eating Disorders]. Psychiatrische Praxis, 40, 332–338.CrossRefPubMedGoogle Scholar
- O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington DC: National Academies Press.Google Scholar
- Stice, E., Rohde, P., Shaw, H., & Marti, C. N. (2012). Efficacy trial of a selective prevention program targeting both eating disorder symptoms and unhealthy weight gain among female college students. Journal of Consulting and Clinical Psychology, 80, 164–170.CrossRefPubMedPubMedCentralGoogle Scholar