%0 Journal Article
%T Measuring the costs of outreach motivational interviewing for smoking cessation and relapse prevention among low-income pregnant women
%A Jennifer Ruger
%A Karen M Emmons
%A Margaret H Kearney
%A Milton C Weinstein
%J BMC Pregnancy and Childbirth
%D 2009
%I BioMed Central
%R 10.1186/1471-2393-9-46
%X Randomized controlled trial (1997-2000) collecting primary cost data for intervention. A sample of 302 low-income pregnant women was recruited from multiple obstetrical sites in the Boston metropolitan area. MI delivered by outreach health nurses vs. usual care (UC), with economic costs as the main outcome measures.The total cost of the MI intervention for 156 participants was $48,672 or $312 per participant. The total cost of $311.8 per participant for the MI intervention compared with a cost of $4.82 per participant for usual care, a difference of $307 ([CI], $289.2 to $322.8). The total fixed costs of the MI were $3,930 and the total variable costs of the MI were $44,710. The total expected program costs for delivering MI to 500 participants would be 147,430, assuming no economies of scale in program delivery. The main cost components of outreach MI were intervention delivery, travel time, scheduling, and training.Grounded in economic theory, this methodology systematically identifies and measures resource utilization, using a process tracking system and calculates both component-specific and total costs of outreach MI. The methodology could help improve collection of accurate data on costs and estimates of the real resource costs of interventions alongside clinical trials and improve the validity and reliability of estimates of resource costs for interventions targeted at underserved and hard-to-reach populations.Economic theory provides the philosophical foundation for valuing costs in judging medical and public health interventions. Resources used in, and saved as a result of, medical and public health programs must be measured in terms of their monetary costs to understand the overall implications of such interventions. Under economic theory, the opportunity cost of a resource - or its value in its next best or alternative use - is the real cost of that resource to society. Under ideal circumstances (e.g., perfect competition, absence of market failures such
%U http://www.biomedcentral.com/1471-2393/9/46