Facilitators and barriers to the use of economic evaluations in nutrition and public health

Aims: Interventions targeting diets have the potential to reduce a consistent fraction of the chronic disease burden. Economic evaluations of such interventions can be an important tool in guiding public health practitioners and decision makers at various levels, yet there are still not many economic evaluations in this area. This qualitative study explored facilitators and barriers in conducting and using economic analyses to inform decision makers in the field of public health nutrition. Methods: Data were collected through written, open-ended questionnaires administered to twenty-three participants (13 from academia and 10 from government) using purposive sampling and analysed through a conventional content analysis. Results: The analysis revealed two broad categories of barriers, which included: i) “Methodological challenges”, and; ii) “Barriers related to application of economic evaluations.” Two main categories of facilitators were also identified: i) “Facilitators to improving the methodology of economic evaluations”, with subcategories further detailing frameworks and methods to be applied, and; ii) “Facilitators to broaden the use of economic evaluations”, with most subcategories addressing science-into-policy translations. These barriers and facilitators to the use of economic evaluations in public health are perceived differently by researchers and policymakers, the former more focused on implementation aspects, the latter more concerned by methodological gaps. Conclusion: Public health nutrition policies seldom take into account data from formal economic evaluations. Economic evaluation methodologies can be improved to ensure their broader application to decision making.