A review of economic evaluations of behavior change interventions: setting an agenda for research methods and practice

BACKGROUND: The objective of this study was to review methodological economic evaluations of lifestyle behavior change interventions (LBCIs) examine how they address methodological challenges for public health evaluation identified in the literature. METHODS: Pubmed and the NHS evaluation database were searched for published studies in six key areas behavior change: smoking, physical activity, dietary behavior, (illegal) use, alcohol use and sexual behavior. From included studies (n = 142), extracted data on general study characteristics, characteristics of the methodological quality and handling of methodological challenges. Economic evaluation evidence for LBCIs showed a number of weaknesses: study design and characteristics of evaluated interventions were not reported; methodological quality showed several shortcomings and addressing methodological challenges remained limited. CONCLUSIONS: findings of this review we propose an agenda for improving future support decision-making. Recommendations for practice include improving of essential study details and increasing adherence with good practice Recommendations for research methods focus on mapping out complex causal for modeling, developing measures to capture broader domains of community outcomes, testing methods for considering equity, identifying non-health sector costs and advancing methods for evidence synthesis.