Joanna Charles
Supervised by Prof. Rhiannon Tudor
Edwards and Dr. Tracey Bywater
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Conduct disorders cost the public health system significantly; Knapp
et al. (1999) found 30% of child consultations with general
practitioners were for CD.
Knapp et al. (1999) also found the cost of treating a child with CD
on the NHS was £2457.
Scott et al. 2001 found that the cost of public services for those
aged 28 years with CD in childhood was 10 times higher, £70,019
than those with no history of CD, £7,423 therefore it is imperative to
find a cost-effective solution to treat CD to ease the strain on the
NHS.
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One of the most effective treatments for CD are parenting
programmes.
The Incredible Years Parenting programmes provide evidence
based interventions designed to prevent and treat children with
or at risk of CD by supporting parents in the acquisition of an
array of skills to reduce negative behaviour and promote
positive behaviour and interactions.
Incredible Years is one of only two parenting interventions
recognised and recommended by the National Institute for
Health and Clinical Excellence (NICE, 2006).
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Previous research has shown the Incredible Years BASIC Parenting
Programme to be cost effective in treating CD in children aged
between 3-4 years, Edwards et al. 2007.
It is important to tackle conduct disorder as it can have damaging
effects on social relationships, well being, education and future
prospects, Rutter and Giller (1983).
Robins (1966) found 40-50% of children with CD go on to develop
anti-social personality as adults. Research has also found a link
between child CD and adult anti-social behaviour e.g. theft,
violence, drunk driving, illegal drug use, group violence, carrying
and/or using weapons, Farrington (1995)
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78 mothers and their toddlers, 1-3 years old (53 intervention and 25
control), were accessed at their 6 and 12 month follow-up from the
main Randomised Controlled Trial conducted by Nia Griffith, and
asked to complete additional economic measures; The EQ-5D (Kind
et al., 1995) and the Client Receipt Service Inventory (CRSI)
(Chisholm et al., 2000).
Eighteen Group leaders were asked to complete a weekly cost diary
over the 12 week delivery of the programme, to establish the costs
of running a group.
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We will fully cost the programme and calculate a cost-effectiveness
ratio by dividing the mean cost by the mean effect for both
intervention and control groups to show the probability that this
parenting programme is good-value for money, with comparison to
previous work such as Edwards et al’s work on the BASIC
programme.
We will establish if service use and therefore costs of service use
decreases after attending a parenting programme and cost a 1 point
improvement on the BDI (Beck et al. 1961) to bring parental
depression below clinical cut-off.
This programme will be evaluated using MRC (2008) guidelines on
designing and evaluating complex interventions
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Complex interventions are typified by several interacting
components, which present a number of special problems for
evaluators, in addition to the practical and methodological
difficulties of any successful evaluation.
Parenting programmes should be considered complex interventions
as they contain a multitude of interacting factors, have implications
for many sources such as policy makers, practitioners, parents,
children and siblings.
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A literature review of the economic evidence of parenting
programmes.
A paper on parents’ Quality of Life (QALY) from data obtained using
the EQ-5D (Kind et al., 1995) exploring how parents’ QALY effects
their children’s QALY.
A paper using modelling to investigate how to model the long-term
benefits of parenting programmes.