A 12-Month Trial-Based Economic Evaluation Comparing Positive Parenting Program (Triple P) and Circle of Security Parenting Program (COSP) Versus Treatment as Usual for Families With Young Children (2-6 Years).

Abstract

A 12-month trial economic evaluation was conducted to compare the Triple P-Positive Parenting Program (Triple P) versus treatment as usual (TAU) and the Circle of Security Parenting Program (COSP) versus TAU from a societal perspective. Trial data were used to determine the costs of delivering the interventions and the 12-month costs associated with children's health and social care service use based on the Child and Adolescent Service Use Schedule questionnaire, which was completed by caregivers of children aged 2-6. All costs were expressed in 2024 Canadian dollars. To calculate quality-adjusted-life-years (QALYs), caregivers documented their children's quality of life using the Health Status Classification System Preschool Version (HSCSPV) and the Health Utility Index 3 for children less or more than 5 years of age, respectively. Cost-effectiveness acceptability curves were used to represent the uncertainty. Several sensitivity analyses were conducted (e.g., change in Triple P intervention costs). The trial recruited 502 caregivers (93% female, mean age [standard deviation] of 36 years [6.7]) of 502 children (41% female, mean age of 3.8 years [SD = 1.4]). The differences in 12-month societal costs and QALYs between Triple P and TAU were $121 (95% Confidence interval [CI]: -$258, $486) and 0.009 (95% CI: -0.018, 0.039), respectively. The differences in 12-month societal costs and QALYs between COSP and TAU were -$253 (95% CI: -$552, $40) and 0.004 (95% CI: -0.026, 0.035), respectively. Assuming that society was willing to spend up to $100,000 for each additional QALY gained, the probabilities that Triple P and COSP were cost-effective compared to TAU were 0.71 and 0.68, respectively. The results of the sensitivity analyses were consistent with the main analyses. The trial results suggest that compared to TAU, Triple P and COSP represent efficient use of public resources.