Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study

Background Communities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility. Methods This study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars. Results State-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost. Conclusion We identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments..

Medienart:	E-Artikel

Erscheinungsjahr:	2024
Erschienen:	2024

Enthalten in:	Zur Gesamtaufnahme - volume:19
Enthalten in:	Addiction science & clinical practice - 19(2024), 1 vom: 02. Apr.

Sprache:	Englisch

Beteiligte Personen:

Montoya, Iván D. [VerfasserIn] Watson, Colleen [VerfasserIn] Aldridge, Arnie [VerfasserIn] Ryan, Danielle [VerfasserIn] Murphy, Sean M. [VerfasserIn] Amuchi, Brenda [VerfasserIn] McCollister, Kathryn E. [VerfasserIn] Schackman, Bruce R. [VerfasserIn] Bush, Joshua L. [VerfasserIn] Speer, Drew [VerfasserIn] Harlow, Kristin [VerfasserIn] Orme, Stephen [VerfasserIn] Zarkin, Gary A. [VerfasserIn] Castry, Mathieu [VerfasserIn] Seiber, Eric E. [VerfasserIn] Barocas, Joshua A. [VerfasserIn] Linas, Benjamin P. [VerfasserIn] Starbird, Laura E. [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	Community engagement Cost analysis Intervention implementation Opioid use disorder Start-up cost

Anmerkungen:	© The Author(s) 2024

doi:	10.1186/s13722-024-00454-w

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	SPR055391583