title: A review of economic evaluations of behavior change interventions: setting an agenda for research methods and practice.
abstract: BACKGROUND
  The objective of this study was to review methodological quality of economic evaluations of lifestyle behavior change interventions (LBCIs) and to examine how they address methodological challenges for public health economic evaluation identified in the literature.
  
  
  METHODS
  Pubmed and the NHS economic evaluation database were searched for published studies in six key areas for behavior change: smoking, physical activity, dietary behavior, (illegal) drug use, alcohol use and sexual behavior. From included studies (n = 142), we extracted data on general study characteristics, characteristics of the LBCIs, methodological quality and handling of methodological challenges.
  
  
  RESULTS
  Economic evaluation evidence for LBCIs showed a number of weaknesses: methods, study design and characteristics of evaluated interventions were not well reported; methodological quality showed several shortcomings and progress with addressing methodological challenges remained limited.
  
  
  CONCLUSIONS
  Based on the findings of this review we propose an agenda for improving future evidence to support decision-making. Recommendations for practice include improving reporting of essential study details and increasing adherence with good practice standards. Recommendations for research methods focus on mapping out complex causal pathways for modeling, developing measures to capture broader domains of wellbeing and community outcomes, testing methods for considering equity, identifying relevant non-health sector costs and advancing methods for evidence synthesis.
authors: Caphri School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Duboisdomein 30, Maastricht 6229 GT, The Netherlands.
authors: Adrienne F G
authors: AF
authors: Alayli-Goebbels
authors: Caphri School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Duboisdomein 30, Maastricht 6229 GT, The Netherlands.
authors: Silvia M A A
authors: SM
authors: Evers
authors: Dance 4 Life International, Spuistraat 239, Amsterdam 1012 VP, The Netherlands.
authors: Daria
authors: D
authors: Alexeeva
authors: Caphri School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Duboisdomein 30, Maastricht 6229 GT, The Netherlands.
authors: André J H A
authors: AJ
authors: Ament
authors: Caphri School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, Peter Debyeplein 1, Maastricht 6229 HA, The Netherlands.
authors: Nanne K
authors: NK
authors: de Vries
authors: GlaxoSmithKline GmbH & Co KG, München 80339, Germany.
authors: Jan C
authors: JC
authors: Tilly
authors: Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam 3062 PA, The Netherlands.
authors: Johan L
authors: JL
authors: Severens
mesh_terms: D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006302:Health Services Research; D006801:Humans; D008019:Life Style; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care; D011634:Public Health / Q000191:economics*; D012107:Research Design; D012725:Sexual Behavior; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000517:prevention & control
keywords: cost-effectiveness; methods; public health