title: Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?
abstract: BACKGROUND
  Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context.
  
  
  METHODS
  We investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models.
  
  
  RESULTS
  The relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole.
  
  
  CONCLUSIONS
  The study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.
authors.affiliation: Caphri School of Public Health and Primary Care, Department of Health Services Research, Maastricht University, PO Box 616, Maastricht, 6200 MD, The Netherlands. t.benning@rocva.nl.
authors.forename: Tim M
authors.initials: TM
authors.lastname: Benning
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleueler Strasse 176-178, 50935, Koeln, Germany. Adrienne.Alayli@oahpp.ca.
authors.forename: Adrienne F G
authors.initials: AF
authors.lastname: Alayli-Goebbels
authors.affiliation: Regional Public Health Service Limburg-Noord, PO Box 11, Venlo, 5900 AA, The Netherlands. mj.aarts@maastrichtuniversity.nl.
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Aarts
authors.affiliation: Institute of Health Policy & Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, PO Box 1738, Rotterdam, 3000 DR, The Netherlands. stolk@bmg.eur.nl.
authors.forename: Elly
authors.initials: E
authors.lastname: Stolk
authors.affiliation: Centre for Nutrition, Prevention and Healthcare, National Institute of Public Health and the Environment, PO Box 1, Bilthoven, 3720 BA, The Netherlands. ardine.de.wit@rivm.nl.|Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands. ardine.de.wit@rivm.nl.
authors.forename: G Ardine
authors.initials: GA
authors.lastname: de Wit
authors.affiliation: Department of Psychology, Health & Technology, University of Twente, PO Box 217, Enschede, 7500 AE, The Netherlands. h.c.prenger@utwente.nl.
authors.forename: Rilana
authors.initials: R
authors.lastname: Prenger
authors.affiliation: Department of Psychology, Health & Technology, University of Twente, PO Box 217, Enschede, 7500 AE, The Netherlands. l.m.a.braakman-jansen@utwente.nl.
authors.forename: Louise M A
authors.initials: LM
authors.lastname: Braakman-Jansen
authors.affiliation: Caphri School of Public Health and Primary Care, Department of Health Services Research, Maastricht University, PO Box 616, Maastricht, 6200 MD, The Netherlands. s.evers@maastrichtuniversity.nl.
authors.forename: Silvia M A A
authors.initials: SM
authors.lastname: Evers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012931:Social Environment; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult