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Understanding the stakeholders' intention to use economic decision-support tools: A cross-sectional study with the

Kei Long Cheung¹, Silvia M A A Evers², Mickaël Hiligsmann¹

¹Caphri school of Public Health and Primary Care, Health Services Research, Maastricht University, Duboisdomein 30, GT Maastricht, 6229, The Netherlands.

Health Policy (Amsterdam, Netherlands)

|January 1, 2016

Abstract

Background:

Despite an increased number of economic evaluations of tobacco control interventions, the uptake by stakeholders continues to be limited. Understanding the underlying mechanism in adopting such economic decision-support tools by stakeholders is therefore important. By applying the I-Change Model, this study aims to identify which factors determine potential uptake of an economic decision-support tool, i.e., the Return on Investment tool.

Methods:

Stakeholders (decision-makers, purchasers of services/pharma products, professionals/service providers, evidence generators and advocates of health promotion) were interviewed in five countries, using an I-Change based questionnaire. MANOVA's were conducted to assess differences between intenders and non-intenders regarding beliefs. A multiple regression analysis was conducted to identify the main explanatory variables of intention to use an economic decision-support tool.

Findings:

Ninety-three stakeholders participated. Significant differences in beliefs were found between non-intenders and intenders: risk perception, attitude, social support, and self-efficacy towards using the tool. Regression showed that demographics, pre-motivational, and motivational factors explained 69% of the variation in intention.

Discussion:

This study is the first to provide a theoretical framework to understand differences in beliefs between stakeholders who do or do not intend to use economic decision-support tools, and empirically corroborating the framework. This contributes to our understanding of the facilitators and barriers to the uptake of these studies.

Keywords:

Decision-support tool Economic evaluations Health policy Tobacco control Uptake

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