An economic analysis of Native CHOICES

Area of Science:

• Public Health
• Health Economics
• Preventive Medicine

Background:

• Fetal alcohol spectrum disorders (FASDs) are a significant public health concern linked to alcohol-exposed pregnancies (AEPs).
• The Native CHOICES program, a culturally adapted intervention, effectively reduces AEP risk in American Indian communities.
• This study provides the first economic analysis of the Native CHOICES program.

Purpose of the Study:

• To conduct an economic analysis of the Native CHOICES program.
• To assess the cost-benefit, cost-effectiveness, and quality-adjusted life years (QALYs) gained from Native CHOICES.
• To evaluate the program's impact on reducing AEPs and FASDs.

Main Methods:

• Utilized pre-pandemic data from a randomized controlled trial of Native CHOICES.
• Conducted economic assessments including cost-benefit, cost-effectiveness, and QALY analysis.
• Focused on a Northern Plains American Indian community.

Main Results:

• Native CHOICES reduced AEP risk by 18-20% and FASDs by 6.84-7.6% within 6 months post-participation.
• The program yielded a net economic benefit of $308,295 to $376,951 over 6 months.
• Cost efficiency for FASDs avoided ranged from $84,887 to $93,709, with $2330-$2572 per QALY gained.

Conclusions:

• Native CHOICES is a cost-effective intervention for preventing AEPs and FASDs.
• The program demonstrates positive economic returns and improved health outcomes for American Indian participants.
• Culturally adapted public health programs can be both effective and economically viable.