Mieke Steenbakkers

Costs of the 'Hartslag Limburg' community heart health intervention

BackgroundLittle is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution.MethodsHartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000). Special attention was paid to reach persons with a low socio-economic status.Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004.ResultsThe economic costs of the interventions that were implemented within the five-year community programme (n = 180,000) were calculated to be about €900,000. €555,000 was spent on interventions to change peoples exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programmes network and external subsidy providers contributed the other 90% of the costs.ConclusionThe current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very large. Cost sharing was facilitated by the unique approach used in the Hartslag Limburg programme.

The Dutch heart health community intervention “Hartslag Limburg”: evaluation design and baseline data

Hartslag Limburg, a cardiovascular diseases (CVD) prevention programme, integrates a community strategy and a high‐risk strategy. The present paper presents the evaluation design for, and baseline data from, the community intervention. The conceptual framework of the community intervention and its evaluation study were based on programme planning and evaluation models. Within this framework, community organization principles and methods and health education theories and methods were applied. Pre‐test/post‐test control group designs were used to study changes at the individual and the organizational level. The baseline results confirm the need to carry out a comprehensive CVD prevention community project, and the appropriateness of the conceptual model that is used for the development of interventions.

The process evaluation of a dutch community health project.

This article reports on the design and results of the process evaluation of the Dutch community project “Healthy Bergeyk.” The major goal of this project was a reduction in cancer-related risk behavior prevalence, especially smoking and high fat consumption. The project was designed to integrate health education theory and methods with community organization principles. An intersectoral local project group was formed for project implementation. The main objectives of the process evaluation were to assess what was done and how this was evaluated by participants and leaders of activities, project group members and the community in general. Data were gathered throughout the implementation period using minutes of meetings, registration forms, pre-structured telephone interviews, written questionnaires, and semi-structured interviews. Community members were involved in the data collection. The results indicate that the project group organized many health activities in their community in a short time period. Positive elements of the project concern the intersectoral co-operation and the workbook supplied to the project group. Time pressure and limited possibilities for community initiatives were the main negative aspects of the project. The implications of the findings for both the community health project and the process evaluation are discussed.