{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T22:19:26Z","timestamp":1780697966160,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2011,4,24]],"date-time":"2011-04-24T00:00:00Z","timestamp":1303603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Rationale, aims and objectives\u2002<\/jats:bold> Cardiovascular disease (CVD) often arises from modifiable lifestyle factors. Health care professionals may lack the skills and resources to sustain behaviour change, lay \u2018health trainers\u2019 (LHT) offer a potential alternative. We sought to assess the cost\u2010effectiveness of using a LHT to improve heart\u2010health lifestyles in deprived communities.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Participants in this randomized trial were aged \u226518 years with at least one risk factor for CVD (hypertension, raised cholesterol, diabetes, BMI&gt;30 or current smoker). Both groups received health promotion literature. LHT were also able to provide intervention participants with information, advice and support aimed at changing beliefs and behaviour. Costs and quality\u2010adjusted life year (QALY) changes were estimated over 6 months. The cost\u2010utility [incremental cost\u2010effectiveness ratio (ICER)] of LHT was calculated and assessed in relation to the cost\u2010effectiveness threshold of \u00a320\u2003000\u201330\u2003000 per QALY. The probability of LHT being cost\u2010effective was also calculated.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Seventy\u2010two participants were randomized to a LHT, with 38 controls. The mean cost of the LHT intervention was \u00a3151. On average, other health and social service costs fell by \u00a321 for controls and \u00a375 for intervention participants giving a LHT mean overall incremental cost of \u00a398. The mean QALY gains were 0.022 and 0.028, respectively. The ICER for LHT was \u00a314\u2003480, yet there was a 61% chance of making the wrong decision at a \u00a320\u2003000\/QALY threshold.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> LHT provision was estimated to be cost\u2010effective for people at risk of CVD. However, a large level of uncertainty was associated with that decision.<\/jats:p>","DOI":"10.1111\/j.1365-2753.2011.01686.x","type":"journal-article","created":{"date-parts":[[2011,4,25]],"date-time":"2011-04-25T00:53:37Z","timestamp":1303692817000},"page":"835-840","source":"Crossref","is-referenced-by-count":21,"title":["Increasing heart\u2010health lifestyles in deprived communities: economic evaluation of lay health trainers"],"prefix":"10.1111","volume":"18","author":[{"given":"Garry 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