{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:25:11Z","timestamp":1765959911113},"reference-count":0,"publisher":"BMJ","issue":"9","funder":[{"name":"Swedish Research Council for Health, Working Life and Welfare (FORTE)"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study investigates the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention, compared with care-as-usual, over the periods of pregnancy, delivery and the child\u2019s first 2\u2009years of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We adopted a register-based retrospective observational design using existing data sources with respect to both exposures and outcomes. Health outcomes and costs were compared between geographical areas that received care-as-usual (non-Salut area) and areas where the programme was implemented (Salut area). We included mothers and their children from both the Salut and non-Salut areas if: (1) the child was born 2002\u20132004 (premeasure period) or (2) the child was born 2006\u20132008 (postmeasure period). The effectiveness study adopted two strategies: (1) a matched difference-in-difference analysis using data from all participants and (2) a longitudinal analysis restricted to mothers who had given birth twice, that is, both in the premeasure and postmeasure periods. The economic evaluation was performed from a healthcare and a limited societal perspective. Outcomes were clustered during pregnancy, delivery and birth and the child\u2019s first 2\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Difference-in-difference analyses did not yield any significant effect on the outcomes. Longitudinal analyses resulted in significant positive improvement in Apgar scores, reflecting the newborn\u2019s physical condition, with more children having a normal Apgar score (1\u2009min +3%, 5\u2009min +1%). The cost of the programme was international dollar (INT$)308\/child. From both costing perspectives, the programme yielded higher effects and lower costs than care-as-usual, being thus cost-saving (probability of around 50%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that the Salut Programme is an effective universal intervention to improve maternal and child health, and it may be good value for money; however, there is large uncertainty around the cost estimates.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016732","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T00:10:19Z","timestamp":1506125419000},"page":"e016732","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children? A register-based retrospective observational study"],"prefix":"10.1136","volume":"7","author":[{"given":"Jenny","family":"H\u00e4ggstr\u00f6m","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipa","family":"Sampaio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Eurenius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anni-Maria","family":"Pulkki-Br\u00e4nnstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneli","family":"Ivarsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Lindkvist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inna","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,9,21]]},"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-016732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T03:10:11Z","timestamp":1601089811000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-016732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":0,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2017,9,27]]},"published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1136\/bmjopen-2017-016732"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-016732","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9]]}}}