1. Evaluating the Cost-Effectiveness of the Incredible Years Toddler Programme Joanna Charles Bangor University, Wales Dr. Rhiannon Tudor-Edwards, Prof. Judy Hutchings, Dr. Tracey Bywater, Dr. David Daley and Nia Griffith Objective To find out whether the Incredible Years Toddler Programme (1-3 years) is at least as cost effective as the Incredible Years Basic Parenting Programme with pre-school (3- 4 years) children. Participants The trial is open to families with toddlers living in Flying Start areas around Wales. Control (N=40) and intervention (N=80) groups from the main Randomised Controlled Trial will be accessed at their 6 and 12 month follow-up and asked to complete the additional economic measures. Eighteen Group leaders will be asked to complete a weekly cost diary, to establish costs of running a group. Measure of Cost We will fully cost the set up and running costs of delivering the IY Toddler Parenting Programme to parents. We will use a client service receipt inventory (CSRI) to ask parents to record health, social care and local education service use before the trial follow up period of 6 months. We will use National and Local sources of cost e.g. Department of Health 2007/2008, Curtis and Netten 2006 Measures for Children The Ages and Stages Questionnaire (ASQ; Bricker & Squire, 1994) identifies young children (3 months to 5 years) who show potential developmental delays. This will be used to assess whether the parenting programme helps to enhance the children’s development. Client Service Receipt Inventory (CRSI) (Chisholm et al., 2000) enquires as to the number of contacts the child has had with health, social care and educational professionals in the last 6 months. This will be used to assess whether service use changes after attending the programme. Measures for Parents The Beck Depression Inventory (BDI; (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) This is a 21-item inventory measuring the severity of characteristic attitudes and symptoms associated with depression. This will be used to assess the levels of depression in the sample and whether it reduces after attending the programme. The EQ-5D; (Kind et al., 1995) a measure of general health, mobility, pain, depression, self-care. This measure will be used to assess changes in parent health after attending the programme. Client Service Receipt Inventory (CRSI) (Chisholm et al., 2000) reports on the health and social service use by the parent in the last six months. This measure will be used to assess whether service use changes after attending the programme. For more information contact: Joanna Charles Email: j.charles@bangor.ac.uk Tel: 01248 383956j.charles@bangor.ac.uk Visit our website: www.bangor.ac.uk/imscar/healtheconomics www.bangor.ac.uk/imscar/healtheconomics Perspective of analysis We will adopt a multi-agency public sector perspective in comparing costs and outcomes in this trial. Study Design An incremental cost-effectiveness analysis following the Medical Research Council (MRC) guide to the design and evaluation of complex interventions, MRC (2008).This will be supported by a more general cost-consequence analysis. Background Conduct disorder costs society greatly. The costs of publicly resourced services for those aged 28 years with conduct disorder in childhood are estimated to be 10 times higher than those with no behavioural problems in childhood, Scott et al., 2001. The Basic Parenting Programme has been shown to reduce the risk of long term conduct disorder in many randomised trials. The Incredible Years Toddler Parenting Programme is a 12 week programme that builds parenting skills by promoting positive relationships, social and emotional coaching, praise and encouragement and handling misbehaviour but has yet to be tested. Statistical Analysis We will use boot-strapping to construct cost-effectiveness activity curves (CEAS) to show the probability that this parenting programme is good-value for money. We will establish what it costs to bring parental depression below clinical cut-off on the BDI and to enhance child development on the ASQ.