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Objective: This systematic review updates an existing review examining the cost‐effectiveness of interventions to prevent and treat eating disorders (EDs). Method: Literature search was conducted in Academic Search Complete, MEDLINE, CINAHL, PsycINFO, EconLit, Global Health, ERIC, Health Business Elite, and Health Policy Reference Center electronic databases, capturing studies published between March 2017 to April 2023. Hand‐searching was conducted as supplementary including gray literature search. Included articles were (1) full economic evaluations or return‐on‐investment studies, (2) in English and (3) aimed at prevention and treatment of any ED. Included studies were added and synthesized with previously reviewed studies. Screening and extraction followed PRISMA guidelines. Quality assessment was conducted using the Drummond checklist. PROSPERO registration CRD42021287464. Results: A total of 28 studies were identified, including 15 published after the previous review. There were nine prevention, seven anorexia nervosa (AN) treatment, five bulimia nervosa (BN) treatment, four binge‐eating disorder (BED), and three non‐specific ED treatment studies. Findings indicate value‐for‐money evidence supporting all interventions. Quality assessment showed studies were fair‐to‐good quality. Discussion: There has been significant growth in cost‐effectiveness studies over the last 5 years. Findings suggest that interventions to prevent and treat ED offer value for money. Interventions such as Featback (ED prevention and non‐specific ED treatment); focal psychodynamic therapy, enhanced cognitive behavioral therapy, and high‐calorie refeeding (AN treatment); stepped‐care with assisted self‐help and internet‐based cognitive behavioral therapy (BN treatment); and cognitive behavioral therapy guided self‐help intervention (BED treatment) have good quality economic evidence. Further research in implementation of interventions is required. Public Significance Statement: The increasing prevalence of ED globally has significant impact on healthcare systems, families, and society. This review is showcasing the value for money of interventions of eating disorders prevention and treatment. This review found that existing interventions offers positive economic benefit for the healthcare system. [ABSTRACT FROM AUTHOR]

Objective: This study explored the relationship between unhealthy weight control behaviors (UWCBs) and their associated economic costs among adolescents using the 2014–2018 Longitudinal Study of Australian Children (LSAC). Methods: LSAC data in Wave 6 (n = 3538 adolescents aged 14–15 years), Wave 7 n = 3089 adolescents aged 16–17 years), and Wave 8 (n = 3037 adolescents aged 18–19 years) were derived from a representative sample of Australian adolescents. UWCBs were measured using the self‐reported Branched Eating Disorder Test questionnaire. UWCBs were sub‐classified into having fasting behaviors, using weight loss supplements or purging behaviors. Economic costs include healthcare and productivity costs to caregivers. Healthcare costs were measured using data from the Medicare and Pharmaceutical Benefits, which includes both medical and pharmaceutical costs. Productivity losses were measured using caregivers' lost leisure time due to UWCBs among adolescents. Results: The mixed effect model identified statistically significant higher economic costs (mean difference = $453, 95% CIs $154, $752), higher health care costs (mean difference = $399, 95% CIs $102, $695), and higher productivity costs (mean difference = $59, 95% CIs $29, $90) for adolescents with UWCBs compared to their peers with no UWCBs. Subgroup analysis revealed that higher costs were associated with fasting and purging behaviors. Discussion: UWCBs were associated with increased economic costs during adolescence. Our finding suggests there should be a policy focus on tackling UWCBs to reduce the economic burden on the healthcare system and society. Public Significance: The study contributes to existing knowledge by investigating the direct healthcare costs and productivity losses associated with unhealthy weight control behaviors in Australian adolescents (14–18 years old) using a dataset that follows Australian adolescents over time. We found that engaging in unhealthy weight control behaviors such as fasting, using weight loss supplements, and purging was linked to higher costs among adolescents, suggesting policies should focus on addressing these behaviors. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Prevention programs for eating disorders (EDs) and high body index mass (BMI) have the potential to reduce the onset of these interconnected public health concerns. However, it remains unclear whether routine implementation of such programs would be cost‐effective. This study aims to determine the cost‐effectiveness of an intervention that aims to prevent both ED and high BMI.A Markov model was developed to evaluate the incremental cost‐effectiveness of a targeted school‐based program, Healthy Weight, that aims to prevent both EDs and high BMI among Australian adolescents with body image concerns (aged 15–18 years), versus a “no intervention” comparator. A cost‐utility analysis was conducted from a “healthcare and education” sector perspective with costs (measured in 2019 Australian dollars) and health impacts modeled over the lifetime of the target population. An incremental cost‐effectiveness ratio (ICER), expressed as cost per health‐adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions.The mean intervention cost and HALYs gained were AUD$2.13 million (95% CI, AUD$1.83–2.43 million) and 146 (95% CI, 90–209), respectively. With healthcare cost‐savings (AUD$3.97 million) included, the intervention was predicted to be cost‐saving (AUD$1.83 million; 95% CI, AUD$0.51–3.21 million). Primary findings were robust to extensive sensitivity analyses.The Healthy Weight intervention is likely to represent good value‐for‐money. To ensure the successful implementation of this program at the population level, further research on its feasibility and acceptability among schools and the wider community is required. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

Background and aims Design Setting Participants Intervention and comparator Measurements Comments Alcohol use and anxiety often co‐occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost‐effectiveness of a web‐based, self‐guided alcohol and anxiety‐focused program, compared with a web‐based brief alcohol‐focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects.This RCT will be conducted with a 1:1 parallel group.The study will be a web‐based trial in Australia.Individuals aged 17–30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety (n = 500) will be recruited through social media, media (TV, print) and community networks.Participants will be randomly allocated to receive a web‐based, integrated alcohol‐anxiety program plus technical and motivational telephone/e‐mail support (intervention) or a web‐based brief alcohol‐feedback program (control).Clinical measures will be assessed at baseline, post‐intervention (2 months), 6 months (primary end‐point), 12 months and 18 months. Co‐primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge‐drinking frequency; alcohol‐related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post‐intervention), health‐care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention‐to‐treat framework. The economic evaluation will analyze individual‐level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change.This will be the first trial to test whether a developmentally targeted, web‐based, integrated alcohol‐anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol‐anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost. [ABSTRACT FROM AUTHOR]