The PHEM-B toolbox of methods for incorporating the influences on Behaviour into Public Health Economic Models

Hazel Squires*, Michael Kelly, Nigel Gilbert, Falko Sniehotta, Robin Purshouse, Leandro Garcia, Penny Breeze, Alan Brennan, Benjamin Gardner, Sophie Bright, Alastair Fischer, Alison Heppenstall, Joanna Davan Wetton, Monica Hernandez‐Alava, Jennifer Boyd, Charlotte Buckley, Ivo Vlaev, Robert Smith, Ali Abbas, Roger GibbMadeleine Henney, Esther Moore, Angel Chater

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
It is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions.

Methods
A core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox.

Results
The PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required.

Conclusions
This is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation.
Original languageEnglish
Article number2794
JournalBMC Public Health
Volume24
DOIs
Publication statusPublished - 12 Oct 2024

Keywords

  • PHEM-B toolbox
  • Public Health Economic Models
  • Public Health
  • public health interventions

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