Cost-effectiveness of preventing child internalising problems: results from the translational trial of Cool Little Kids at school entry

Mary Lou Chatterton*, Jordana K. Bayer, Lidia Engel, Ronald M. Rapee, Ruth Beatson, Harriet Hiscock, Lesley Bretherton, Melissa Wake, Cathrine Mihalopoulos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Objective: A translational trial evaluated the effectiveness of screening for inhibited childhood temperament, followed by a preventive parenting program -Cool Little Kids. This study determined the cost-effectiveness from societal and health sector perspectives using trial data. Method: Resources to deliver the screening and parenting sessions were determined from study records. Parents completed a questionnaire reporting resources used at one-year follow-up. Standard Australian unit costs were applied. Clinical outcomes for children and parental quality adjusted life-years (QALYs) were used to calculate incremental cost-effectiveness ratios (ICERs). Results: Total societal costs were lower, but non-significant for the intervention compared to the control group (mean difference -$500 p = 0.937). Total health sector costs were significantly greater (mean difference $1,956; p = 0.015). The intervention led to significantly fewer internalising symptoms (Strengths and Difficulties Questionnaire (SDQ)-emotional difficulties adjusted mean difference −0.5; p = 0.006), fewer children with SDQ-emotional symptoms in the abnormal range (24.2 % vs. 33.0 % p =.014) and fewer with diagnosed anxiety (44.2 % vs. 50.2 % p = 0.427). From the societal perspective, the intervention would likely be cost-effective. Health sector ICERs were $1,171/SDQ-emotional symptom decrease, $51/abnormal SDQ avoided and $77/anxiety case avoided. Conclusions: This economic analysis alongside an implementation study provides an early indication that Cool Little Kids may be cost-effective.

Original languageEnglish
Article number102191
Pages (from-to)1-9
Number of pages9
JournalJournal of Anxiety Disorders
Publication statusPublished - Mar 2020


  • cost-effectiveness
  • child, anxiety disorders
  • prevention
  • translation
  • randomised controlled trial


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