Objective To investigate the cost effectiveness of a
Design An incremental cost effectiveness analysis
alongside a pragmatic randomised controlled trial of the
effectiveness of a group parenting programme delivered
through Sure Start in the community.
Setting Sure Start areas in north and mid Wales.
Participants Parents of 116 children aged 36-59 months
(87% of the clinical sample) at risk of developing conduct
disorders defined by scoring over the clinical cut off on the
Eyberg child behaviour inventory). Children were
identified by health visitors and recruited by the research
Intervention The Webster-Stratton Incredible Years basic
parenting programme or a six month waiting list control.
Main outcome measure Incremental cost per unit of
improvement on the intensity score of the Eyberg child
Results The bootstrapped incremental cost effectiveness
ratio point estimate was £73 (€109, $142) per one point
improvement on the intensity score (95% confidence
interval £42 to £140). It would cost £5486 (€8190,
$10 666) to bring the child with the highest intensity score
to below the clinical cut-off point and £1344 (€2006,
$2618) to bring the average child in the intervention
group within the non-clinical limits on the intensity score
(below 127). For a ceiling ratio of £100 (€149, $194) per
point increase in intensity score, there is an 83.9%
chance of the intervention being cost effective. The mean
cost per child attending the parenting group was £1934
(€2887, $3760) for eight children and £1289 (€1924,
$2506) for 12 children, including initial costs and
materials for training group leaders. When we categorised
the sample into relatively mild, moderate, and severe
behaviour groups based on intensity scores at baseline
the intervention seemed more cost effective in those with
the highest risk of developing conduct disorder.
Conclusion This parenting programme improves child
behaviour as measured by the intensity score of the
Eyberg child behaviour inventory at a relatively low cost
and was cost effective compared with the waiting list
control. This parenting programme involves modest costs
and demonstrates strong clinical effect, suggesting it
would represent good value for money for public spending.