UNASSIGNED: Parkinson\'s disease (PD) is an incurable, progressive, neurodegenerative disorder. As PD advances and symptoms progress, patients become increasingly dependent on family and carers. Traditional cost-effectiveness analyses (CEA) only consider patient and payer-related outcomes, failing to acknowledge impacts on families, carers, and broader society. This novel Social Return on Investment (SROI) analysis aimed to evaluate the broader impact created by improving access to levodopa (LD) device-aided therapies (DATs) for people living with advanced PD (aPD) in Australia.
UNASSIGNED: A forecast SROI analysis over a three-year time horizon was conducted. People living with aPD and their families were recruited for qualitative interviews or a quantitative survey. Secondary research and clinical trial data was used to supplement the primary research. Outcomes were valued and assessed in a SROI value map in Microsoft Excel™. Financial proxies were assigned to each final outcome based on willingness-to-pay, economic valuation, and replacement value. Treatment cost inputs were sourced from Pharmaceutical Benefits Schedule (PBS) and Medicare Benefits Scheme (MBS) published prices.
UNASSIGNED: Twenty-four interviews were conducted, and 55 survey responses were received. For every $1 invested in access to LD-based DATs in Australia, an estimated $1.79 of social value is created. Over 3 years, it was estimated $277.16 million will be invested and $406.77 million of social return will be created. This value is shared between people living with aPD (27%), their partners (22%), children (36%), and the Australian Government (15%). Most of the value created is social and emotional in nature, including reduced worry, increased connection to family and friends, and increased hope for the future.
UNASSIGNED: Investment in LD-based DATs is expected to generate a positive social return. Over 50% of the value is created for the partners and children of people living with aPD. This value would not be captured in traditional CEA. The SROI methodology highlights the importance of investing in aPD treatment, capturing the social value created by improved access to LD-based DATs.

BACKGROUND: Home automation can deliver important outcomes for people with disabilities, including enhanced independence. Despite the millions of dollars spent on home automation in Australia and other developed nations, to date, there has been no economic evaluation of this type of assistive technology.
METHODS: A social return on investment analysis of home automation study was undertaken. Primary data were collected using qualitative interviews with home automation consumers and other key stakeholders, including occupational therapists, a spinal rehabilitation physician, peer support advocate, and managers and technical personnel from home automation providers (n = 17). The analysis was supported by (1) secondary data from a scoping review on outcomes from home automation and (2) additional literature searches to identify suitable financial proxies and to make estimates of the proportion of home automation users expected to experience each outcome. A scenario approach was used with three home automation scenarios developed with increasing complexity and costs to calculate the social return on investment.
RESULTS: Eight outcomes from the use of home automation were identified, including reduced reliance on carers and family members, increased independence, and improved energy and comfort. The social return on investment ranged from $38.80 (low cost) to $15.10 (high cost) for every $1 invested across a 10-year benefit period, with the financial proxy for reduced care attendant hours contributing the most to the social return ratio. Even the highest cost scenario was repaid in social value within the first year of the benefit period.
CONCLUSIONS: This study suggests that home automation represents a sound investment and has a significant impact on the overall quality of life of people with disabilities. Focusing on the financial savings in care attendant hours alone should be compelling evidence for funders to recognise home automation\'s value and continue to fund this assistive technology.
UNASSIGNED: A consumer representative was a member of the project steering group, which supported the research team at all stages of the project.
CONCLUSIONS: When people get injured, their disability can stop them doing things around the home that they used to be able to do. Technology can help people with disabilities do things like open and close doors and turn off taps by pressing a button, so they do not have to wait for someone to help them. This technology can be expensive, but no one has looked at if it is worth the money. We spoke to some people with disabilities who used this type of technology, and they told us their lives were better now they used this technology. For example, they told us they were able to do things for themselves, they did not need carers as much, and they had better mental health. We spoke to businesses about the costs of different types of technology that can be used in the home. We then put a dollar value on the ways people with disabilities told us their lives were better. For example, for better mental health, we worked out how much it would cost to see a psychologist for 1 year. We found that the dollar value of the ways in which people with disabilities\' lives were improved was at least 15 times more than the costs of the technology. This study therefore shows that this technology is worth the money and improves the lives of people with disabilities following serious injury.

UNASSIGNED: Physical activity and sport (PAS) have been related to many health outcomes and social benefits. The main aim of this research is to build a Social Return on Investment (SROI) model of PAS based on experts\' opinion to clarify the domains of impact and how to measure and value them.
UNASSIGNED: A Delphi method will be employed with a systematic review on the SROI framework applied to PAS and initial interviews with experts informing the design of the Delphi survey statements. Three iterative rounds of communication with the expert panel will be carried out. Participants will indicate their level of agreement with each statement on a five-point Likert scale. During the second and third iterative rounds, experts will reappraise the statements and will be provided with a summary of the group responses from the panel. A statement will have reached consensus if ≥70% of the panel agree/strongly agree or disagree/strongly disagree after round 3. Finally, group meetings (3-4 experts) will be conducted to ask about the measurement and valuation methods for each domain.
UNASSIGNED: The final goal of this project will result in the design of a toolkit for organizations, professionals, and policymakers on how to measure the social benefits of PAS.

Due to the Democratic Republic of the Congo’s (DRC) precarious health system that provides only limited access to health care, the European Union, via Memisa Belgium, implemented a program to strengthen provision of and access to health care (known as PRO DS) in the provinces of Kongo Central and Ituri. This program took a holistic approach, seeking to improve equitable access and combat malnutrition.
To measure the program’s social return on investment and to estimate the cost per capita and effectiveness per euro invested (efficiency), a 61-month (1 July 2017 to 31 July 2022) cost-effectiveness evaluation with a societal perspective was carried out. The double-difference method was used to compare the results of PRO DS and non-PRO DS zones. The social return on investment was assessed via the ratio of effectiveness to costs.
Analyses revealed the program cost between 3.72 and 3.96 euros per capita per year (2022) in Kongo Central, and between 3.12 and 3.36 euros in Ituri. Importantly, it was cost-effective in the areas of reproductive health, nutrition, and the use of health and nutrition services.
The program’s strong nutritional component and overall holistic vision may explain why it was so efficient. PRO DS stands out from other programs that focus solely on one specific problem or population. Although the program has some limitations, it would be worthwhile for the government to invest in it.
Face à l’accès limité aux soins et à la précarité des structures sanitaires en République démocratique du Congo, l’Union européenne par l’intermédiaire de Memisa Belgique avait mis en œuvre le Programme de renforcement de l’offre et développement de l’accès aux soins de santé (PRO DS) dans les provinces du Kongo-Central et de l’Ituri. Ce programme se caractérisait par une approche holistique d’équité d’accès et de lutte contre la malnutrition.
Pour mesurer le retour social sur investissement du programme et estimer son coût par habitant et son efficacité par euros investis (efficience), une évaluation coûts-efficacité avec une perspective sociétale de 61 mois (1er juillet 2017 au 31 juillet 2022) a été réalisée. La méthode de double différence, qui compare les résultats des zones PRO DS et des zones non PRO DS, a été utilisée. Le retour social sur investissement a été évalué par le biais du rapport entre l’efficacité et les coûts.
Les analyses ont montré que le programme coûtait par année et par habitant entre 3,72 et 3,96 euros (2022) au Kongo-Central, et entre 3,12 et 3,36 euros en Ituri. De plus, il était coût-efficace dans plusieurs domaines, telles la santé de la reproduction, la nutrition, l’utilisation des services de santé et nutritionnels.
L’efficience du programme pourrait s’expliquer par sa vision holistique avec un fort volet « Nutrition ». PRO DS se démarque d’autres programmes qui agissent uniquement sur une problématique ou population spécifique. Malgré ses quelques imperfections, le gouvernement mériterait d’y investir.

UNASSIGNED: Scarcity of resources and mounting pressures on health systems make it critical to evaluate new and existing public health interventions related to physical activity and nutrition. The Social Return on Investment (SROI) framework has gained prominence for capturing traditional variables such as economic costs and returns, as well as wider beneficial social and environmental outcomes. A scoping review was conducted to present the existing evidence on the SROI of physical activity and nutrition interventions, demonstrating the wider benefits of these interventions.
UNASSIGNED: Existing peer-reviewed evidence and grey literature was collated to identify physical activity and nutrition interventions that were evaluated using the SROI framework between January 1996 up until February 2022. Only literature published in the English language, interventions that were conducted in high-income countries were considered for inclusion. Study information and economic data was entered into a pre-prepared data extraction sheet and eligible studies were quality assessed using a 12-point quality assessment framework for SROI studies.
UNASSIGNED: This review identified a total of 21 SROI studies, with only four deriving from peer-reviewed literature sources. In total, 18 studies evaluated physical activity interventions, one study was purely focused on nutrition, whereas the two remaining studies presented a mix of physical activity and nutrition. The majority of studies derived from the United Kingdom (n = 16) with very few of the studies published prior to 2010 (n = 1). In total, four studies were classified as low quality based on the 12-point quality assessment framework used for this review. Outcomes of the relevant studies show that the benefits of these interventions have added value to families, communities and the wider environments of the target groups.
UNASSIGNED: This scoping review is adding to research conducted to understand the wider value of public health interventions such as physical activity and nutrition interventions using the SROI framework. This is important so that the development and implementation of public health interventions have the greatest value to people and society, which also benefits decision-makers to effectively and sustainably allocate scarce resources.

Increased time spent in nature can enhance physical health and mental wellbeing. The UK Government\'s \'25 Year Environment Plan\' recommends extending the health benefits of contact with nature to a wider group of people, including those with mental health challenges. This study investigated whether nature-based interventions (NBIs) for people with mild mental health challenges could generate a positive social return on investment (SROI). Between May 2017 and January 2019, 120 participants at six outdoor sites in Wales participated in a 6 to 12-week NBI, which consisted of a weekly 2- to 4-h session. Quantitative data were collected from baseline and follow-up questionnaires identifying participant demographics and measuring mental wellbeing, physical activity, self-efficacy, and social trust. Wellbeing valuation generated a range of social value ratios by applying the Housing Association Charitable Trust (HACT) Social Value Calculator (SVC 4.0) and HACT Mental Health Social Value Calculator (MHSVC 1.0). Seventy-four participants (62%) completed follow-up questionnaires at 6 months. SROI ratios were calculated using the SVC for physical activity, self-efficacy, and social trust. The MHSVC generated social value ratios for mental wellbeing. The base case results revealed a positive social value ratio for participants, ranging from British Pound Sterling (GBP) 2.57 to GBP 4.67 for every GBP 1 invested, indicating favourable outcomes in terms of value generated.

Companion animals play a central role in many families and are especially valued by those who are socially isolated. Crisis situations such as acute hospitalizations, homelessness, and natural disasters can make it difficult to preserve the human-animal bond and can result in animals being surrendered or euthanized. Social support programs like the RSPCA NSW Emergency Boarding and Homelessness program support people experiencing crisis situations with emergency pet boarding, access to veterinary treatment and individualized case management. This study aimed to estimate the social return on investment (SROI) for this program using the standard SROI methodology. In-depth interviews were conducted with 13 program stakeholders and questionnaire responses were received from 29 program clients. Outcomes were quantified for four stakeholder groups: program clients, client\'s animals, RSPCA Inspectors, animal pounds, and shelters. Clients and their animals experienced the bulk of the benefit from the program, estimated to have a combined value of over AUD 5 million for the 2020-2021 financial year. The estimated social return on investment was AUD 8.21 for each AUD 1 invested. The study demonstrates that keeping people together with their companion animals or ensuring they are reunited as soon as possible can reduce stressors and improve outcomes for people and animals.

There is extensive evidence for the cost-effectiveness of programmatic and additional tuberculosis (TB) interventions, but no studies have employed the social return on investment (SROI) methodology. We conducted a SROI analysis to measure the benefits of a community health worker (CHW) model for active TB case finding and patient-centered care.
This mixed-method study took place alongside a TB intervention implemented in Ho Chi Minh City, Viet Nam, between October-2017 - September-2019. The valuation encompassed beneficiary, health system and societal perspectives over a 5-year time-horizon. We conducted a rapid literature review, two focus group discussions and 14 in-depth interviews to identify and validate pertinent stakeholders and material value drivers. We compiled quantitative data from the TB program\'s and the intervention\'s surveillance systems, ecological databases, scientific publications, project accounts and 11 beneficiary surveys. We mapped, quantified and monetized value drivers to derive a crude financial benefit, which was adjusted for four counterfactuals. We calculated a SROI based on the net present value (NPV) of benefits and investments using a discounted cash flow model with a discount rate of 3.5%. A scenario analysis assessed SROI at varying discount rates of 0-10%.
The mathematical model yielded NPVs of US$235,511 in investments and US$8,497,183 in benefits. This suggested a return of US$36.08 for each dollar invested, ranging from US$31.66-US39.00 for varying discount rate scenarios.
The evaluated CHW-based TB intervention generated substantial individual and societal benefits. The SROI methodology may be an alternative for the economic evaluation of healthcare interventions.

BACKGROUND: People with disability following a serious injury require long-term care. The most common injuries resulting in long-term disability are spinal cord and acquired brain injuries. While the long-term effects are difficult to predict and will vary between individuals, the costs of care and recovery span well beyond the initial treatment phase and include long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. \"Home automation\" refers to technology that automates or remotely controls household functions. Home automation costs vastly differ, but home automation has the potential to positively impact the lives of people with disabilities. However, there is a dearth of evidence relating to the impact of home automation for people with a disability and few rigorous evaluations about the costs and return on investment.
OBJECTIVE: The purpose of this study is to describe the impact of home automation for people with long-term disability following a serious injury (such as a motor vehicle accident) using case studies, and by conducting an evaluation of the costs and outcomes for individuals, families, and the wider community using a Social Return on Investment (SROI) approach.
METHODS: SROI is a form of economic evaluation that develops a theory of change to examine the relationship among inputs, outputs, and outcomes and, in recent years, has gained popularity internationally, including in Australia. SROI has six phases: (1) identify scope and stakeholders, (2) map outcomes, (3) evidence outcomes and give them value, (4) establish impact, (5) calculate the SROI, and (6) report findings. Individuals with a disability who use home automation and key stakeholders will be interviewed. Stakeholders will be individuals involved in home automation for people with disabilities, such as allied health professionals, medical practitioners, equipment suppliers, engineers, and maintenance professionals. Users of home automation will be people who have a disability following a serious injury, have the capacity to provide consent, and have 1 or more elements of home automation. The impact of home automation will be established with financial proxies and appropriate discounts applied to avoid overestimating the social return. The SROI ratio will be calculated, and findings will be reported.
RESULTS: The project was funded in November 2021 by the Lifetime Support Authority. Recruitment is underway, and data collection is expected to be completed by October 2022. The final results of the study will be published in March 2023.
CONCLUSIONS: To our knowledge, this study represents the first study in Australia and internationally to employ SROI to estimate the social, personal, and community outcomes of home automation for people with a disability following a serious injury. This research will provide valuable information for funders, consumers, researchers, and the public to guide and inform future decision-making.
UNASSIGNED: DERR1-10.2196/42493.

BACKGROUND: Unmanaged consequences of cancer and its treatment are high among patients with lung cancer and their informal carers, resulting in avoidable healthcare use and financial burden. Provision of cancer supportive care addressing the impacts of cancer and its treatment has demonstrated efficacy in mitigating these consequences; however, globally, there is a lack of investment in these services. Paucity of robust economic evidence regarding benefit of cancer supportive care has limited policy impact and allocation of resources. This study therefore utilised a Social Return on Investment (SROI) methodology to conduct a forecast evaluation of lung cancer supportive care services, to ascertain potential social value and return on investment.
METHODS: An SROI economic evaluation model was developed using qualitative stakeholder consultations synthesised with published evidence to develop the inputs, outcomes and financial value associated with the delivery of a hypothetical model of quality lung cancer supportive care services over a one and five year period. SROI ratios were generated to determine the social value and cost savings associated per every $1AUD invested in cancer supportive care for both the healthcare system and patients. Deadweight, drop off and attribution were calculated, and sensitivity analysis was performed to confirm the stability of the model.
RESULTS: The value generated from modelled supportive care service investments in a one-year period resulted in an SROI ratio of 1:9; that is, for every dollar invested in supportive care, AUD$9.00 social return is obtained when savings to the healthcare system and benefits to the patients are combined. At five-years, these same investments resulted in greater cumulative value generated for both the patient and the healthcare system, with a SROI ratio of 1:11.
CONCLUSIONS: Our study provides strong evidence for policy makers, clinicians and consumers to advocate for further investment in cancer supportive care, as demonstrated cost savings could be achieved through implementation of the proposed supportive care service model, with these accruing over a five-year period. The SROI model provides a comprehensive framework detailing supportive care services and the health workforce necessary to achieve value-based outcomes for patients and the healthcare system.