Calculating the costs of establishing and delivering KiVa in Wales Dr Joanna Charles Centre for Health Economics and Medicines Evaluation, Bangor University

Background Local authorities and schools face difficult decisions against a backdrop of constrained and decreasing budgets. There is a need to implement effective programmes and at the same time for schools and local authorities to know and understand the budgetary impact of implementing such programmes. Health economics is interested in the interplay between costs and outcomes/benefits and uses techniques to provide a framework for identifying the costs and benefits of different options (Glick et al., 2007). Schools have been identified as an important setting for public health programmes, including those aiming to address bullying (The Kings Fund, 2013).

Methods Micro-costing - a bottom-up approach used to estimate the cost of setting up and delivering an intervention. It involves collecting detailed information about the resources required to deliver the intervention, and subsequently assigning economic unit costs to each component of resource use. Information was collected from; - record books completed by teachers and the school KiVa lead - the KiVa project team KiVa costs were separated into recurrent (delivery costs e.g., time to deliver KiVa sessions) and non-recurrent costs (initial set up costs such as purchase of materials and training).

Methods We used national estimates of teacher, head teacher and classroom assistant salaries, and sense checked these estimates with teachers who took part in the Welsh evaluation. A school year of 39 weeks for delivery of KiVa was used to calculate the cost per hour for school staff costs, taking sickness, CPD and holidays into account. Salary calculations were inclusive of employers’ on-costs (25%). Average total costs per school (based on data from the 11 schools taking part in the research) and cost per child (obtained by dividing the total cost by the number of children receiving the programme), Costs are presented in UK Pounds Sterling for the year , using a local authority perspective

Results Non-Recurrent CostsRecurrent Costs  Training courses  Materials such as Manuals, Posters and Tabards. School teachers wear high-visibility tabards with the KiVa logo to demonstrate a presence of the programme within a school and highlight their presence during break and lunch times so that children know to whom to report incidences of bullying  Staff costs for school staff attending training  Staff costs for the trainer delivering training  Travel costs to attend training for school staff  Travel costs to attend training for the KiVa trainer  Staff costs for school staff attending Twilight implementation session. This session is delivered before schools begin implementing KiVa and is designed to provide a platform for school staff to gain feedback and ask questions before they deliver the programme in their schools.  Staff costs for the trainer delivering the Twilight session  Travel costs to attend Twilight session for school staff  Travel costs to attend Twilight session for the KiVa trainer  KiVa launches within schools, including a staff meeting, meeting with pupils, a parents evening and newsletters explaining the programme sent out at the beginning of term  Annual registration with KiVa Finland, the programme developers.  Staff time preparing KiVa sessions  Staff time delivering KiVa sessions  Time spent by teaching assistants helping children complete the child online survey. The child online survey is completed by each class once a year and asks them to report on the numbers and incidents of bullying they have encountered. It is designed to discuss and define what bullying is and teach children how to recognise the signs; it also produces annual statistics that a school can use to explore their current levels of bullying incidence.  Staff costs for school staff attending Support/Coaching sessions. Support/Coaching sessions were delivered each term and provided a peer group with trainer support where staff could share their experiences of delivering KiVa and gain feedback from peers.  Costs for the trainer to deliver Support/Coaching sessions.  Travel costs to attend Support/Coaching sessions for school staff  Travel costs to attend Support/Coaching sessions for the KiVa trainer  Lunch and refreshments for Support/Coaching sessions  Other time spent by school staff on KiVa related activities (e.g., conducting assemblies, answering staff queries and creating passwords for online surveys and games)

Results As KiVa originated in Finland, in order to implement KiVa in Wales translation of materials was undertaken prior to the Welsh evaluation. The total cost of this translation was £3,835. The total non-recurrent/ set up costs of KiVa per school, per year were £1, (equating to a cost per child of £1.00). The total recurrent/delivery costs of KiVa per school, per year were £ (equating to a cost per child of £0.57). Therefore, the total costs to set up and deliver KiVa in Wales as part of the evaluation was £2, per school, equating to £1.57 per child.

Results Opportunity Costs In the evaluation, the project team mapped KiVa onto the Personal Social Educational (PSE) activity and curriculum of schools taking part, covering over 50% of this curriculum. We recognise this may not be the case for all schools and therefore calculated the opportunity costs for schools if KiVa was delivered as an additional lesson on top of usual activities, and host KiVa launches, staff meetings and parents evening separate to usual events for parents and staff. We report our minimum opportunity costs calculations based upon information provided in the evaluation and using national estimates of teacher salaries. Minimum opportunity costs per school to set up and deliver KiVa were £4, if schools were to deliver KiVa on top of usual PSE activities and set up separate events to launch KiVa with parents and teachers outside of existing meetings and events such as parent’s evening.

Conclusion This is the first micro-costing of KiVa in a UK setting, demonstrating it cost £2, per school, per year, equating to £1.57 per pupil to set up and deliver KiVa in the evaluation schools. Subsequent ongoing deliver costs amount to £ per school, per year (equating to a cost per child of £0.57). The majority of costs were accrued by the set-up of the programme, registration with the programme developers and purchase of materials. As the KiVa programme maps closely onto about half of the PSE curriculum, lessons were being delivered as part of usual activity, which represented a minimal opportunity cost for the schools taking part in the evaluation and could provide an example of implementation for future schools wishing to roll-out the programme.

Implications The costs presented are grounded within the context of the evaluation, under “real world” circumstances differing staff levels and bands could impact upon the running costs of KiVa. Our report highlights the initial resources required by a school wishing to implement KiVa in future. For those interested in delivering the programme it is worth considering the impact of staff turn- over, and its effects on programme delivery – particularly relevant if a KiVa lead moves to another school. KiVa is aimed to be adopted at a whole school level, with structures in place so KiVa leads train others within their schools. However, schools need a designated KiVa lead. There is a potential and opportunity for Local Authorities to train their own KiVa trainer, who could recruit and train school staff, reduced the implication of staff turn-over with regards to the KiVa lead. However this person would have to have a contract that allowed them both time to train and provide ongoing support to the schools that they train.

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