Recently, Bolu Yang, a graduate of the Master of Global Health program at Duke Kunshan University and a joint PhD student of Wuhan University and Duke Kunshan University, published a research paper titled “Economic Evaluation of a Multicomponent mHealth Intervention for Stroke Management in Rural China: Cluster-Randomized Trial With 6-Year Follow-Up” as the first author in the internationally renowned journal JMIR mHealth and uHealth.
The study was led by Professor Lijing L. Yan (School of Public Health, Wuhan University; Global Health Research Center, Duke Kunshan University) and her team at the Global Health Research Center of Duke Kunshan University, conducted in Hebei Province over a six-year period. The published paper focuses on the SINEMA intervention model and provides a systematic evaluation of the short-term and long-term economic benefits of the mobile health (mHealth)-based SINEMA intervention for stroke management among patients in rural China.
Significant Cost-Effectiveness and Sustained Long-Term Impact
The study found that the SINEMA intervention was cost-effective both in the short term and over the long run. The figure clearly illustrates that the SINEMA intervention demonstrated stable and remarkably high cost-effectiveness in both the short term (trial period) and the long term (follow-up period). Results from probabilistic sensitivity analyses and acceptability analyses under varying willingness-to-pay thresholds consistently supported the conclusion that the intervention is cost-effective.
Feasible for Nationwide Implementation with Manageable Costs
The research team also conducted a budget impact analysis to assess the financial feasibility of scaling up the SINEMA model nationwide. The research team assumed that the SINEMA intervention could reach China’s rural stroke population within five years. The table presents the projected implementation costs for Year 1 and Year 5, comparing two rollout scenarios: Scenario A — independent program implementation, and Scenario B — integration into the National Basic Public Health Service.
Findings showed low per-capita costs in both scenarios, suggesting that nationwide implementation would impose a limited financial burden. These results indicate that the SINEMA model is highly feasible for large-scale adoption, offering policymakers clear and evidence-based cost references for nationwide deployment.
“This economic evaluation fills a critical gap in existing research,” said Bolu Yang.“The SINEMA model — a community-based and technology-enabled approach — is not only a solution for rural China but also holds great potential to transform secondary stroke prevention in resource-limited settings worldwide. Looking ahead, this model could serve as a reference for managing other chronic diseases across diverse global contexts.”
The research team has previously published several studies, providing empirical evidence for innovative practices and intervention outcomes in primary-level chronic disease management.
Written by Ruoning Feng
