Beyond compliance: ACE and the disability standards for education in 2005.

The Disability Standards for Education 2005 make it unlawful for an education authority to discriminate against a person on the grounds of the person's disability, and providers of adult and community education (ACE) are specifically noted as education authorities in the Standards. Most ACE providers, working as they do from a community development basis, would consider themselves to be non-discriminatory. The devil, nevertheless, is in the detail, and it is one particular detail of the Standards that this article considers – Part 7: Standards for student support services. Research has indicated that this is an area with which ACE providers are likely to have problems. This article looks firstly at the place of people with a disability in ACE, and then at some of the provisions of the Standards as they relate to student support. Evidence to support the discussion is taken from three research projects into ACE provision for people with a disability. These studies are outlined before the author moves on to some of the issues indicated in the research. Further, some suggestions are made for compliance, and the need for ACE providers to go beyond compliance and consider advocacy to support the inclusion of people with a disability into ACE.

Assessing cost-effectiveness in obesity (ACE-Obesity) : an overview of the ACE approach, economic methods and cost results

Background : The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study.

Methods : The Assessing Cost-Effectiveness (ACE) approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'.

Results : The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum) and when expressed as a 'cost per child' estimate (from <AUD1.0 [reduction of TV advertising of high fat foods/high sugar drinks] to >AUD31,000 [laparoscopic adjustable gastric banding for morbidly obese adolescents]). High costs per child reflected cost structure, target population and/or under-utilisation.

Conclusions : The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and second stage filter considerations for each intervention assessed will be presented and analysed.

Assessing the Cost Effectiveness of obesity interventions - the ACE model

A workshop presentation