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Economic evaluation of a community-based obesity prevention program in children: the APPLE project

Kirsten A McAuley1, Rachael W Taylor, Victoria L Farmer

  • 1Edgar National Centre for Diabetes Research, Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand.

Obesity (Silver Spring, Md.)
|May 16, 2009
PubMed

Insights

The APPLE project successfully reduced children's excessive weight gain through lifestyle and exercise initiatives. This cost-effective obesity prevention strategy prevented 2.0 kg of weight gain per child by age 15.

Area of Science:

  • Public Health
  • Pediatric Obesity Prevention
  • Health Economics

Background:

  • Childhood obesity is a growing public health concern requiring effective, cost-efficient prevention strategies.
  • Few studies have evaluated the cost-effectiveness of childhood obesity interventions.
  • The APPLE project aimed to address this gap by assessing a community-based obesity prevention program.

Purpose of the Study:

  • To assess the costs and health benefits of the APPLE (A Pilot Program for Lifestyle and Exercise) project.
  • To determine the cost-effectiveness of a school-based obesity prevention initiative in New Zealand children.
  • To evaluate the impact on weight z-score and health-related quality of life (HRQoL).

Main Methods:

  • A 2-year controlled community-based obesity prevention initiative was implemented in New Zealand children (5-12 years).
  • The study estimated marginal costs and compared them with kilograms of weight gain prevented.
  • Health Utilities Index (HUI) was used to measure HRQoL.

Main Results:

  • The total project cost was NZ$357,490 (NZ$1,281 per child over 2 years).
  • Weight z-score was significantly reduced by 0.18 units at 2 years and 0.17 units at 4 years in the intervention group.
  • HRQoL did not differ significantly between groups, but the weight reduction is equivalent to 2.0 kg prevented weight gain by age 15.

Conclusions:

  • The APPLE project demonstrated success in significantly reducing excessive weight gain rates in children.
  • The intervention proved cost-effective, with costs ranging from NZ$664-1,708 per kg of weight gain prevented over 4 years.
  • Community-based programs utilizing activity coordinators and nutrition promotion are viable strategies for childhood obesity prevention.

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