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Cost-effectiveness of physical activity intervention in children - results based on the Physical Activity and
Virpi Kuvaja-Köllner1, Niina Lintu2, Virpi Lindi2,3
1Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland. virpi-liisa.kuvaja-kollner@uef.fi.
Insights
A physical activity (PA) intervention combining counseling and exercise clubs significantly increased children's PA. This intervention is cost-effective, with a cost of €8.62 per additional hour of PA, including parental time costs.
Area of Science:
- Public Health
- Pediatrics
- Health Economics
Background:
- Childhood obesity is a growing public health concern.
- Physical activity (PA) interventions are crucial for promoting healthy lifestyles in children.
- Assessing the cost-effectiveness of PA interventions is vital for healthcare planning.
Purpose of the Study:
- To evaluate the cost-effectiveness of a 2-year physical activity (PA) intervention for primary school children.
- To compare a combined family-based PA counseling and after-school exercise club program against a no-intervention control group.
- To determine the cost per hour of increased PA from an extended service payer's perspective.
Main Methods:
- A randomized controlled trial involving 506 primary school children.
- Intervention group received six PA counseling sessions and access to after-school exercise clubs.
- Control group received standard health advice; PA change over two years was the primary outcome measure.
Main Results:
- Total PA increased by 108 hours in the intervention group versus a decrease of 65.5 hours in the control group over two years.
- The incremental cost-effectiveness ratio (ICER) was €6.21 per hour of PA increase (excluding parental time) and €8.62 (including parental time).
- Sensitivity analyses showed ICERs of €3.10 and €4.31 without assuming linear PA change.
Conclusions:
- The PA intervention is cost-effective compared to no intervention.
- The intervention is considered cost-effective if the payer's willingness-to-pay exceeds €8.62 per additional hour of PA, including parental time costs.
- This highlights the economic viability of structured PA programs for children.
Background:
We assessed the cost-effectiveness of a 2-year physical activity (PA) intervention combining family-based PA counselling and after-school exercise clubs in primary-school children compared to no intervention from an extended service payer's perspective.
Methods:
The participants included 506 children (245 girls, 261 boys) allocated to an intervention group (306 children, 60 %) and a control group (200 children, 40 %). The children and their parents in the intervention group had six PA counselling visits, and the children also had the opportunity to participate in after-school exercise clubs. The control group received verbal and written advice on health-improving PA at baseline. A change in total PA over two years was used as the outcome measure. Intervention costs included those related to the family-based PA counselling, the after-school exercise clubs, and the parents' taking time off to travel to and participate in the counselling. The cost-effectiveness analyses were performed using the intention-to-treat principle. The costs per increased PA hour (incremental cost-effectiveness ratio, ICER) were based on net monetary benefit (NMB) regression adjusted for baseline PA and background variables. The results are presented with NMB and cost-effectiveness acceptability curves.
Results:
Over two years, total PA increased on average by 108 h in the intervention group (95 % confidence interval [CI] from 95 to 121, p < 0.001) and decreased by 65.5 h (95 % CI from 81.7 to 48.3, p < 0.001) in the control group, the difference being 173.7 h. the incremental effectiveness was 87 (173/2) hours. For two years, the intervention costs were €619 without parents' time use costs and €860 with these costs. The costs per increased PA hour were €6.21 without and €8.62 with these costs. The willingness to pay required for 95 % probability of cost-effectiveness was €14 and €19 with these costs. The sensitivity analyses revealed that the ICER without assuming this linear change in PA were €3.10 and €4.31.
Conclusions:
The PA intervention would be cost-effective compared to no intervention among children if the service payer's willingness-to-pay for a 1-hour increase in PA is €8.62 with parents' time costs.
Trial Registration:
ClinicalTrials.gov: NCT01803776. Registered 4 March 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=01803776&cntry=&state=&city=&dist= .
