Economic evaluation of a multi-strategy intervention that improves school-based physical activity policy...

Area of Science:

• Public Health
• Health Economics
• Educational Policy

Background:

• Government policies mandating physical activity in schools are often poorly implemented.
• The Physically Active Children in Education (PACE) intervention is designed to support schools in policy implementation.
• This study evaluates the investment value and cost-effectiveness of the PACE intervention from a health service provider's perspective.

Purpose of the Study:

• To evaluate the return on investment for health service providers delivering the PACE intervention.
• To identify potential areas for adaptation to reduce program costs for wider scalability.
• To determine the cost-effectiveness of the PACE intervention in increasing school-based physical activity.

Main Methods:

• A prospective economic evaluation was conducted in 61 primary schools in New South Wales, Australia.
• Schools were randomized to either the PACE intervention or a wait-list control group.
• Effectiveness was measured by the mean weekly minutes of physical activity implemented by teachers, with costs analyzed from a public finance perspective.

Main Results:

• The total cost for the health service provider to deliver PACE was $35,692, averaging $1151 per school.
• Training in-school champions ($19,437) and educational outreach ($4992) were the most significant cost contributors.
• The incremental cost-effectiveness ratio (ICER) was $29 per additional minute of weekly physical activity implemented per school.

Conclusions:

• The PACE intervention represents a potentially cost-effective strategy for enhancing school policy implementation regarding physical activity.
• The required investment leverages existing health service infrastructure, suggesting manageable additional costs for schools.
• Adaptations to PACE strategies could significantly improve delivery cost-efficiency for broader implementation.