Economically viable population-based interventions to promote physical activity behavior based on a systematic review

Physical inactivity contributes to substantial public health and economic burdens. This study reviews the cost-effectiveness of population-based physical activity interventions. The literature search focused on studies that have successfully promoted physical activity behavior based on valid measurement.

The systematic literature search was conducted across five electronic databases in January 2021. To facilitate comparison between studies, the results on effect size and cost-effectiveness (incremental cost-effectiveness ratio, ICER) were harmonized.

All five studies included in this review were trial-based economic evaluations, of which two studies modeled long-term cost-effectiveness. The included studies were mainly print-based interventions, and their ICER values ranged from 0.15 to 4.14 US$ (2024) per metabolic equivalent of task hour gained (including only intervention costs). The most economically viable intervention utilized computer-tailored physical activity advice in the general population, while three interventions targeted inactive adults.

Only a few intervention studies showed positive effects on physical activity behavior and evaluated their cost-effectiveness at the population level. Future studies should consider accurate cost calculations and reporting, high-quality methods for measuring physical activity behavior, and inter-individual variations. Moreover, unified standardized methods for determining the cost-effectiveness of physical activity interventions are needed.