Economic evaluation of a childhood obesity prevention programme for children: Results from the WAVES cluster randomised controlled trial conducted in schools.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
07
11
2018
accepted:
21
06
2019
entrez:
11
7
2019
pubmed:
11
7
2019
medline:
27
2
2020
Statut:
epublish
Résumé
Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6-7 years when compared to 'usual activities'. A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves. At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective. The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention. This paper uses data collected by the WAVES trial: Controlled trials ISRCTN97000586 (registered May 2010).
Sections du résumé
BACKGROUND
Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6-7 years when compared to 'usual activities'.
METHODS
A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves.
RESULTS
At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective.
CONCLUSIONS
The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention.
TRIAL REGISTRATION
This paper uses data collected by the WAVES trial: Controlled trials ISRCTN97000586 (registered May 2010).
Identifiants
pubmed: 31291330
doi: 10.1371/journal.pone.0219500
pii: PONE-D-18-32067
pmc: PMC6619792
doi:
Banques de données
ISRCTN
['ISRCTN97000586']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0219500Subventions
Organisme : Department of Health
ID : 06/85/11
Pays : United Kingdom
Organisme : Department of Health
ID : SRF-2017-10-002
Pays : United Kingdom
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Int J Behav Nutr Phys Act. 2016 Aug 22;13:94
pubmed: 27549382
Med Decis Making. 2013 Nov;33(8):1051-63
pubmed: 23913915
J Sch Health. 2008 Dec;78(12):619-24
pubmed: 19000237
Obesity (Silver Spring). 2010 Jan;18(1):131-6
pubmed: 19444231
BMC Public Health. 2015 May 13;15:488
pubmed: 25968599
Gac Sanit. 2011 May-Jun;25(3):198-204
pubmed: 21324563
Qual Life Res. 2009 Oct;18(8):1105-13
pubmed: 19693703
Eur J Health Econ. 2013 Apr;14(2):185-95
pubmed: 21986721
Arch Dis Child. 1995 Jul;73(1):25-9
pubmed: 7639544
Qual Life Res. 2018 Jun;27(6):1455-1462
pubmed: 29404925
J Occup Environ Med. 2014 Apr;56(4):441-5
pubmed: 24662952
Occup Ther Health Care. 2013 Apr;27(2):99-112
pubmed: 23855569
Prev Med. 1993 Mar;22(2):167-77
pubmed: 8483856
Med Decis Making. 2012 Mar-Apr;32(2):350-61
pubmed: 22016450
Lancet. 2017 Dec 16;390(10113):2627-2642
pubmed: 29029897
BMC Health Serv Res. 2006 Jun 06;6:68
pubmed: 16756680
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
BMC Public Health. 2010 Apr 09;10:184
pubmed: 20380692
JAMA. 2016 Sep 13;316(10):1093-103
pubmed: 27623463
Trials. 2013 Dec 05;14:421
pubmed: 24308301
BMJ. 2018 Feb 7;360:k211
pubmed: 29437667
Health Econ. 2005 May;14(5):487-96
pubmed: 15497198
Health Technol Assess. 2018 Feb;22(8):1-608
pubmed: 29436364
Gesundheitswesen. 2013 Nov;75(11):742-6
pubmed: 24081572
BMJ. 2009 Jun 29;338:b2393
pubmed: 19564179
Lancet Child Adolesc Health. 2018 Jan;2(1):35-45
pubmed: 29302609
Pharmacoeconomics. 2012 Aug 1;30(8):729-47
pubmed: 22788262
PLoS One. 2013 Oct 18;8(10):e77971
pubmed: 24205050
Cost Eff Resour Alloc. 2007 Sep 06;5:12
pubmed: 17822546