Lifetime cost-effectiveness and equity impacts of the Healthy Primary School of the Future initiative.
Childhood obesity
Cost-effectiveness
Health impact modelling
Lifestyle prevention
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
09 Dec 2020
09 Dec 2020
Historique:
received:
24
08
2020
accepted:
21
10
2020
entrez:
10
12
2020
pubmed:
11
12
2020
medline:
28
4
2021
Statut:
epublish
Résumé
This study estimated the lifetime cost-effectiveness and equity impacts associated with two lifestyle interventions in the Dutch primary school setting (targeting 4-12 year olds). The Healthy Primary School of the Future (HPSF; a healthy school lunch and structured physical activity) and the Physical Activity School (PAS; structured physical activity) were compared to the regular Dutch curriculum (N = 1676). An adolescence model, calculating weight development, and the RIVM Chronic Disease Model, calculating overweight-related chronic diseases, were linked to estimate the lifetime impact on chronic diseases, quality adjusted life years (QALYs), healthcare, and productivity costs. Cost-effectiveness was expressed as the additional costs/QALY gained and we used €20,000 as threshold. Scenario analyses accounted for alternative effect maintenance scenarios and equity analyses examined cost-effectiveness in different socioeconomic status (SES) groups. HPSF resulted in a lifetime costs of €773 (societal perspective) and a lifetime QALY gain of 0.039 per child versus control schools. HPSF led to lower costs and more QALYs as compared to PAS. From a societal perspective, HPSF had a cost/QALY gained of €19,734 versus control schools, 50% probability of being cost-effective, and beneficial equity impact (0.02 QALYs gained/child for low versus high SES). The cost-effectiveness threshold was surpassed when intervention effects decayed over time. HPSF may be a cost-effective and equitable strategy for combatting the lifetime burden of unhealthy lifestyles. The win-win situation will, however, only be realised if the intervention effect is sustained into adulthood for all SES groups. Clinicaltrials.gov ( NCT02800616 ). Registered 15 June 2016 - Retrospectively registered.
Sections du résumé
BACKGROUND
BACKGROUND
This study estimated the lifetime cost-effectiveness and equity impacts associated with two lifestyle interventions in the Dutch primary school setting (targeting 4-12 year olds).
METHODS
METHODS
The Healthy Primary School of the Future (HPSF; a healthy school lunch and structured physical activity) and the Physical Activity School (PAS; structured physical activity) were compared to the regular Dutch curriculum (N = 1676). An adolescence model, calculating weight development, and the RIVM Chronic Disease Model, calculating overweight-related chronic diseases, were linked to estimate the lifetime impact on chronic diseases, quality adjusted life years (QALYs), healthcare, and productivity costs. Cost-effectiveness was expressed as the additional costs/QALY gained and we used €20,000 as threshold. Scenario analyses accounted for alternative effect maintenance scenarios and equity analyses examined cost-effectiveness in different socioeconomic status (SES) groups.
RESULTS
RESULTS
HPSF resulted in a lifetime costs of €773 (societal perspective) and a lifetime QALY gain of 0.039 per child versus control schools. HPSF led to lower costs and more QALYs as compared to PAS. From a societal perspective, HPSF had a cost/QALY gained of €19,734 versus control schools, 50% probability of being cost-effective, and beneficial equity impact (0.02 QALYs gained/child for low versus high SES). The cost-effectiveness threshold was surpassed when intervention effects decayed over time.
CONCLUSIONS
CONCLUSIONS
HPSF may be a cost-effective and equitable strategy for combatting the lifetime burden of unhealthy lifestyles. The win-win situation will, however, only be realised if the intervention effect is sustained into adulthood for all SES groups.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov ( NCT02800616 ). Registered 15 June 2016 - Retrospectively registered.
Identifiants
pubmed: 33297992
doi: 10.1186/s12889-020-09744-9
pii: 10.1186/s12889-020-09744-9
pmc: PMC7724829
doi:
Banques de données
ClinicalTrials.gov
['NCT02800616']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1887Subventions
Organisme : Limburg Provincial Authorities
ID : 200130003
Organisme : Friesland Campina
ID : LLMV00
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