A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions

Sarah Fitzgerald,Aileen Murphy,Ivan J Perry,Ann Kirby,Fiona Geaney

doi:10.1186/s12889-016-3988-7

Sarah Fitzgerald, Aileen Murphy + Show 3 more

Open Access

https://doi.org/10.1186/s12889-016-3988-7

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Abstract

BackgroundThe workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer’s perspective.MethodsCost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace.ResultsThe combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist’s time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs).ConclusionsWithin multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary interventions.Trial registrationCurrent Controlled Trials: ISRCTN35108237. Date of registration: The trial was retrospectively registered on 02/07/2013.

Highlights

The workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours
As research costs were excluded from analysis, physical assessment costs are presented separate to the total costs
This study offers a unique insight into the costs associated with both implementing and maintaining a complex workplace nutrition education and an environmental dietary modification intervention from the perspective of the employer

Summary

Introduction

The workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours. The full impact of dietrelated diseases extends beyond the population health burden to include a considerable financial burden which is attributable to escalating healthcare spending [3,4,5,6] This financial burden is borne by society and by employers as diet-related diseases have been linked to absenteeism and productivity loss in the workplace [7]. In this environment of mounting healthcare costs and ongoing financial constraints, emphasis is being increasingly placed on treatment of diet-related diseases rather than preventative measures [2]. Dietary interventions that support low intakes of saturated fat, sugar and salt and high intakes of fruit and vegetables are considered to be one of the preferred costeffective interventions for easing the burden [1,2,3]

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