Abstract
BackgroundPhysical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds.ObjectiveWe aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps.MethodsWe used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs.ResultsThe modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention.ConclusionsA mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.
Highlights
Insufficient physical activity is associated with an increased risk of cardiovascular diseases, cancers, and poor mental health [1,2,3]
The one-off mass media campaign promoting smartphone apps for physical activity resulted in an increase of 28 quality-adjusted life years (QALYs) (95% uncertainty interval (UI) 8-72) over the lifetime of the 2011 population, or 0.008 QALYs gained per 1000 people
Health gains per capita were higher in older age groups, and, assuming the intervention costs were spread evenly across the eligible population, the intervention was more likely to be cost-effective in older age groups compared to younger age groups
Summary
Insufficient physical activity is associated with an increased risk of cardiovascular diseases, cancers, and poor mental health [1,2,3]. International recommendations state that adults should aim to accumulate at least 150 minutes of moderate-to-vigorous physical activity (MVPA) throughout the week [1,4]. 1 (page number not for citation purposes) in the United States, 34% in India, 47% in Brazil, and 42% in New Zealand [5]. Strategies to increase physical activity at the population level are needed, and the promotion of smartphone apps for physical activity is one promising avenue for intervention. Encouraging the use of high-quality apps provides a potential opportunity to increase population-level physical activity owing to the large potential reach and low cost of apps. Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds
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