Methodological review of model-based cost-effectiveness analyses of school-based interventions to increase pupils’ level of physical activity

Dominika Batorova,Jan Sorensen

doi:10.4025/jphyseduc.v30i1.3013

Abstract

A large number of school-based interventions promoting physical activity have been developed. Due to difficulties of obtaining observational data on the long-term effect and cost consequences, modelling techniques offer opportunities to consider the long-term health and economic consequences. The aim of this is to provide an overview of modelling approaches applied in economic evaluations of school-based physical activity programmes. It identifies key methodological choices, challenges and areas with a lack of evidence.A literature search was conducted to identify all relevant studies published within the last 10 years. The included studies were described with focus on main methodological aspects, including the costs, effects and modelling techniques. Results shows eight model-based economic analyses of school-based physical activity programmes were identified. The majority of these studies concluded that the interventions had a high probability of being cost-effective or even cost saving based on the national-specific thresholds. Although most studies did provide a description of the models, details on the methodological choices were not always transparent. Moreover, evidence on the effectiveness and inclusion of all relevant cost categories were found to be challenging. In concluion different modelling methodologies have been used to assess the cost-effectiveness of school-based physical activity programmes. Only few studies have evaluated the long-term cost-effectiveness and they have challenging methodological issues.

Highlights

There are many well-documented health benefits of being physically active including reduced risk of obesity, diabetes, high blood pressure, high cholesterol, asthma and arthritis[1]
The objective of this study was to review recent model-based analyses addressing the cost-effectiveness of school-based interventions aimed at increasing physical activity in children and adolescents, and to describe the variation in methods applied to model potential long-term effects and costs of the interventions
All the studies undertook the evaluation from a societal perspective except for the study by Rush et al.[18] which used the perspective of the funding body, and Ekwaru et al.[21] that applied a school system’s perspective

Summary

Introduction

There are many well-documented health benefits of being physically active including reduced risk of obesity, diabetes, high blood pressure, high cholesterol, asthma and arthritis[1]. Regular physical activity appears to have positive impacts on health, cognition, self-esteem and academic achievement[2]. Regular physical activity in young age may have positive impacts on the health in adulthood since physically active children and. Studies have suggested that only modest interventions are necessary to achieve bodyweight change in children[4,5,6]. Due to these benefits, the World Health Organisation (WHO) recommends that children and adolescents accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity (MVPA) each day[7]. The proportion of children/adolescents who comply with this recommendation is often low[8]

Objectives

Methods

Results

Discussion

Conclusion