Abstract
Physical inactivity has been identified as a leading risk factor for premature mortality globally, and adolescents, in particular, have low physical activity levels. Schools have been identified as a setting to tackle physical inactivity. Economic evidence of school-based physical activity programmes is limited, and the costs of these programmes are not always collected in full. This paper describes a micro-costing and cost-consequence analysis of the ‘Girls Active’ secondary school-based programme as part of a cluster randomised controlled trial (RCT). Micro-costing and cost-consequence analyses were conducted using bespoke cost diaries and questionnaires to collect programme delivery information. Outcomes for the cost-consequence analysis included health-related quality of life measured by the Child Health Utility-9D (CHU-9D), primary care General Practitioner (GP) and school-based (school nurse and school counsellor) service use as part of a cluster RCT of the ‘Girls Active’ programme. Overall, 1,752 secondary pupils were recruited and a complete case sample of 997 participants (Intervention n = 570, Control n = 427) was used for the cost-consequence analysis. The micro-costing analysis demonstrated that, depending upon how the programme was delivered, ‘Girls Active’ costs ranged from £1,054 (£2 per pupil, per school year) to £3,489 (£7 per pupil, per school year). The least costly option was to absorb ‘Girls Active’ strictly within curriculum hours. The analysis demonstrated no effect for the programme for the three main outcomes of interest (health-related quality of life, physical activity and service use).Micro-costing analyses demonstrated the costs of delivering the ‘Girls Active’ programme, addressing a gap in the United Kingdom (UK) literature regarding economic evidence from school-based physical activity programmes. This paper provides recommendations for those gathering cost and service use data in school settings to supplement validated and objective measures, furthering economic research in this field.Trial registration: -ISRCTN, ISRCTN10688342.
Highlights
The World Health Organisation [1] identified a lack of physical activity as the fourth leading risk factor for global mortality, accounting for 6% of deaths globally
The lack of economic evidence surrounding this topic is problematic to agencies and local authorities in guiding decisions to deliver evidence-based interventions, which would be considered a good use of resources
A supporting information file [S1 Table] shows a unit cost table outlining the published unit costs used in this cost-consequence analysis and their sources
Summary
The World Health Organisation [1] identified a lack of physical activity as the fourth leading risk factor for global mortality, accounting for 6% of deaths globally. There is a paucity of evidence for school-based physical activity interventions in the UK [7] and a lack of cost-effectiveness evidence globally surrounding physical activity interventions/ programmes for children [8,9]. The lack of economic evidence surrounding this topic is problematic to agencies and local authorities in guiding decisions to deliver evidence-based interventions, which would be considered a good use of resources. Local authorities and schools face difficult decisions about which services and resources to purchase against a backdrop of constrained and decreasing budgets. There is a need to implement effective programmes and, at the same time, for schools and local authorities to know and understand the budgetary implications of implementing such programmes
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