201540 Cost-effectiveness of physical activity interventions: Analysis from a systematic review

Tuesday, November 10, 2009: 11:00 AM

Shinyi Wu, PhD , RAND Corporation, Santa Monica, CA
Yuyan Shi, MA , Pardee RAND Graduate School, Santa Monica, CA
Deborah Cohen, MD, MPH , RAND Corporation, Santa Monica, CA
Marjorie Pearson, PhD , RAND Corporation, Santa Monica, CA
Background: Cost-effectiveness (CE) analysis can help decision makers maximize the use of scarce resources available to promote physical activity (PA). We developed a method to translate PA outcomes into a common measure of effectiveness and estimated intervention costs in order to compare CE across a wide variety of PA intervention strategies.

Methods: A systematic literature review was conducted that identified 92 interventions from 5579 articles for CE analysis. CE ratios were calculated as cost per unit of metabolic equivalent (MET) hour gained per day per individual reached. PA benefits were compared to US guideline recommended levels (1.5 MET hours per day for adults and 3.0 for school-age children).

Results: The most cost-effective strategy was point of decision prompts (e.g. signs to prompt stair use), with a median of $0.07/MET-hour/day/person, because of its low cost and large population reached. However, the benefit is limited to only meeting 0.2% of guideline recommended PA levels. School-based PA interventions targeted at children and adolescents (e.g. PA education, promotion of out-of-school PA) were relatively cost-effective (median $0.33/MET-hour/day/person) when no additional school staff's labor costs were required. These interventions generated an average 18% guideline recommended PA. Even the least cost-effective interventions high intensity individually-adapted behavior change and social support programs have low CE ratios (median $0.90- and $1.16/MET-hour/day/person, respectively), and, on average, generated more than 30% guideline recommended PA.

Conclusions: The analysis found many PA interventions cost-effective (CE ratios less than $1/MET-hour/day/person) and generated activities that significantly enhanced meeting recommended PA guidelines.

Learning Objectives:
1) Formulate cost-effectiveness of PA interventions using a standard method 2) Compare cost-effectiveness of different types of PA interventions

Keywords: Physical Activity, Public Health Education and Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a researcher at RAND Health and an assistant professor in the Department of Industrial and Systems Engineering at University of Southern California. I have over 10 years of research experience using the methods of cost-effectiveness analysis, economic modeling, and systematic review. I am the principle investigator of the Physical Activity Cost-Effectiveness Study from which the abstract is developed.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.