Online Program

333485
Cost-effectiveness of school, early child care and afterschool based nutrition policies and programs to prevent obesity


Wednesday, November 4, 2015 : 9:10 a.m. - 9:30 a.m.

Angie L. Cradock, ScD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Jessica L. Barrett, MPH, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Erica Kenney, ScD, MPH, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Zachary J. Ward, MPH, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA
Catherine M. Giles, MPH, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Stephen Resch, Ph.D., Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA
Y. Claire Wang, MD, ScD, Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY
Steven L. Gortmaker, PhD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Background:Schools, child care facilities and afterschool programs are critical settings for policy and programmatic interventions to address childhood obesity. This study estimates the potential health impact and cost-effectiveness of reducing screen time exposure in early child care settings, improving standards for snack foods and beverages in schools and improving snacks served during afterschool programs.

Methods:The CHildhood Obesity Intervention Cost-Effectiveness Study (CHOICES) systematic review process and microsimulation model were used to estimate the impact and cost effectiveness of three nutrition policies targeting improved food and beverage offerings to children and reduced screen time. Healthcare costs averted and the cost-effectiveness of ten-year reductions in body mass index (BMI), childhood obesity prevalence and gains in quality-adjusted life years (QALYs) were estimated for the 2015 U.S. population.

Results: Costs of implementing these policies or programs in the first year range between $3.2 and $16 million with an estimated potential reach of between 370,000 and 13.3 million children aged 3-18 years. These interventions are estimated to reduce BMI by 0.023 – 0.243 unit per person on average.  Over a ten-year period, these interventions are estimated to cost $15 to $627 per BMI unit reduced. Resulting healthcare cost reductions and cost-effectiveness to reduce childhood obesity and increase QALYs will be presented.

Conclusions: Cost-effectiveness analysis of interventions can assist in comparing the estimated impact of various policy and program options on short-term outcomes, costs and populations impacted. These interventions may reduce BMI at lower cost than recognized clinical interventions and have potential large population reach.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Evaluate the impact and cost-effectiveness of policies to improve food and beverage offerings and reduce screen time in child-centered settings.

Keyword(s): Policy/Policy Development, Children and Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Cradock is a Deputy Director at the Harvard School of Public Health Prevention Research Center on Nutrition and Physical Activity (HPRC) and a Senior Research Scientist at the Harvard School of Public Health where her research is primarily focused on the social and environmental factors associated with physical activity and nutrition behaviors among youth. Specific areas of interest include school and neighborhood environments, community-based intervention research, and policy research.
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.