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Cost-effectiveness of reducing children’s sedentary time and increasing physical activity at school: the Transform-Us! intervention

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dc.contributor.authorBrown, V.
dc.contributor.authorSheppard, L.
dc.contributor.authorSalmon, J.
dc.contributor.authorArundell, L.
dc.contributor.authorCerin, E.
dc.contributor.authorRidgers, N.D.
dc.contributor.authorHesketh, K.D.
dc.contributor.authorDaly, R.M.
dc.contributor.authorDunstan, D.W.
dc.contributor.authorBrown, H.
dc.contributor.authorGatta, J.D.
dc.contributor.authorChinapaw, J.M.M.
dc.contributor.authorMoodie, M.
dc.date.issued2024
dc.descriptionData source: Electronic supplementary material, https://doi.org/10.1186/s12966-024-01560-3
dc.description.abstract<h4>Background</h4>Improving physical activity and reducing sedentary behavior represent important areas for intervention in childhood in order to reduce the burden of chronic disease related to obesity and physical inactivity in later life. This paper aims to determine the cost-effectiveness of a multi-arm primary school-based intervention to increase physical activity and/or reduce sedentary time in 8-9 year old children (Transform-Us!).<h4>Methods</h4>Modelled cost-utility analysis, using costs and effects from a cluster randomized controlled trial of a 30-month intervention that used pedagogical and environmental strategies to reduce and break up sedentary behaviour (SB-I), promote physical activity (PA-I), or a combined approach (PA + SB-I), compared to current practice. A validated multiple-cohort lifetable model (ACE-Obesity Policy model) estimated the obesity and physical activity-related health outcomes (measured as change in body mass index and change in metabolic equivalent task minutes respectively) and healthcare cost-savings over the cohort's lifetime from the public-payer perspective, assuming the intervention was delivered to all 8-9 year old children attending Australian Government primary schools. Sensitivity analyses tested the impact on cost-effectiveness of varying key input parameters, including maintenance of intervention effect assumptions.<h4>Results</h4>Cost-effectiveness results demonstrated that, when compared to control schools, the PA-I and SB-I intervention arms were "dominant", meaning that they resulted in net health benefits and healthcare cost-savings if the intervention effects were maintained. When the costs and effects of these intervention arms were extrapolated to the Australian population, results suggested significant potential as obesity prevention measures (PA-I: 60,780 HALYs saved (95% UI 15,007-109,413), healthcare cost-savings AUD641M (95% UI AUD165M-$1.1B); SB-I: 61,126 HALYs saved (95% UI 11,770 - 111,249), healthcare cost-savings AUD654M (95% UI AUD126M-1.2B)). The PA-I and SB-I interventions remained cost-effective in sensitivity analysis, assuming the full decay of intervention effect after 10 years.<h4>Conclusions</h4>The PA-I and SB-I Transform-Us! intervention arms represent good value for money and could lead to health benefits and healthcare cost-savings arising from the prevention of chronic disease in later life if intervention effects are sustained.<h4>Trial registration</h4>International Standard Randomized Controlled Trial Number (ISRCTN83725066). Australia and New Zealand Clinical Trials Registry Number (ACTRN12609000715279).
dc.identifier.citationInternational Journal of Behavioral Nutrition and Physical Activity, 2024; 21(1):15-
dc.identifier.doi10.1186/s12966-024-01560-3
dc.identifier.issn1479-5868
dc.identifier.issn1479-5868
dc.identifier.orcidRidgers, N.D. [0000-0001-5713-3515]
dc.identifier.urihttps://hdl.handle.net/11541.2/38012
dc.language.isoen
dc.publisherSpringer Science and Business Media LLC
dc.relation.fundingNHMRC 533815
dc.relation.fundingARC FT130100637
dc.relation.fundingDART 1078360
dc.relation.fundingDART 1176885
dc.relation.fundingNational Heart Foundation of Australia 101895
dc.relation.fundingNational Heart Foundation of Australia FT140100085
dc.relation.fundingState Government of Victoria
dc.rightsCopyright 2024 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. (http://creativecommons.org/licenses/by/4.0/.)
dc.source.urihttps://doi.org/10.1186/s12966-024-01560-3
dc.subjectHumans
dc.subjectObesity
dc.subjectChronic Disease
dc.subjectExercise
dc.subjectSchools
dc.subjectChild
dc.subjectHealth Promotion
dc.subjectCost-Benefit Analysis
dc.subjectAustralia
dc.subjectSedentary Behavior
dc.titleCost-effectiveness of reducing children’s sedentary time and increasing physical activity at school: the Transform-Us! intervention
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12283499650001831 13306159360001831 9916835328501831
ror.mmsid9916835328501831

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