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Table 2 Study description and key economc findings (alphabetically sorted)

From: Quality assessment of economic evaluations of health promotion programs for children and adolescents—a systematic review using the example of physical activity

Author/Year/(Country)

Intervention components

Target/Age group

Setting

Study design

Perspective, time horizon, discounting

Measure of effects

Price Year/Currency unit, considered cost categories

Result [in 2011 US$]*

Brown et al. 2007 (USA) [23]

Physical activity, nutrition

Children, grades three, four and five, 8–11 years

School

CUA, using a model approach (calculating additional benefit)

Society, modeling over a 25-year period, costs and benefits at 3 %

Cases of adult overweight prevented (40–64 years), QALYs saved

2004, US$, intervention costs, avoided treatment costs, avoided productivity loss costs

Cost per QALY saved = US$ 900 [US$ 1072.52], Net benefit = US$ 68,125 [US$ 81,183.60]

Kesztyüs et al. 2011 (GER) [26]

Health education, physical activity breaks, and parent involvement

Children, primary school, second grade, 7–8 years

School

CEA, using intervention results

Society, 1 year, not stated

Differences in waist-to-height ratio, waist circumference, and BMI,

2008, EUR, total intervention costs, intervention costs per child

ICER (WC) = EUR 11.11 [US$ 14.67] per cm prevented

ICER (WHtR) = EUR 18.55 [US$ 24.50] per unit prevented

Krauth et al. 2013 (GER) [28]

3 additional PE lessons per week

Children, primary school

School

CEA, using intervention results

Society, not stated, not stated

Reduction in BMI, increase in physical activity

No price year, EUR, intervention costs, intervention costs per child per school year

EUR 619/child/year for significant results [US$ 789.54]

McAuley et al. 2010 (NZ) [29]

Nutrition and physical activity

Children, 5–12 years

School/Community

CEA, using intervention results

Society, 4 years, costs at 5 %

Weight gain avoided, QALY

2006, NZ$, no development costs, total costs

NZ$ 664–1708 [US$ 515.53–1326.1] per kg avoided weight gain (depending on age), no QALY gain reported

Moodie et al. 2009 (AUS) [22]

“Walking School Bus” encouraging physical activity

Children, 5–7 years

School/Community

CUA, using a model approach

Society, lifetime, costs and benefits both at 3 %

Reduction in BMI, increase in physical activity, energy expenditure

2001, AU$, total costs

Lifetime DALYs, Cost per: DALY saved: AU$ 760,000 [US$ 669,138.39] (net, gross: AU$ 770,000 [US$ 677,942.84])

- BMI unit saved: AU$ 87,000 [US$ 76,598.74]

Moodie et al. 2010 (AUS) [34]

After-school care for children from 3 to 5 pm including a physical activity program

Children, primary school, 5–11 years

School

CUA, using a model approach

Society, lifetime, costs and benefits both at 3 %

Reduction in BMI, increase in physical activity, energy expenditure

2001, AU$, total cost

Lifetime DALYs, Gross cost per:

- DALY saved: AU$ 82,000 [US$ 72,196.51] (net, gross: AU$ 90,000 [US$ 79,240.07]

- BMI unit saved: AU$ 8200 [US$ 7219.65]

Moodie et al. 2011 (AUS) [35]

Lessons, information evenings, promotion of the program

Children, 5th and 6th school years, 10–11 years

School/Community

CUA, using a model approach

Society, lifetime, costs and benefits both at 3 %

Reduction in BMI, increase in physical activity, energy expenditure, DALY

2001, AU$, total costs

Lifetime DALYs, Cost per:

- DALY saved: AU$ 117,000 [US$ 103,012.09] (net, gross: AU$ 125,000 [US$ 110,055.66])

- BMI unit saved: AU$ 13,000 [US$ 11,445.79]

Moodie et al. 2013 (AUS) [30]

Interdisciplinary approach, including nutrition and physical activity and reducing screen time

Children, 4–12 years

School/Community

CUA, using a model approach

Society, lifetime, costs and benefits both at 3 %

Reduction in BMI, DALY

2006, AU$, total costs

Lifetime DALYs, Cost per:

- DALY saved: AU$ 20,227 [US$ 15,478.09] (net, gross: AU$ 22,978 [US$ 17,583.21])

- BMI unit saved: AU$ 399 [US$ 305.32]

Peterson et al. 2008 (USA) [21]

Media campaign

Teenagers, 12–17 years

Society

CEA, using intervention results

Only program costs, not reported, not stated

Questionnaire, extrapolated to population: “contemplated doing more exercise”, “has done more exercise”

No price year, US$, development costs of the program and costs for “product placement”

Cost per person who did more exercise: between US$ 5.11 [US$ 6.68] and US$ 153.19 [US$ 200.12] for the individual sections of the campaign, US$ 8.87 [US$ 11.59] for the whole campaign

Pringle et al. 2010 (UK) [24]

Activity classes, free swimming activities

Population (children 10–17 years)

Community

CUA, using a model approach

Key implementation and running costs, not stated, not stated

Change in MPA, QALY

2003, £, costs/completer improving MPA

Cost per QALY gained

- Activity: £ 94 [US$ 166.07]

- Swimming: £ 103 [US$ 181.97]

NHS savings per completer

- Activity: £ 769 [US$ 1358.59]

- Swimming: £ 2111 [US$ 3729.49]

Rush et al. 2014 (NZ) [37]

Multicomponent through-school physical activity and nutrition program

Primary school children, 6–8 and 9–11 years

School

CUA, using a model approach

Funder’s perspective, lifetime, costs and outcomes both at 3.5 %

QALY, increased life expectancy.

2011, NZ$, lifetime costs, incremental costs

ICER/QALY (older children): NZ$ 24,690 [US$ 16,570.47], ICER/QALY (younger children): NZ$ 30,438 [US$ 20,428.19]

Existing model used to extrapolate the effects and costs

Wang et al. 2003 (USA) [36]

Interdisciplinary approach, lessons, sport materials, wellness, teacher training

Children 6th–8th school year, 11–13 years

School

CUA, using a model approach (calculating additional benefit)

Society, modeling over a 25-year period, costs and benefits both at 3 %

Cases of adult overweight prevented (5.805), QALYs (4.13)

1996, US$, intervention costs, avoided treatment costs, avoided productivity loss costs

Cost per QALY saved: US$ 4305 [US$ 6179.08], Net benefit: US$ 7313 [US$ 10,496.55]

Wang et al. 2008 (USA) [27]

After school program: physical activity, healthy snacks, support with homework, and “academic enrichment”

Children, Elementary school, 6–10 years

School

CEA, using intervention results

Society, 1 year, not stated

% Reduction in body fat

2003, US$, intervention costs, after-school care costs without intervention

US$ 417 [US$ 509.89] per % point body fat reduction

Wang et al. 2011 (USA) [25]

Interdisciplinary approach, lessons, sport materials, wellness, teacher training

Children (6th–8th school year), 11–13 years

School

CUA, using a model approach (calculating additional benefit)

Society, 10 years, costs and benefits both at 3 %

DWCB avoided, QALYs

2010, US$, total costs

Cost per QALY saved (DWCB and obesity combined) = US$ 2966 [US$ 3060.91], net benefit (DWCB + obesity) = US$ 14,238 [US$ 14,693.62]

  1. *Results were adjusted to the year 2011 (year of the study with the newest data) using consumer price index (CPI) as part of the Main Economic Indicators (MEI) of the OECD and purchasing power parity (PPP) conversion rate of the year of the latest intervention to convert numerical results to U.S. dollars
  2. AU$ Australian dollar, AUS Australia, CEA cost-effectiveness analysis, CUA cost–utility analysis, DALY disability adjusted life year, DWCB disordered weight control behaviors, EUR Euro, £ Great British pound, MPA moderate physical activity, NHS national health service, NZ New Zealand, NZ$ New Zealand dollar, QALY quality adjusted life year, USA United States of America, US$ U.S. dollar, WC waist circumference, WHtR waist-to-height ratio