Cost‐Effectiveness of 2 Support Models for a Healthy School Initiative*

Finster, Matthew; Feldman, Jill

doi:10.1111/josh.12931

Cited by 4 publications

(21 citation statements)

References 21 publications

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“…114 Thirty-eight studies evaluated interventions with the main components cutting across multiple intervention categories. 31,38,[52][53][54]60,61,[63][64][65][66][67][68]70,73,75,76,79,80,83,94,[99][100][101][102][107][108][109][110][111]123,125,130,131,134,137,139,140 All but three of these multi-category interventions involved behavioral components: Of the three that did not, one intervention targeted food standards across English schools, 83 while two others sought to change the school drinking water environment in the United States. 73,76 One study considered hypothetical scenarios of reduction in the prevalence of obesity, and no intervention was specified.…”

Section: Key Cost-effectiveness Resultsmentioning

confidence: 99%

“…60,61,67,75,76,106,107,109,111,112,167 The economic evaluation of e-health interventions ("the use of information and communications technology in support of health and health-related fields" 184 ) and interventions with m-health (a subset of ehealth based on mobile wireless technologies 185 ) components at their core emerged only within the past 5 years. 47,48,79,113,114,133,142,171,177 The costing of these interventions reveals contemporary complexities attended by the omission of associated resource use and costs. One study excluded costs relating to research and development of a multicomponent m-health intervention, 133 while another study reported difficulties obtaining similar costs.…”

Section: Study Characteristics Across All Intervention Groupingsmentioning

confidence: 99%

“…Of all the included studies, 18 reported variations of non-anthropometric measures as the primary outcome. 53,[57][58][59]66,72,85,92,113,114,132,133,135,[139][140][141]179,180 In two studies, consequences were measured primarily as a change in the proportion of schools that adhered to a canteen policy, 108 [33][34][35][66][67][68][69][70][71][72][73][74][75][76][77][78][79][84][85][86][87][88][89][90][91][92][93][94][95][96]…”

Section: Estimation Of Consequencesmentioning

confidence: 99%

“…T A B L E 2 Descriptive analysis of the key assessment items for individual studies targeting only prevention. practices, 136 or a change in overall wellness (School Health Index) score, 79 respectively.…”

Section: Estimation Of Consequencesmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of economic evaluations of interventions targeting childhood overweight and obesity

Onyimadu,

Violato,

Astbury

et al. 2023

Obesity Reviews

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Summary This systematic review critically appraised and synthesized evidence from economic evaluations of interventions targeting childhood excess weight. We conducted systematic searches in 11 databases from inception to April 19, 2023. Studies were eligible if they evaluated interventions targeting children up to 18 years and the study intervention(s) targeted childhood excess weight or sought to improve diet or physical activity, regardless of the type of economic evaluation or the underpinning study design. We synthesized evidence using narrative synthesis methods. One‐hundred fifty‐one studies met the eligibility criteria and were classified into three groups based on the intervention approach: prevention‐only (13 studies), prevention and treatment (100 studies), and treatment‐only (38 studies). The predominant setting and study design differed considerably between the three groups of studies. However, compared with usual care, most interventions were deemed cost‐effective. The study participants' ages, sex, and socioeconomic status were crucial to intervention cost‐effectiveness. Interventions whose effects were projected beyond childhood, such as bariatric surgery, lower protein infant formula, and home‐based general practitioner consultations, tended to be cost‐effective. However, cost‐effectiveness was sensitive to the assumptions underlying the persistence and intensity of such effects. Our findings can inform future recommendations on the conduct of economic evaluations of interventions targeting childhood overweight and obesity, as well as practice and policy recommendations.

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Section: Key Cost-effectiveness Resultsmentioning

confidence: 99%

Section: Study Characteristics Across All Intervention Groupingsmentioning

confidence: 99%

Section: Estimation Of Consequencesmentioning

confidence: 99%

Section: Estimation Of Consequencesmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of economic evaluations of interventions targeting childhood overweight and obesity

Onyimadu,

Violato,

Astbury

et al. 2023

Obesity Reviews

View full text Add to dashboard Cite

show abstract

“…As a result, no broad conclusions regarding the value for money offered by implementation interventions applied to public health interventions were possible. Further economic evaluations of public health implementation interventions have emerged since this review [45][46][47][48][49][50]; however, the field of work remains small and studies are highly variable by topic, research design, setting and outcome measure(s). Cost evaluations of public health implementation interventions, especially via cost-effectiveness estimates, are needed to enhance understanding and ultimately to increase the uptake of evidence-based practices across settings [41,43,51,52].…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of a multi-strategy intervention that improves school-based physical activity policy implementation

et al. 2022

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Background Internationally, government policies mandating schools to provide students with opportunities to participate in physical activity are poorly implemented. The multi-component Physically Active Children in Education (PACE) intervention effectively assists schools to implement one such policy. We evaluated the value of investment by health service providers tasked with intervention delivery, and explored where adaptations might be targeted to reduce program costs for scale-up. Methods A prospective trial-based economic evaluation of an implementation intervention in 61 primary schools in New South Wales (NSW), Australia. Schools were randomised to the PACE intervention or a wait-list control. PACE strategies included centralised technical assistance, ongoing consultation, principal's mandated change, identifying and preparing in-school champions, educational outreach visits, and provision of educational materials and equipment. Effectiveness was measured as the mean weekly minutes of physical activity implemented by classroom teachers, recorded in a daily log book at baseline and 12-month follow-up. Delivery costs (reported in $AUD, 2018) were evaluated from a public finance perspective. Cost data were used to calculate: total intervention cost, cost per strategy and incremental cost (overall across all schools and as an average per school). Incremental cost-effectiveness ratios (ICERs) were calculated as the incremental cost of delivering PACE divided by the estimated intervention effect. Results PACE cost the health service provider a total of $35,692 (95% uncertainty interval [UI] $32,411, $38,331) to deliver; an average cost per school of $1151 (95%UI $1046, $1236). Training in-school champions was the largest contributor: $19,437 total; $627 ($0 to $648) average per school. Educational outreach was the second largest contributor: $4992 total; $161 ($0 to $528) average per school. The ICER was $29 (95%UI $17, $64) for every additional minute of weekly physical activity implemented per school. Conclusion PACE is a potentially cost-effective intervention for increasing schools implementation of a policy mandate. The investment required by the health service provider makes use of existing funding and infrastructure; the additional cost to assist schools to implement the policy is likely not that much. PACE strategies may be adapted to substantially improve delivery costs. Trial registration Australia New Zealand Clinical Trials Registry ACTRN12617001265369; Prospectively registered 1st September 2017 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373520

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Use of an activity-based time tracking tool to support implementation of a school district-level technical assistance intervention

Lin,

Offstein,

Malner

et al. 2024

Preprint

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Background. Detailed time and cost data are often lacking in implementation science, particularly in school-based interventions. In a pilot intervention in one Chicago Public Schools’ geographic network, a Network Specialist was hired to provide schools with tailored technical assistance (TA) to support compliance with over 50 health-related policies (the Healthy CPS initiative). This study describes the methods for developing and implementing an activity-based time tracking tool to assess the Network Specialist’s fidelity, time, and cost in providing TA using a Multi-Tiered System of Supports framework (“Tier 1” universal support, “Tier 2” targeted support, and “Tier 3” intensive, individualized support). Methods. The tool was developed in close collaboration with the Network Specialist to capture the Specialist’s interactions with schools between 2020–2023. Key informant interviews and asynchronous post-hoc feedback were qualitatively analyzed to assess the Specialist’s feedback on the tool. Descriptive statistics on school interactions, tiers of support provided, and domains of implementation support provided using the SISTER implementation science framework were generated from the tracking tool data. Differences in mean baseline Healthy CPS policy compliance based on the extent of schools’ interactions with the Specialist in each tier of support were computed using Wald tests. Results. The Specialist described the tracking tool as feasible and useful in providing tailored support and advocated for its continued use as the intervention is expanded to additional networks. The Specialist spent the highest proportion of time and costs (41.4%, $39,117) providing intensive Tier 3 supports, and those supports were targeted toward schools with the most need. Schools receiving the most Tier 3 supports had lower baseline Healthy CPS compliance of 64.4%, versus 78.4% and 67.3% for schools receiving low and medium levels of Tier 3 supports, respectively (p-value = 0.045). Conclusions. Expanded use of time and cost tracking is needed in implementation science, particularly for school-based interventions. Time tracking tools help collect data on intervention activities that inform decision-makers about how to implement interventions with fidelity. Our findings point to the value of using a collaborative, partner-engaged approach to developing the tracking tool with the end user to maximize its feasibility, usefulness, utilization, and sustainability.

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Cost‐Effectiveness of 2 Support Models for a Healthy School Initiative*

Cited by 4 publications

References 21 publications

A systematic review of economic evaluations of interventions targeting childhood overweight and obesity

A systematic review of economic evaluations of interventions targeting childhood overweight and obesity

Economic evaluation of a multi-strategy intervention that improves school-based physical activity policy implementation

Use of an activity-based time tracking tool to support implementation of a school district-level technical assistance intervention

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