Cost Effectiveness of Community-Based Physical Activity Interventions

Roux, Larissa; Pratt, Michael; Tengs, Tammy O.; Yore, Michelle M.; Yanagawa, Teri L.; Bos, Jill Van Den; Rutt, Candace; Brownson, Ross C.; Powell, Kenneth E.; Heath, Gregory W.; Kohl, Harold W.; Teutsch, Steven M.; Cawley, John; Lee, I.-Min; West, Linda; Buchner, David M.

doi:10.1016/j.amepre.2008.06.040

Cited by 259 publications

(299 citation statements)

References 39 publications

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“…Based on the recent data it has been estimated that 17-91% of adults living in developing countries and 4-85% in developed countries do not meet the WHO's physical activity guidelines for the healthy levels of physical activity recommended by WHO (EUphact, 2008;Oldridge, 2008;WHO Global Status Report NCDs, 2010). For example, the prevalence of physical inactivity was the highest among Canadian adults (85%), followed by EU members (71%), Argentina population (68%), Polish adults (64%), English adults (63%), Americans (54.1%), South Africans (52%), the people living in France (33%), China (31.1%) (aged 15-69), Thailand (19%), Mongolia (9%), and Bangladesh less than 10% (Martin et al, 2001;Saris et al, 2004;Roux et al, 2008;Drygas et al, 2009;WHO Global Status Report NCDs, 2010;Colley et al, 2011;Department of Health, 2011;Australian Bureau of Statistic 2012;Rishiraj, 2013;Zhang and Chaaban, 2013). These data show that physical inactivity have reached epidemic state in developed countries.…”

Section: Health and Economic Costs Of Physical Inactivity Joanna Krukmentioning

confidence: 99%

“…Also, Cadilhac and co-workers (2011) have developed simulation models that show that a 10% reduction in physical inactivity causes the decrease of incident cases of disease by 6000 deaths during 2000 and total cost savings of AUD 258 million. Similarly, the calculated cost-effectiveness of interventions by Roux et al (2008) in order to promote adequate physical activity, although a high (ranged between $14000 and $69000 per quality-adjusted life year) appears profitable. This authors estimate the following considerable reduction of civilization diseases incidence per 100,000: 5-15 cases for colorectal cancer, 15-58 cases for breast cancer, 59-207 cases for diabetes type 2, and 140-476 cases for coronary heart disease over lifetime.…”

Section: Costs Of Physical Inactivitymentioning

confidence: 99%

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Health and Economic Costs of Physical Inactivity

Kruk

2014

Asian Pacific Journal of Cancer Prevention

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Section: Health and Economic Costs Of Physical Inactivity Joanna Krukmentioning

confidence: 99%

Section: Costs Of Physical Inactivitymentioning

confidence: 99%

Health and Economic Costs of Physical Inactivity

Kruk

2014

Asian Pacific Journal of Cancer Prevention

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“…122 Population interventions tend to work quickly 77,78 and to be cost saving. 53,73,101 Structural changes to avoid chronic diseases are now favoured from several sides. 137 The growing literature of the possible impact of structural strategies on health signals a paradigm shift in CVD prevention.…”

Section: Discussionmentioning

confidence: 99%

“…A simulation study showed that change in environment to support more active lifestyle was cost-effective. 101 Public perception of the importance of physical activity is still relative low in some countries, e.g. Croatia.…”

Section: Physical Inactivitymentioning

confidence: 99%

Population-level changes to promote cardiovascular health

Jørgensen

Capewell

Prescott

et al. 2012

Eur J Prev Cardiolog

125

107

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Background: Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD. Design and Methods: Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol). Results: Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life. Conclusion: Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.

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“…These results are comparable with the cost-effectiveness of community-based PA (US$14,000-69,000 per QALY) and behavioural (US$235-30,419 per QALY) interventions found in previous reviews. 118,119 In the medium-term analysis, the results of the hypothetical control scenarios in which the RCT comparison group 12-month data were extrapolated, after excluding the 11% of men who lost ≥ 5% weight at 12 months (scenarios 4 and 5), do not triangulate with the scenarios in which baseline data are extrapolated (base case and scenario 1), as we might have expected. (These scenarios all take into account the fact that the comparison group lost weight during the RCT.…”

Section: Medium-term and Lifetime Cost-effectiveness Of The Football mentioning

confidence: 99%

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

et al. 2018

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Background Rising levels of obesity require interventions that support people in long-term weight loss. The Football Fans in Training (FFIT) programme uses loyalty to football teams to engage men in weight loss. In 2011/12, a randomised controlled trial (RCT) found that the FFIT programme was effective in helping men lose weight up to 12 months. Objectives To investigate the long-term weight, and other physical, behavioural and psychological outcomes up to 3.5 years after the start of the RCT; the predictors, mediators and men’s qualitative experiences of long-term weight loss; cost-effectiveness; and the potential for long-term follow-up via men’s medical records. Design A mixed-methods, longitudinal cohort study. Setting Thirteen professional Scottish football clubs from the RCT and 16 additional Scottish football clubs that delivered the FFIT programme in 2015/16. Participants A total of 665 men who were aged 35–65 years at the RCT baseline measures and who consented to follow-up after the RCT (intervention group, n = 316; comparison group, n = 349), and 511 men who took part in the 2015/16 deliveries of the FFIT programme. Interventions None as part of this study. Main outcome measures Objectively measured weight change from the RCT baseline to 3.5 years. Results In total, 488 out of 665 men (73.4%) attended 3.5-year measurements. Participants in the FFIT follow-up intervention group sustained a mean weight loss from baseline of 2.90 kg [95% confidence interval (CI) 1.78 to 4.02 kg; p < 0.001], and 32.2% (75/233) weighed ≥ 5% less than at baseline. Participants in the FFIT follow-up comparison group (who participated in routine deliveries of the FFIT programme after the RCT) lost a mean of 2.71 kg (95% CI 1.65 to 3.77 kg; p < 0.001), and 31.8% (81/255) achieved ≥ 5% weight loss. Both groups showed long-term improvements in body mass index, waist circumference, percentage body fat, blood pressure, self-reported physical activity (PA) (including walking), the consumption of fatty and sugary foods, fruit and vegetables and alcohol, portion sizes, self-esteem, positive and negative affect, and physical and mental health-related quality of life (HRQoL). Mediators included self-reported PA (including walking) and sitting time, the consumption of fatty and sugary foods and fruit and vegetables, portion sizes, self-esteem, positive affect, physical HRQoL, self-monitoring of weight, autonomous regulation, internal locus of control, perceived competence, and relatedness to other FFIT programme participants and family members. In qualitative interviews, men described continuing to self-monitor weight and PA. Many felt that PA was important for weight control, and walking remained popular; most were still aware of portion sizes and tried to eat fewer snacks. The FFIT programme was associated with an incremental cost-effectiveness of £10,700–15,300 per quality-adjusted life-year (QALY) gained at 3.5 years, and around £2000 per QALY gained in the lifetime analysis. Medical record linkage provided rich information about the clinical health outcomes of the FFIT RCT participants, and 90% of men (459/511) who took part in the 2015/16 FFIT programme gave permission for future linkage. Conclusions Participation in the FFIT programme under both research (during the FFIT RCT) and routine (after the FFIT RCT) delivery conditions led to significant long-term weight loss. Further research should investigate (1) how to design programmes to improve long-term weight loss maintenance, (2) longer-term follow-up of FFIT RCT participants and (3) very long-term follow-up via medical record linkage. Trial registration Current Controlled Trials ISRCTN32677491. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 9. See the NIHR Journals Library website for further project information. The Scottish Executive Health Department Chief Scientist Office (CSO) funded the feasibility pilot that preceded the FFIT RCT (CZG/2/504). The Medical Research Council (MRC) funded Kate Hunt and additional developmental research through the MRC/CSO Social and Public Health Sciences Unit Gender and Health programme (5TK50/25605200-68094).

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Cost Effectiveness of Community-Based Physical Activity Interventions

Cited by 259 publications

References 39 publications

Health and Economic Costs of Physical Inactivity

Health and Economic Costs of Physical Inactivity

Population-level changes to promote cardiovascular health

Long-term weight loss following a randomised controlled trial of a weight management programme for men delivered through professional football clubs: the Football Fans in Training follow-up study

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