The cost-effectiveness of a successful community-based obesity prevention program: The be active eat well program

摘要

Objective To examine the cost-effectiveness of Be Active Eat Well (BAEW), a large, multifaceted, community-based capacity-building demonstration program that promoted healthy eating and physical activity for Australian children aged 4-12 years between 2003 and 2006. Design and Methods A quasi-experimental, longitudinal design was used with anthropometric data collected at baseline (1001 children - intervention; 1183 - comparator) and follow-up. A societal perspective was employed, with intervention resource use measured retrospectively based on process evaluation reports, school newsletters, reports, and key stakeholder interviews, and valued in 2006 Australian dollars (AUD). Outcomes were measured as Body Mass Index (BMI) units saved and Disability Adjusted Life Years (DALYs) averted over the predicted cohort lifetime, and reported as incremental cost-effectiveness ratios (with 95% uncertainty intervals). Results The intervention cost AUD0.34M ($0.31M; $0.38M) annually, and resulted in savings of 547 (-104; 1209) BMI units and 10.2 (-0.19; 21.6) DALYs. This translated to modest cost offsets of AUD27 311 ($1803; $58 242) and a net cost per DALY saved of AUD29 798 (dominated; $0.26M). Conclusions BAEW was affordable and cost-effective, and generated substantial spin-offs in terms of activity beyond funding levels. Elements fundamental to its success and any potential cost efficiencies associated with scaling-up now require identification.