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Economic evaluation of a childhood obesity prevention programme for children: Results from the WAVES cluster randomised controlled trial conducted in schools

Author

Listed:
  • Alastair Canaway
  • Emma Frew
  • Emma Lancashire
  • Miranda Pallan
  • Karla Hemming
  • Peymane Adab
  • on behalf of the WAVES trial investigators

Abstract

Background: Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6–7 years when compared to ‘usual activities’. Methods: A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves. Results: At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective. Conclusions: The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention. Trial registration: This paper uses data collected by the WAVES trial: Controlled trials ISRCTN97000586 (registered May 2010).

Suggested Citation

  • Alastair Canaway & Emma Frew & Emma Lancashire & Miranda Pallan & Karla Hemming & Peymane Adab & on behalf of the WAVES trial investigators, 2019. "Economic evaluation of a childhood obesity prevention programme for children: Results from the WAVES cluster randomised controlled trial conducted in schools," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-14, July.
    • Handle: RePEc:plo:pone00:0219500
    DOI: 10.1371/journal.pone.0219500
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    References listed on IDEAS

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    1. Manuel Gomes & Karla Díaz-Ordaz & Richard Grieve & Michael G. Kenward, 2013. "Multiple Imputation Methods for Handling Missing Data in Cost-effectiveness Analyses That Use Data from Hierarchical Studies," Medical Decision Making, , vol. 33(8), pages 1051-1063, November.
    2. Manuel Gomes & Edmond S.-W. Ng & Richard Grieve & Richard Nixon & James Carpenter & Simon G. Thompson, 2012. "Developing Appropriate Methods for Cost-Effectiveness Analysis of Cluster Randomized Trials," Medical Decision Making, , vol. 32(2), pages 350-361, March.
    3. Dorothea Kesztyüs & Anja Schreiber & Tamara Wirt & Martina Wiedom & Jens Dreyhaupt & Susanne Brandstetter & Benjamin Koch & Olivia Wartha & Rainer Muche & Martin Wabitsch & Reinhold Kilian & Jürgen St, 2013. "Economic evaluation of URMEL-ICE, a school-based overweight prevention programme comprising metabolism, exercise and lifestyle intervention in children," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 185-195, April.
    4. Katherine Stevens, 2012. "Valuation of the Child Health Utility 9D Index," PharmacoEconomics, Springer, vol. 30(8), pages 729-747, August.
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    Cited by:

    1. Gudrun M. W. Bjørnelv & Vidar Halsteinli & Bård E. Kulseng & Diana Sonntag & Rønnaug A. Ødegaard, 2021. "Modeling Obesity in Norway (The MOON Study): A Decision-Analytic Approach—Prevalence, Costs, and Years of Life Lost," Medical Decision Making, , vol. 41(1), pages 21-36, January.
    2. Patricia E Jessiman & Katie Powell & Philippa Williams & Hannah Fairbrother & Mary Crowder & Joanna G Williams & Ruth Kipping, 2021. "A systems map of the determinants of child health inequalities in England at the local level," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-25, February.

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