Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Mar 20;18(1):378.
doi: 10.1186/s12889-018-5315-y.

Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness

Kathryn L Reilly  1   2   3   4 , Penny Reeves  5   6 , Simon Deeming  5   6 , Sze Lin Yoong  5   6   7   8 , Luke Wolfenden  5   6   7   8 , Nicole Nathan  5   6   7   8 , John Wiggers  5   6   7   8
Affiliations
Randomized Controlled Trial

Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness

Kathryn L Reilly et al. BMC Public Health. .

Abstract

Background: No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy.

Methods: An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy.

Results: The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness.

Conclusions: The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

Keywords: Childhood obesity; Economic evaluation; Healthy eating policies; Implementation strategies.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Approval to conduct the study was obtained from the Hunter New England Human Research Ethics Committee (no. 06/07/26/4.04), The University of Newcastle Human Research Ethics Committee (Approval Number H-2008-0343) as well as the NSW Department of Education and the relevant Catholic Schools Offices.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Incremental Cost Effectiveness Ratios for the three trials
Fig. 2
Fig. 2
Sensitivity Analysis for high intensity and medium intensity interventions
Fig. 3
Fig. 3
Indirect comparison between High Intensity Intervention and Medium Intensity Intervention
See this image and copyright information in PMC

References

    1. GBD 2013 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386:2287–2323. doi: 10.1016/S0140-6736(15)00128-2. - DOI - PMC - PubMed
    1. Australian Institute of Health and Welfare 2014. Australia’s health 2014. Australia’s health series no. 14. Cat. No. AUS 178. Canberra: AIHW. 2014.
    1. Magarey AMDL, Boulton TJ. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust. 2001;174(11):561–564. - PubMed
    1. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993;22(2):167–177. doi: 10.1006/pmed.1993.1014. - DOI - PubMed
    1. Withrow D, Alter DA. The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obes Rev. 2011;12(2):131–141. doi: 10.1111/j.1467-789X.2009.00712.x. - DOI - PubMed

Publication types

LinkOut - more resources