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Meta-Analysis
. 2021 Feb 2;18(3):1356.
doi: 10.3390/ijerph18031356.

A Systematic Review of Economic Evaluations of Health-Promoting Food Retail-Based Interventions

Affiliations
Meta-Analysis

A Systematic Review of Economic Evaluations of Health-Promoting Food Retail-Based Interventions

Huong Ngoc Quynh Tran et al. Int J Environ Res Public Health. .

Abstract

Background: While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations.

Methods: A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results: Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption.

Conclusion: The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.

Keywords: economic evaluation; food retail intervention; healthy diet; obesity prevention.

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Conflict of interest statement

The authors declare no conflicts of interest. The sponsors had no role in the design, execution, interpretation, or writing of the study.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart summarising the inclusion and exclusion process.
Figure 2
Figure 2
Intervention effect pathway and assumptions. Notes: DALYs: Disability-adjusted life years, QALYs: Quality-adjusted life years.

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