TY  - JOUR
PY  - 2020//
TI  - Lifetime cost-effectiveness and equity impacts of the Healthy Primary School of the Future initiative
JO  - BMC public health
A1  - Oosterhoff, Marije
A1  - Over, Eelco A. B.
A1  - van Giessen, Anoukh
A1  - Hoogenveen, Rudolf T.
A1  - Bosma, Hans
A1  - van Schayck, Onno C. P.
A1  - Joore, Manuela A.
SP  - e1887
EP  - e1887
VL  - 20
IS  - 1
N2  - BACKGROUND: This study estimated the lifetime cost-effectiveness and equity impacts associated with two lifestyle interventions in the Dutch primary school setting (targeting 4-12 year olds).     METHODS: The Healthy Primary School of the Future (HPSF; a healthy school lunch and structured physical activity) and the Physical Activity School (PAS; structured physical activity) were compared to the regular Dutch curriculum (N = 1676). An adolescence model, calculating weight development, and the RIVM Chronic Disease Model, calculating overweight-related chronic diseases, were linked to estimate the lifetime impact on chronic diseases, quality adjusted life years (QALYs), healthcare, and productivity costs. Cost-effectiveness was expressed as the additional costs/QALY gained and we used €20,000 as threshold. Scenario analyses accounted for alternative effect maintenance scenarios and equity analyses examined cost-effectiveness in different socioeconomic status (SES) groups.     RESULTS: HPSF resulted in a lifetime costs of €773 (societal perspective) and a lifetime QALY gain of 0.039 per child versus control schools. HPSF led to lower costs and more QALYs as compared to PAS. From a societal perspective, HPSF had a cost/QALY gained of €19,734 versus control schools, 50% probability of being cost-effective, and beneficial equity impact (0.02 QALYs gained/child for low versus high SES). The cost-effectiveness threshold was surpassed when intervention effects decayed over time.     CONCLUSIONS: HPSF may be a cost-effective and equitable strategy for combatting the lifetime burden of unhealthy lifestyles. The win-win situation will, however, only be realised if the intervention effect is sustained into adulthood for all SES groups.     TRIAL REGISTRATION: Clinicaltrials.gov ( NCT02800616 ). Registered 15 June 2016 - Retrospectively registered.<p />  <p>Language: en</p>
LA  - en
SN  - 1471-2458
UR  - http://dx.doi.org/10.1186/s12889-020-09744-9
ID  - ref1
ER  -