Background While school-based health prevention programmes are effective in addressing unhealthy diet and physical inactivity, little is known about their economic implications. We conducted an economic evaluation of the programmes that were previously identified as feasible, acceptable, and sustainable in the Canadian context. Methods This study builds on a meta-analysis of the effectiveness of feasible, acceptable, and sustainable school-based health promotion programmes. A micro-simulation model incorporated intervention effects on multiple risk factors to estimate incremental cost-effectiveness and return on investment (ROI) of comprehensive school health (CSH), multicomponent, and physical education (PE) curriculum modification programmes. Cost-effectiveness was expressed as the programme costs below which the programme would be cost-effective at a CA$50 000 threshold level. Results The estimated costs below which interventions were cost-effective per quality-adjusted life year gained were CA$682, CA$444, and CA$416 per student for CSH, multicomponent, and PE curriculum modification programmes, respectively. CSH programmes remained cost-effective per year of chronic disease prevented for costs of up to CA$3384 per student, compared to CA$1911 and CA$1987 for multicomponent and PE curriculum modification interventions, respectively. If the interventions were implemented at total discounted intervention costs of CA$100 per student, ROI through the avoidance of direct healthcare costs related to the treatment and management of chronic diseases would be 824% for CSH, 465% for multicomponent interventions, and 484% for PE curriculum modification interventions. Conclusions Whereas each examined intervention types showed favourable economic benefits, CSH programmes appeared to be the most cost-effective and to have the highest ROI.

中文翻译：

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学校慢性病预防健康促进计划的成本效益和投资回报


背景 虽然以学校为基础的健康预防计划可以有效解决不健康饮食和缺乏身体活动的问题，但对其经济影响却知之甚少。我们对之前被认为在加拿大背景下可行、可接受和可持续的计划进行了经济评估。方法 本研究建立在对可行、可接受和可持续的学校健康促进计划有效性的荟萃分析的基础上。微观模拟模型结合了对多个风险因素的干预效果，以估计综合学校健康 (CSH)、多组成部分和体育 (PE) 课程修改计划的增量成本效益和投资回报 (ROI)。成本效益表示为计划成本，低于该成本计划在 50 000 加元的阈值水平上将具有成本效益。结果 CSH、多组成部分和体育课程修改计划的估计成本分别为每名学生 682 加元、444 加元和 416 加元，低于该干预措施的成本效益的每个获得的质量调整生命年。 CSH 项目每年预防慢性疾病仍具有成本效益，每位学生的成本高达 3384 加元，而多成分和体育课程修改干预措施的成本分别为 1911 加元和 1987 加元。如果以每位学生 100 加元的总折扣干预成本实施干预措施，则通过避免与慢性病治疗和管理相关的直接医疗费用，CSH 的投资回报率为 824%，多成分干预措施为 465%，而慢性病治疗为 484%。体育课程修改干预。 结论 虽然每种检查的干预类型都显示出良好的经济效益，但 CSH 计划似乎最具成本效益且具有最高的投资回报率。