Evidence map›Paper›PMID 28542399›Full record

ArticlePloS one2017

Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach.

John Paul Ekwaru, Arto Ohinmaa, Bach Xuan Tran, Solmaz Setayeshgar, Jeffrey A Johnson, Paul J Veugelers

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In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Methods for the economic evaluation of obesity prevention dietary interventions in children: A systematic review and critical appraisal of the evidence.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022
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  12. Can school-based physical activity foster social mobility?Canadian journal of public health = Revue canadienne de sante publique · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

John Paul EkwaruSchool of Public Health, University of Alberta, Edmonton, Alberta, Canada.ORCID http://orcid.org/0000-0001-7385-4769
Arto OhinmaaSchool of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Bach Xuan TranInstitute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Solmaz SetayeshgarSchool of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Jeffrey A JohnsonSchool of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Paul J VeugelersSchool of Public Health, University of Alberta, Edmonton, Alberta, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach.

methodsWe developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY), from a school system's cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate.

resultsThe incremental cost-effectiveness ratio(ICER) of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER < CA$50,000. In probabilistic sensitivity analysis, APPLE Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICER<CA$50,000, and more than 93% of the time when using a threshold of ICER<CA$100,000.

conclusionSchool-based health promotion, such as APPLE Schools is a cost-effective intervention for obesity prevention and reduction of chronic disease risk over the lifetime. Expanding the coverage and allocating resources towards school-based programs like the APPLE Schools program, is likely to reduce the public health burden of obesity and chronic diseases.

Indexed as

Cost-Benefit AnalysisModels, TheoreticalBody WeightCanadaChildHumansMarkov ChainsOutcome Assessment, Health CareProbabilityQuality-Adjusted Life YearsSchool Health ServicesSchools

Identifiers

PMID28542399
PMCPMC5436822

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.