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Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

Department of Economics, University of New Mexico, Albuquerque, NM 87131, USA
Institute of Gerontology, College of Public Health, The University of Georgia, Athens, GA 30606, USA
Center for Population Health and Aging, Texas A&M School of Public Health, College Station, TX 77842, USA
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2017, 14(5), 545;
Received: 28 March 2017 / Revised: 16 May 2017 / Accepted: 17 May 2017 / Published: 20 May 2017
(This article belongs to the Special Issue Aging and Health Promotion)
PDF [326 KB, uploaded 23 May 2017]


The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select, a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days (p < 0.05) over the 12-week program. Cost-effectiveness ratios ranged from $1374 to $1452 per QALY gained. The reported cost-effective ratios are well within the common cost-effectiveness threshold of $50,000 for a gained QALY. Some sociodemographic differences were also observed in program impact and cost. Non-Hispanic whites experienced significant improvements in healthy days from baseline to the follow-up period and had higher cost-effectiveness ratios. Results indicate that the Texercise Select program is a cost-effective strategy for increasing physical activity and improving healthy dietary practices among older adults as compared to similar health promotion interventions. In line with the significant improvement in healthy days, physical activity and nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits. View Full-Text
Keywords: cost-effectiveness; program dissemination; physical activity; nutrition; Timed Up-and-Go; healthy days; EuroQol cost-effectiveness; program dissemination; physical activity; nutrition; Timed Up-and-Go; healthy days; EuroQol
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Akanni, O.O.; Smith, M.L.; Ory, M.G. Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select. Int. J. Environ. Res. Public Health 2017, 14, 545.

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