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Open AccessFeature PaperArticle

An Enhanced Approach for Economic Evaluation of Long-Term Benefits of School-Based Health Promotion Programs

School of Public Health, University of Alberta, 3-50 University Terrace, 8303–112 St, Edmonton, AB T6G 2T4, Canada
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Nutrients 2020, 12(4), 1101; https://doi.org/10.3390/nu12041101
Received: 31 March 2020 / Revised: 10 April 2020 / Accepted: 12 April 2020 / Published: 16 April 2020
(This article belongs to the Section Nutrition and Public Health)
Chronic diseases constitute a tremendous public health burden globally. Poor nutrition, inactive lifestyles, and obesity are established independent risk factors for chronic diseases. Public health decision-makers are in desperate need of effective and cost-effective programs that prevent chronic diseases. To date, most economic evaluations consider the effect of these programs on body weight, without considering their effects on other risk factors (nutrition and physical activity). We propose an economic evaluation approach that considers program effects on multiple risk factors rather than on a single risk factor. For demonstration, we developed an enhanced model that incorporates health promotion program effects on four risk factors (weight status, physical activity, and fruit and vegetable consumption). Relative to this enhanced model, a model that considered only the effect on weight status produced incremental cost-effectiveness ratio (ICER) estimates for quality-adjusted life years that were 1% to 43% higher, and ICER estimates for years with chronic disease prevented that were 1% to 26% higher. The corresponding estimates for return on investment were 1% to 20% lower. To avoid an underestimation of the economic benefits of chronic disease prevention programs, we recommend economic evaluations consider program effects on multiple risk factors. View Full-Text
Keywords: economic evaluation; school health; health promotion; chronic disease prevention; economic evaluation method; cost-effectiveness; return on investment; weight status; physical activity; nutrition; vegetables; fruits economic evaluation; school health; health promotion; chronic disease prevention; economic evaluation method; cost-effectiveness; return on investment; weight status; physical activity; nutrition; vegetables; fruits
MDPI and ACS Style

Ekwaru, J.P.; Ohinmaa, A.; Veugelers, P.J. An Enhanced Approach for Economic Evaluation of Long-Term Benefits of School-Based Health Promotion Programs. Nutrients 2020, 12, 1101.

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