Cost and Cost-Effectiveness of Students for Nutrition and eXercise (SNaX)

详细信息    查看全文

• 作者：Joseph A. Ladapo ; MD ; PhD^a ; ^b ; ^{joseph.ladapo@nyumc.org" class="auth_mail" title="E-mail the corresponding author} ; Laura M. Bogart ; PhD^c ; ^d ; ^e ; David J. Klein ; MS^c ; ^e ; Burton O. Cowgill ; PhD ; MPH^f ; Kimberly Uyeda ; MD ; MPH^g ; David G. Binkle ; MPA^h ; Elizabeth R. Stevens ; MPH^b ; Mark A. Schuster ; MD ; PhD^c ; ^d
• 关键词：adolescents ; cost ; cost-effectiveness ; fruits ; health promotion ; nutrition ; schools ; vegetables
• 刊名：Academic Pediatrics
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：16
• 期：3
• 页码：247-253
• 全文大小：187 K

文摘

To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle school–based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education.

Methods

Five intervention and 5 control middle schools (mean enrollment, 1520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes.

Results

The costs of implementing the program over 5 weeks were $5433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold.

Conclusions

SNaX demonstrated the feasibility and cost-effectiveness of a middle school–based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation.