The effectiveness and cost-effectiveness of a complex community sport intervention to increase physical activity: an interrupted time series design

Abstract

Objectives: An effectiveness and cost-effectiveness analyses of two-staged community sports interventions; taster sports sessions compared with portfolio of community sport sessions.

Design: Quasi-experiment using an interrupted time series design.

Setting: Community sports projects delivered by eight lead partners in London Borough of Hounslow, UK.

Participants: Inactive people aged 14 plus years (n=246) were recruited between May 2013 and February 2014.

Interventions: Community sports interventions delivered in two stages, 6-week programme of taster sport sessions (stage 1) and 6-week programme of portfolio of community sporting sessions delivered by trained coaches (stage 2).

Outcome measures: (a) Change in days with ≥30 min of self-reported vigorous intensity physical activity (PA), moderate intensity PA, walking and sport; and (b) change in subjective well-being and EQ5D5L quality-adjusted life-years (QALYs).

Methods: Interrupted time series analysis evaluated the effectiveness of the two-staged sports programmes. Cost-effectiveness analysis compares stage 2 with stage 1 from a provider's perspective, reporting outcomes of incremental cost per QALY (2015/2016 price year). Uncertainty was assessed using deterministic and probabilistic sensitivity analyses.

Results: Compared with stage 1, counterfactual change at 21 days in PA was lower for vigorous (log odds: -0.52; 95% CI -1 to -0.03), moderate PA (-0.50; 95% CI 0.94 to 0.05) and sport(-0.56; 95% CI -1.02 to -0.10). Stage 2 increased walking (0.28; 95% CI 0.3 to 0.52). Effect overtime was similar. Counterfactual change at 21 days in well-being was positive particularly for 'happiness' (0.29; 95% CI 0.06 to 0.51). Stage 2 was more expensive (£101 per participant) but increased QALYs (0.001; 95% CI -0.034 to 0.036). Cost per QALY for stage 2 was £50 000 and has 29% chance of being cost-effective (£30 000 threshold).

Conclusion: Community-based sport interventions could increase PA among inactive people. Less intensive sports sessions may be more effective and cost-effective.

Keywords: complex community sport intervention; cost; interrupted time series; quasi experimental design; sports, physical activity,.