The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China

Liping Meng; Haiquan Xu; Ailing Liu; Joop van Raaij; Wanda Bemelmans; Xiaoqi Hu; Qian Zhang; Songming Du; Hongyun Fang; Jun Ma; Guifa Xu; Ying Li; Hongwei Guo; Lin Du; Guansheng Ma

doi:10.1371/journal.pone.0077971

The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China

PLoS One. 2013 Oct 18;8(10):e77971. doi: 10.1371/journal.pone.0077971. eCollection 2013.

Authors

Liping Meng¹, Haiquan Xu, Ailing Liu, Joop van Raaij, Wanda Bemelmans, Xiaoqi Hu, Qian Zhang, Songming Du, Hongyun Fang, Jun Ma, Guifa Xu, Ying Li, Hongwei Guo, Lin Du, Guansheng Ma

Affiliation

¹ National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China.

Abstract

Background: The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA) is more cost-effective than the same intensity of single intervention.

Methods: And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its' control group were located in other 5 cities. In nutrition education group, 'nutrition and health classes' were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m(2) (SE 0.09) and 0.01 (SE 0.11) in the combined intervention, respectively, significantly lower than that in its' control group (0.82 ± 0.09 for BMI, 0.10 ± 0.11 for BAZ). No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its' control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively.

Conclusions: The school-based integrated obesity intervention program was cost-effectiveness for children in urban China.

Trial registration: Chinese Clinical Trial Registry ChiCTR-PRC-09000402 URL:http://www.chictr.org/cn/

Publication types

Comparative Study
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Case-Control Studies
Child
China
Cost-Benefit Analysis*
Exercise*
Female
Follow-Up Studies
Health Education*
Health Promotion
Humans
Male
Outcome Assessment, Health Care
Pediatric Obesity / economics*
Pediatric Obesity / prevention & control
Schools / economics*

Associated data

ChiCTR/PRC-09000402

Grants and funding

This project has been funded by China Ministry of Science & Technology as “Key Projects in the National Science & Technology Pillar Program during the Eleventh Five-Year Plan Period”, grant number 2008BAI58B05. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.