The Short-Term Value of the "Healthy Primary School of the Future" Initiative: A Social Return on Investment Analysis

Marije Oosterhoff; Onno C P van Schayck; Nina H M Bartelink; Hans Bosma; Maartje Willeboordse; Bjorn Winkens; Manuela A Joore

doi:10.3389/fpubh.2020.00401

The Short-Term Value of the "Healthy Primary School of the Future" Initiative: A Social Return on Investment Analysis

Front Public Health. 2020 Aug 21:8:401. doi: 10.3389/fpubh.2020.00401. eCollection 2020.

Authors

Marije Oosterhoff¹, Onno C P van Schayck², Nina H M Bartelink³, Hans Bosma⁴, Maartje Willeboordse², Bjorn Winkens⁵, Manuela A Joore¹

Affiliations

¹ Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
² Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
³ Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
⁴ Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
⁵ Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.

Abstract

Background: This study examines the social return on investment (SROI) of the "Healthy Primary School of the Future" initiative after 2 years. Methods: Healthy Primary Schools of the Future (HPSF) provide a healthy lunch and daily structured physical activity sessions, whereas Physical Activity Schools (PAS) focus on physical activity only. We evaluated the 2-years investments and effects (N = 1,676 children) of both school environments (four schools) compared to control schools (four schools). Investments and outcomes were grouped within the healthcare, education, household & leisure, and labor & social security sector. Outcomes that could be expressed in monetary terms were used for the calculation of social return on investment. Results: HPSF and PAS created outcomes for the healthcare sector by favorable changes in health behaviors, body mass index [both significant], and medical resource use [not significant]. Outcomes for the education sector included a favorable impact on perceived social behaviors and school satisfaction, and absenteeism from school [latter not significant], and more engagement with the community was experienced. The per child investments, €859 (HPSF) and €1017 (PAS), generated a benefit of €8 (HPSF) and €49 (PAS) due to reduced school absenteeism and medical resource use. Conclusions: Within 2 years of intervention implementation, the HPSF initiative created outcomes in several sectors, but the benefits did not outweigh the investments. Follow-up assessments as well as modeling long-term outcomes are needed to assess the total value of the interventions. Until then, the SROI framework can inform strategies for obtaining stakeholder support and intervention implementation. Trial registration: The study was registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616).

Keywords: child; economic evaluation; health promoting schools; health promotion/economics; social return on investment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Exercise*
Health Behavior
Humans
Lunch
Schools*

Associated data

ClinicalTrials.gov/NCT02800616