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Gc, Vijay S., Suhrcke, Marc, Atkin, Andrew J. 
ORCID: https://orcid.org/0000-0002-3819-3448, van Sluijs, Esther M. F. and Turner, David ORCID: https://orcid.org/0000-0002-1689-4147
(2019)
The cost-effectiveness of physical activity interventions in adolescents: model development and illustration using two exemplar interventions.
BMJ Open, 9 (8).
ISSN 2044-6055
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Abstract
Objective : To develop a model to assess the long-term costs and health outcomes of physical activity interventions targeting adolescents. Design : A Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken. Setting : School and community Participants : A hypothetical cohort of adolescents aged 16 years at baseline. Interventions : Two exemplar school-based: a comparatively simple, after-school intervention and a more complex multi-component intervention compared to usual care. Primary and secondary outcome measures: Incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained. Results : The model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time. Conclusions : The model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
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