Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study
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{"title"=>"Cost-effectiveness of interventions to promote physical activity: A modelling study", "type"=>"journal", "authors"=>[{"first_name"=>"Linda J.", "last_name"=>"Cobiac", "scopus_author_id"=>"35108698100"}, {"first_name"=>"Theo", "last_name"=>"Vos", "scopus_author_id"=>"7003628012"}, {"first_name"=>"Jan J.", "last_name"=>"Barendregt", "scopus_author_id"=>"7006040458"}], "year"=>2009, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-68049135973", "sgr"=>"68049135973", "pui"=>"355033310", "isbn"=>"1549-1676", "pmid"=>"19597537", "doi"=>"10.1371/journal.pmed.1000110"}, "id"=>"a13ee035-7325-38a4-b5f4-a9997aad5ee5", "abstract"=>"Background: Physical inactivity is a key risk factor for chronic disease, but a growing number of people are not achieving the recommended levels of physical activity necessary for good health. Australians are no exception; despite Australia's image as a sporting nation, with success at the elite level, the majority of Australians do not get enough physical activity. There are many options for intervention, from individually tailored advice, such as counselling from a general practitioner, to population-wide approaches, such as mass media campaigns, but the most cost-effective mix of interventions is unknown. In this study we evaluate the cost-effectiveness of interventions to promote physical activity.Methods and Findings: From evidence of intervention efficacy in the physical activity literature and evaluation of the health sector costs of intervention and disease treatment, we model the cost impacts and health outcomes of six physical activity interventions, over the lifetime of the Australian population. We then determine cost-effectiveness of each intervention against current practice for physical activity intervention in Australia and derive the optimal pathway for implementation. Based on current evidence of intervention effectiveness, the intervention programs that encourage use of pedometers (Dominant) and mass media-based community campaigns (Dominant) are the most cost-effective strategies to implement and are very likely to be cost-saving. The internet-based intervention program (AUS$3,000/DALY), the GP physical activity prescription program (AUS$12,000/DALY), and the program to encourage more active transport (AUS$20,000/DALY), although less likely to be cost-saving, have a high probability of being under a AUS$50,000 per DALY threshold. GP referral to an exercise physiologist (AUS$79,000/DALY) is the least cost-effective option if high time and travel costs for patients in screening and consulting an exercise physiologist are considered.Conclusions: Intervention to promote physical activity is recommended as a public health measure. Despite substantial variability in the quantity and quality of evidence on intervention effectiveness, and uncertainty about the long-term sustainability of behavioural changes, it is highly likely that as a package, all six interventions could lead to substantial improvement in population health at a cost saving to the health sector.", "link"=>"http://www.mendeley.com/research/costeffectiveness-interventions-promote-physical-activity-modelling-study-4", "reader_count"=>143, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>6, "Librarian"=>1, "Researcher"=>26, "Student > Doctoral Student"=>8, "Student > Ph. D. 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Student"=>30, "Student > Postgraduate"=>8, "Student > Master"=>29, "Other"=>9, "Student > Bachelor"=>8, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>5, "Professor"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Agricultural and Biological Sciences"=>6, "Arts and Humanities"=>2, "Business, Management and Accounting"=>2, "Computer Science"=>4, "Decision Sciences"=>2, "Economics, Econometrics and Finance"=>7, "Engineering"=>1, "Nursing and Health Professions"=>6, "Mathematics"=>1, "Medicine and Dentistry"=>55, "Sports and Recreations"=>15, "Physics and Astronomy"=>1, "Psychology"=>5, "Social Sciences"=>26}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>55}, "Social Sciences"=>{"Social Sciences"=>26}, "Decision Sciences"=>{"Decision Sciences"=>2}, "Sports and Recreations"=>{"Sports and Recreations"=>15}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>5}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>10}, "Arts and Humanities"=>{"Arts and Humanities"=>2}, "Engineering"=>{"Engineering"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>7}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>6}, "Computer Science"=>{"Computer Science"=>4}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>6}}, "reader_count_by_country"=>{"Canada"=>1, "Netherlands"=>1, "Argentina"=>1, "United States"=>4, "United Kingdom"=>3, "South Africa"=>1, "Australia"=>3, "France"=>1, "Chile"=>1, "Tunisia"=>1}, "group_count"=>13}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/891236"], "description"=>"<p>Cost-effectiveness of physical activity interventions when compared with current practice.</p>", "links"=>[], "tags"=>["interventions", "compared"], "article_id"=>561696, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t003", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_effectiveness_of_physical_activity_interventions_when_compared_with_current_practice_/561696", "title"=>"Cost-effectiveness of physical activity interventions when compared with current practice.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:28:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/890873"], "description"=>"<p>Cost-effectiveness of the physical activity interventions when compared with current practice.</p>", "links"=>[], "tags"=>["interventions", "compared"], "article_id"=>561332, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.g001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cost_effectiveness_of_the_physical_activity_interventions_when_compared_with_current_practice_/561332", "title"=>"Cost-effectiveness of the physical activity interventions when compared with current practice.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2009-07-14 00:22:12"}
  • {"files"=>["https://ndownloader.figshare.com/files/891000"], "description"=>"<p>The physical activity intervention pathway.</p>", "links"=>[], "tags"=>["public health and epidemiology/exercise and sports", "public health and epidemiology/health services research and economics", "public health and epidemiology/preventive medicine"], "article_id"=>561460, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.g002", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_physical_activity_intervention_pathway_/561460", "title"=>"The physical activity intervention pathway.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2009-07-14 00:24:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/891292"], "description"=>"a<p>Activity definitions for intervention analysis: sedentary (<100 MET-min/wk), insufficiently active (<750 MET-min/wk), and sufficiently active (≥750 MET-min/wk ≈30 min of activity on 5 d of the week at a “moderate” intensity of 5 METs, i.e., 5× resting metabolic rate).</p>b<p>All costs are adjusted to real prices in the 2003 reference year using the relevant Health Price Index from the Australian Institute of Health and Welfare <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000110#pmed.1000110-AIHW1\" target=\"_blank\">[52]</a>, or relevant Consumer Price Index from the Australian Bureau of Statistics <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000110#pmed.1000110-ABS1\" target=\"_blank\">[53]</a> where the costs would occur outside of the health sector.</p>", "links"=>[], "tags"=>["costs", "implementing", "interventions", "australia", "baseline"], "article_id"=>561745, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_target_groups_physical_activity_effects_and_costs_associated_with_implementing_the_physical_activity_interventions_in_Australia_for_one_year_2003_baseline_year_/561745", "title"=>"The target groups, physical activity effects, and costs associated with implementing the physical activity interventions in Australia for one year (2003 baseline year).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:29:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/891259"], "description"=>"<p>Current practice for the six physical activity interventions in 2003.</p>", "links"=>[], "tags"=>["interventions"], "article_id"=>561715, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Current_practice_for_the_six_physical_activity_interventions_in_2003_/561715", "title"=>"Current practice for the six physical activity interventions in 2003.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:28:35"}
  • {"files"=>["https://ndownloader.figshare.com/files/891128"], "description"=>"<p>Sensitivity of the intervention pathway to the rate of decay in intervention health effects.</p>", "links"=>[], "tags"=>["pathway", "decay"], "article_id"=>561588, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.g003", "stats"=>{"downloads"=>3, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_of_the_intervention_pathway_to_the_rate_of_decay_in_intervention_health_effects_/561588", "title"=>"Sensitivity of the intervention pathway to the rate of decay in intervention health effects.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2009-07-14 00:26:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/891387"], "description"=>"<p>Acceptability of physical activity interventions when compared with current practice.</p>", "links"=>[], "tags"=>["interventions", "compared"], "article_id"=>561847, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t004", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Acceptability_of_physical_activity_interventions_when_compared_with_current_practice_/561847", "title"=>"Acceptability of physical activity interventions when compared with current practice.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:30:47"}
  • {"files"=>["https://ndownloader.figshare.com/files/441544", "https://ndownloader.figshare.com/files/441677", "https://ndownloader.figshare.com/files/441788"], "description"=>"<div><h3>Background</h3><p>Physical inactivity is a key risk factor for chronic disease, but a growing number of people are not achieving the recommended levels of physical activity necessary for good health. Australians are no exception; despite Australia's image as a sporting nation, with success at the elite level, the majority of Australians do not get enough physical activity. There are many options for intervention, from individually tailored advice, such as counselling from a general practitioner, to population-wide approaches, such as mass media campaigns, but the most cost-effective mix of interventions is unknown. In this study we evaluate the cost-effectiveness of interventions to promote physical activity.</p><h3>Methods and Findings</h3><p>From evidence of intervention efficacy in the physical activity literature and evaluation of the health sector costs of intervention and disease treatment, we model the cost impacts and health outcomes of six physical activity interventions, over the lifetime of the Australian population. We then determine cost-effectiveness of each intervention against current practice for physical activity intervention in Australia and derive the optimal pathway for implementation. Based on current evidence of intervention effectiveness, the intervention programs that encourage use of pedometers (Dominant) and mass media-based community campaigns (Dominant) are the most cost-effective strategies to implement and are very likely to be cost-saving. The internet-based intervention program (AUS$3,000/DALY), the GP physical activity prescription program (AUS$12,000/DALY), and the program to encourage more active transport (AUS$20,000/DALY), although less likely to be cost-saving, have a high probability of being under a AUS$50,000 per DALY threshold. GP referral to an exercise physiologist (AUS$79,000/DALY) is the least cost-effective option if high time and travel costs for patients in screening and consulting an exercise physiologist are considered.</p><h3>Conclusions</h3><p>Intervention to promote physical activity is recommended as a public health measure. Despite substantial variability in the quantity and quality of evidence on intervention effectiveness, and uncertainty about the long-term sustainability of behavioural changes, it is highly likely that as a package, all six interventions could lead to substantial improvement in population health at a cost saving to the health sector.</p><h3></h3><p><em>Please see later in the article for Editors' Summary</em></p></div>", "links"=>[], "tags"=>["cost-effectiveness", "interventions"], "article_id"=>147033, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000110.s001", "https://dx.doi.org/10.1371/journal.pmed.1000110.s002", "https://dx.doi.org/10.1371/journal.pmed.1000110.s003"], "stats"=>{"downloads"=>43, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Cost_Effectiveness_of_Interventions_to_Promote_Physical_Activity_A_Modelling_Study/147033", "title"=>"Cost-Effectiveness of Interventions to Promote Physical Activity: A Modelling Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2009-07-14 01:57:13"}
  • {"files"=>["https://ndownloader.figshare.com/files/891327"], "description"=>"a<p>Base-case scenario.</p>", "links"=>[], "tags"=>["median", "icers", "decay"], "article_id"=>561787, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t006", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_of_the_median_ICERs_to_the_rate_of_decay_in_intervention_health_effects_/561787", "title"=>"Sensitivity of the median ICERs to the rate of decay in intervention health effects.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:29:47"}
  • {"files"=>["https://ndownloader.figshare.com/files/891355"], "description"=>"<p>Each incremental cost-effectiveness ratio represents the cost-effectiveness of adding the intervention to the package (i.e., it does not represent progressive cost-effectiveness of the intervention package compared with the partial null “no intervention” scenario).</p>a<p>The “costs of unrelated health care” includes all costs for disease and injury other than for the physical activity-related diseases explicitly modelled.</p>", "links"=>[], "tags"=>["cost-effectiveness", "interventions"], "article_id"=>561822, "categories"=>["Medicine"], "users"=>["Linda J. Cobiac", "Theo Vos", "Jan J. Barendregt"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000110.t005", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incremental_cost_effectiveness_of_interventions_in_the_physical_activity_pathway_/561822", "title"=>"Incremental cost-effectiveness of interventions in the physical activity pathway.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-07-14 00:30:22"}

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  • {"unique-ip"=>"21", "full-text"=>"19", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"12"}
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  • {"unique-ip"=>"24", "full-text"=>"25", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"3", "year"=>"2016", "month"=>"10"}
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  • {"unique-ip"=>"18", "full-text"=>"20", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
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  • {"unique-ip"=>"18", "full-text"=>"20", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"32", "full-text"=>"45", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
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  • {"unique-ip"=>"34", "full-text"=>"42", "pdf"=>"14", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
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  • {"unique-ip"=>"42", "full-text"=>"42", "pdf"=>"12", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"39", "full-text"=>"48", "pdf"=>"12", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
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Relative Metric

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