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| The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China |
| Meng L, Xu H, Liu A, van Raaij J, Bemelmans W, Hu X, Zhang Q, Du S, Fang H, Ma J, Xu G, Li Y, Guo H, Du L, Ma G |
| PLoS ONE 2013 Oct;8(10):e77971 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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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 to 2010. A total of 8,301 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/m2 (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/.
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