Online Program

284416
Cost-effectiveness of a state policy requiring minimum levels of moderate and vigorous physical activity during elementary school physical education classes


Tuesday, November 5, 2013 : 10:50 a.m. - 11:10 a.m.

Jessica L. Barrett, MPH, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
Steven L. Gortmaker, PhD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Michael W. Long, SD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Zachary Ward, MPH, Center for Health Decision Science, Harvard School of Public Health, Boston, MA
Marj L. Moodie, DrPH, Deakin Health Economics, Deakin Population Health, Deakin University, Burwood, Victoria, Australia
Robert C. Carter, PhD, Deakin Health Economics, Deakin Population Health, Deakin University, Burwood, Victoria, Australia
Gary Sacks, PhD, WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
Boyd Swinburn, PhD, WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia
Y. Claire Wang, MD, ScD, Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY
Angie L. Cradock, ScD, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Introduction: Children are not meeting physical activity recommendations; typical physical education (PE) classes engage children in moderate and vigorous physical activity (MVPA) only 34-37% of instruction time. U.S. states have considered active PE policies specifying minimum percent of PE time spent in MVPA. This study estimates the cost-effectiveness of a hypothetical state policy implemented nationally requiring at least 50% of elementary school PE time devoted to MVPA. Methods: We used the U.S. Assessing Cost Effectiveness model to estimate costs and health benefits of an active PE policy intervention on changes in energy expenditure for the lifetime of a simulated cohort of the 2005 U.S. population aged 5-11 years. Results: Implementation of an elementary school active PE policy would increase mean daily per capita physical activity levels by 0.58 minutes/day MVPA (95% Uncertainty Interval (UI): 0.05–2.23), corresponding to an increased energy expenditure of 1.53 kcal/day (95% UI: 0.13–5.84), among 12.1 million U.S. children (95% UI: 8.9–16.0 million) aged 5-11 years receiving the intervention. At an estimated annual cost of $54.6 million (95% UI: $35.7–$79.7 million), the intervention would cost $1.53 per MET-hour/day gained (95% UI: $0.14–$7.06), or $2.18 per 100 kcal/day (95% UI: $0.20–$10.08). Discussion: There is a lack of evidence for direct BMI impact due to increased physical activity expenditures via an active PE policy, even assuming no compensatory changes in diet and out of school physical activity levels. Additional modeling will estimate the impact of physical activity directly on specific health outcomes.

Learning Areas:

Biostatistics, economics
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Identify the potential costs and health benefits of a hypothetical elementary school active physical education policy intervention. Describe the opportunities and challenges of implementing physical education policy as a childhood obesity prevention strategy.

Keyword(s): Physical Activity, Cost-Effectiveness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a research analyst involved in evaluation and cost-effectiveness modeling of nutrition and physical activity policies and programs related to obesity prevention for the past five years. Among my scientific interests are transportation-related and school-based policies and programs aimed at increasing physical activity levels among children and adolescents.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.