A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

Goyder, Elizabeth; Hind, Daniel; Breckon, Jeff; Dimairo, Munyaradzi; Minton, Jon; Everson-Hock, Emma; Read, Simon; Copeland, Robert J.; Crank, Helen; Horspool, Kimberley; Humphreys, Liam; Hutchison, Andrew; Kesterton, Sue; Latimer, Nicholas; Scott, Emma; Swaile, Peter; Walters, Stephen J.; Wood, Rebecca Carole; Collins, Karen; Cooper, Cindy

doi:10.3310/hta18130

Cited by 29 publications

(75 citation statements)

References 99 publications

(169 reference statements)

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“…Five studies originated from the UK (one of them in Scotland), [35][36][37][38][39] four from New Zealand, 40-43 two from Australia, 44 45 and one each from Sweden 46 and the Netherlands. 47 Of the 15 excluded studies, six reported more intensive interventions and/or did not include a face-to-face component (eg, supervised exercise sessions, mail or telephone contact); [48][49][50][51][52][53] four included a combined intervention targeting multiple behaviours (eg, physical activity and diet); 54-57 two were exercise referral schemes (referral to a physical activity specialist or service); 58 59 two did not report a physical activity or cost-effectiveness outcome 60 61 and one study evaluated the cost-effectiveness of a subsidy programme for general practitioner (GP) involvement in physical activity. 62…”

Section: Literature Searchmentioning

confidence: 99%

Are brief interventions to increase physical activity cost-effective? A systematic review

et al. 2015

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ObjectiveTo determine whether brief interventions promoting physical activity are cost-effective in primary care or community settings.DesignSystematic review of economic evaluations.Methods and data sourcesWe searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit, SPORTDiscus, PEDro, the Cochrane library, National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry up to 20 August 2014. Web of Knowledge was used for cross-reference search. We included studies investigating the cost-effectiveness of brief interventions, as defined by National Institute for Health and Care Excellence, promoting physical activity in primary care or the community. Methodological quality was assessed using Drummond's checklist for economic evaluations. Data were extracted from individual studies fulfilling selection criteria using a standardised pro forma. Comparisons of cost-effectiveness and cost-utility ratios were made between studies.ResultsOf 1840 identified publications, 13 studies fulfilled the inclusion criteria describing 14 brief interventions. Studies varied widely in the methods used, such as the perspective of economic analysis, intervention effects and outcome measures. The incremental cost of moving an inactive person to an active state, estimated for eight studies, ranged from £96 to £986. The cost-utility was estimated in nine studies compared with usual care and varied from £57 to £14 002 per quality-adjusted life year; dominant to £6500 per disability-adjusted life year; and £15 873 per life years gained.ConclusionsBrief interventions promoting physical activity in primary care and the community are likely to be inexpensive compared with usual care. Given the commonly accepted thresholds, they appear to be cost-effective on the whole, although there is notable variation between studies.

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Section: Literature Searchmentioning

confidence: 99%

Are brief interventions to increase physical activity cost-effective? A systematic review

et al. 2015

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“…Of the 14 studies examining a targeted SEP group, six were CUAs, 42–47 and eight were CEAs 48–55 . The majority of the studies originated from the USA (n=9); 42,45–47,49,50,52,54,55 three came from the UK; 43,44,53 and one each from Australia 51 and Iran 48…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies used low income as a measure of SEP 42,45,46,48,50,52,55,56 and six studies used an area‐based level of disadvantage 43,44,49,51,53,54 …”

Section: Resultsmentioning

confidence: 99%

“…SEP specific inputs in modelling : For the modeling of morbidity and mortality in the CUAs, one study used SEP specific mortality inputs, 44 while the other four studies used general population inputs 42,45–47 . In the CEA studies, all studies used SEP‐specific effectiveness/efficacy rates either from the trial on which the study was based or from published sources.…”

Section: Resultsmentioning

confidence: 99%

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Inclusion of equity in economic analyses of public health policies: systematic review and future directions

Lal

Moodie

Peeters

et al. 2018

Australian and New Zealand Journal of Public Health

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Objectives: To assess current approaches to inclusion of equity in economic analysis of public health interventions and to recommend best approaches and future directions. Methods:We conducted a systematic review of studies that have used socioeconomic position (SEP) in cost-effectiveness analyses. Studies were identified using MedLine, EconLit and HEED and were evaluated based on their SEP specific inputs and methods of quantification of the health and financial inequalities.Results: Twenty-nine relevant studies were identified. The majority of studies comparing two or more interventions left interpretation of the size of the health and financial inequality differences to the reader. Newer approaches include: i) use of health inequality measures to quantify health inequalities; ii) inclusion of financial impacts, such as out-of-pocket expenditures; and iii) use of equity weights. The challenge with these approaches is presenting results that policy makers can easily interpret. Conclusions:Using CEA techniques to generate new information about the health equity implications of alternative policy options has not been widely used, but should be considered to inform future decision making.Implications for public health: Inclusion of equity in economic analysis would facilitate a more nuanced comparison of interventions in relation to efficiency, equity and financial impact.

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“…Three other studies have randomised participants following a physical activity intervention into extended contact (Butler et al, 2009;Goyder et al, 2014;Hughes et al, 2010). Butler and colleagues (2009) reported maintenance of change in physical activity four months post-intervention was more successful in a group of cardiac rehabilitation patients that received continued face-to-face contact over six weeks, compared to a no-contact group.…”

Section: Extended Contact In Physical Activity and Dietary Interventionsmentioning

confidence: 99%

Understanding and influencing the maintenance of physical activity and dietary behaviour change in breast cancer survivors

Spark¹

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A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

Cited by 29 publications

References 99 publications

Are brief interventions to increase physical activity cost-effective? A systematic review

Are brief interventions to increase physical activity cost-effective? A systematic review

Inclusion of equity in economic analyses of public health policies: systematic review and future directions

Understanding and influencing the maintenance of physical activity and dietary behaviour change in breast cancer survivors

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