Cost‐effectiveness of scaling up a whole‐of‐community intervention: The Romp & Chomp early childhood obesity prevention intervention

Abstract

Summary Background Given the high prevalence of early childhood overweight and obesity, more evidence is required to better understand the cost‐effectiveness of community‐wide interventions targeting obesity prevention in children aged 0–5 years. Objectives To assess the cost‐effectiveness of the Romp & Chomp community‐wide early childhood obesity prevention intervention if delivered across Australia in 2018 from a funder perspective, against a no‐intervention comparator. Methods Intervention costs were estimated in 2018 Australian dollars. The annual Early Prevention of Obesity in Childhood micro‐simulation model estimated body mass index (BMI) trajectories to age 15 years, based on end of trial data at age 3.5 years. Results from modelled cost‐effectiveness analyses were presented as incremental cost‐effectiveness ratios (ICERs): cost per BMI unit avoided, and cost per quality‐adjusted life year (QALY) gained at age 15 years. Results All Australian children aged 0–5 years (n = 1 906 075) would receive the intervention. Total estimated intervention cost and annual cost per participant were AUD178 million and AUD93, respectively, if implemented nationally. The ICERs were AUD1 126 per BMI unit avoided and AUD26 399 per QALY gained (64% probability of being cost‐effective measured against a AUD50 000 per QALY threshold). Conclusions Romp & Chomp has a fair probability of being cost‐effective if delivered at scale.

Domains of Capacity Building in Whole-Systems Approaches to Prevent Obesity—A “Systematized” Review

“…It is also noteworthy that effective resource management can also have a significant impact on the sustainability of obesity-prevention efforts [ 77 ]. For instance, there is substantial evidence that availability of finances and effective management of such resources can single-handedly determine the longevity and scalability of most obesity-prevention efforts [ 78 ]. Accordingly, there is increasing interest by contemporary interventionists regarding novel, cost-effective strategies in implementing WSAs to obesity prevention.…”

A systematic review of economic evidence for community‐based obesity prevention interventions in children

“…Four further studies 24,[30][31][32] were identified through the grey literature search, resulting in a total of 17 studies included in this review. 17,18,24,[30][31][32][33][34][35][36][37][38][39][40][41][42][43] From the 17 included studies, 15 discrete economic evaluations, protocols, or costing studies of 13 CBIs were identified (Table 1). The economic evaluation of a CBI was reported in full in the publication by Ananthapavan et al 34 and also included as part of a larger prioritysetting study.…”

“…Twelve CBIs were conducted exclusively in high-income countries (HICs) (Table 1). 17,18,24,[30][31][32][33][34][35][36][37][38][39]42,43 The OPIC study was conducted in both high-income and upper-middle-income countries from the Western Pacific region (Fiji, Tonga, New Zealand, Australia). 40,41 Six CBIs were implemented in Australia (BAEW, Fun 'n Healthy in Moreland!, hypothetical CBI, Obesity Prevention and Lifestyle [OPAL],…”

“…Romp & Chomp [R&C], WHO STOPS), 18,30,[33][34][35]39,42,43 Shape Up Somerville [SUS]), 31,32 two in the United Kingdom (Health, Exercise, Nutrition for the Really Young [HENRY] and Optimising Family Engagement in HENRY [OFTEN]), 36,37 one in New Zealand (APPLE), 17 and one in Scotland (Healthy Habits, Happy Homes [4H]) 18 (Table 1). One economic evaluation applied the intervention cost and effect data from an intervention in the Australian setting (BAEW), to estimate the cost-effectiveness if it were implemented in the New Zealand population.…”

“…Seven full economic evaluations of five different CBIs were identified 17,18,24,31,34,35,42 (Table 2). One full economic evaluation was F I G U R E 1 PRISMA flow chart of study selection on economic evidence of obesity prevention intervention.…”