title: Cost effectiveness of community-based physical activity interventions.
abstract: BACKGROUND
  Physical inactivity is associated with the increased risk of many chronic diseases. Such risks decrease with increases in physical activity. This study assessed the cost-effectiveness of population-wide strategies to promote physical activity in adults and followed disease incidence over a lifetime.
  
  
  METHODS
  A lifetime cost-effectiveness analysis from a societal perspective was conducted to estimate the costs, health gains, and cost-effectiveness (dollars per quality-adjusted life year [QALY] gained, relative to no intervention) of seven public health interventions to promote physical activity in a simulated cohort of healthy U.S. adults stratified by age, gender, and physical activity level. Interventions exemplifying each of four strategies strongly recommended by the Task Force on Community Preventive Services were evaluated: community-wide campaigns, individually adapted health behavior change, community social-support interventions, and the creation of or enhanced access to physical activity information and opportunities. Each intervention was compared to a no-intervention alternative. A systematic review of disease burden by physical activity status was used to assess the relative risk of five diseases (coronary heart disease, ischemic stroke, type 2 diabetes, breast cancer, and colorectal cancer) across a spectrum of physical activity levels. Other data were obtained from clinical trials, population-based surveys, and other published literature.
  
  
  RESULTS
  Cost-effectiveness ratios ranged between $14,000 and $69,000 per QALY gained, relative to no intervention. Results were sensitive to intervention-related costs and effect size.
  
  
  CONCLUSIONS
  All of the evaluated physical activity interventions appeared to reduce disease incidence, to be cost-effective, and--compared with other well-accepted preventive strategies--to offer good value for money. The results support using any of the seven evaluated interventions as part of public health efforts to promote physical activity.
authors.affiliation: Physical Activity and Health Branch, Division of Nutrition, Physical Activity and Obesity, CDC, Atlanta, Georgia, USA. lroux@ucalgary.ca
authors.forename: Larissa
authors.initials: L
authors.lastname: Roux
authors.forename: Michael
authors.initials: M
authors.lastname: Pratt
authors.forename: Tammy O
authors.initials: TO
authors.lastname: Tengs
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Yore
authors.forename: Teri L
authors.initials: TL
authors.lastname: Yanagawa
authors.forename: Jill
authors.initials: J
authors.lastname: Van Den Bos
authors.forename: Candace
authors.initials: C
authors.lastname: Rutt
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Powell
authors.forename: Gregory
authors.initials: G
authors.lastname: Heath
authors.forename: Harold W
authors.initials: HW
authors.lastname: Kohl
authors.forename: Steven
authors.initials: S
authors.lastname: Teutsch
authors.forename: John
authors.initials: J
authors.lastname: Cawley
authors.forename: I-Min
authors.initials: IM
authors.lastname: Lee
authors.forename: Linda
authors.initials: L
authors.lastname: West
authors.forename: David M
authors.initials: DM
authors.lastname: Buchner
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002908:Chronic Disease / Q000453:epidemiology / Q000517:prevention & control; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000191:economics; D015444:Exercise; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008019:Life Style; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology