title: Economic evaluation of URMEL-ICE, a school-based overweight prevention programme comprising metabolism, exercise and lifestyle intervention in children.
abstract: OBJECTIVE
  Measuring the impact of the URMEL-ICE school-based overweight prevention programme on anthropometric measures in primary-school children, computing incremental cost-effectiveness relation (ICER) and net monetary benefit (NMB).
  
  
  METHODS
  This is an intervention study with historical control. Propensity score method is applied to account for group differences. One-year teacher-driven classroom implementation is used, which is based on especially developed teaching material including health education, physical activity breaks and parent involvement. 354 children in the control and 365 children in the intervention group at baseline and follow-up were analysed. Effectiveness is measured as cm waist circumference (WC) and unit (0.01) waist-to-height ratio (WHtR) increase prevented in intervention vs. control group using an adjusted two-level model. Standard cost-effectiveness analysis methods, net benefit regression and a societal perspective for a 1-year time horizon are applied.
  
  
  RESULTS
  WC gain was 1.61 cm and WHtR gain was 0.014 significantly less in intervention vs. control group. Intervention costs were euro24.09 per child. ICER was euro11.11 (95% confidence interval (CI) [8.78; 15.02]) per cm WC and euro18.55 (95% CI [14.04; 26.86]) per unit WHtR gain prevented. At a maximum willingness to pay (MWTP) of euro35, both values of the CIs for NMB regarding WC and WHtR are located in the positive range.
  
  
  CONCLUSIONS
  The study gives new information about the cost-effectiveness of structured health promotion embedded in daily routine at primary schools. Assuming a MWTP of euro35 the intervention is cost-effective with a positive NMB. This result may help decision makers in implementing programmes to prevent childhood overweight in school settings.
authors: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany. dorothea.kesztyues@uni-ulm.de
authors: Dorothea
authors: D
authors: Kesztyüs
authors: Anja
authors: A
authors: Schreiber
authors: Tamara
authors: T
authors: Wirt
authors: Martina
authors: M
authors: Wiedom
authors: Jens
authors: J
authors: Dreyhaupt
authors: Susanne
authors: S
authors: Brandstetter
authors: Benjamin
authors: B
authors: Koch
authors: Olivia
authors: O
authors: Wartha
authors: Rainer
authors: R
authors: Muche
authors: Martin
authors: M
authors: Wabitsch
authors: Reinhold
authors: R
authors: Kilian
authors: Jürgen M
authors: JM
authors: Steinacker
mesh_terms: D000886:Anthropometry; D002648:Child; D003362:Cost-Benefit Analysis; D015444:Exercise; D005260:Female; D005858:Germany; D006801:Humans; D008019:Life Style; D008297:Male; D050177:Overweight / Q000378:metabolism / Q000517:prevention & control*; D057216:Propensity Score; D012572:School Health Services / Q000191:economics*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires