title: Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care.
abstract: BACKGROUND
  There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.
  
  
  METHODS
  A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.
  
  
  RESULTS
  An incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.
  
  
  CONCLUSIONS
  As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.
authors.affiliation: Department of Public Health, Ghent University, De Pintelaan 185 9000, Ghent, Belgium. nick.verhaeghe@ugent.be.
authors.forename: Nick
authors.initials: N
authors.lastname: Verhaeghe
authors.forename: Delphine
authors.initials: D
authors.lastname: De Smedt
authors.forename: Jan
authors.initials: J
authors.lastname: De Maeseneer
authors.forename: Lea
authors.initials: L
authors.lastname: Maes
authors.forename: Cornelis
authors.initials: C
authors.lastname: Van Heeringen
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008297:Male; D008390:Markov Chains; D001523:Mental Disorders / Q000150:complications / Q000191:economics*; D008603:Mental Health; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications / Q000191:economics* / Q000523:psychology / Q000628:therapy; D015397:Program Evaluation / Q000191:economics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D035501:Uncertainty; D061217:Weight Reduction Programs; D055815:Young Adult