METHODOLOGICAL REVIEW OF MODEL-BASED COST-EFFECTIVENESS ANALYSES OF SCHOOL-BASED INTERVENTIONS TO INCREASE PUPILS’ LEVEL OF PHYSICAL ACTIVITY

ABSTRACT A large number of school-based interventions promoting physical activity have been developed. Due to difficulties of obtaining observational data on long-term consequences such as effects and costs, modelling techniques offer opportunities to consider these. The aim of this study was to provide an overview of modelling approaches applied in economic evaluations of school-based physical activity programmes. We identify key methodological choices, challenges, and areas with a lack of evidence. A literature search was conducted to identify all relevant studies published within the last 10 years. The included studies were described with focus on main methodological aspects, including the costs, effects, and modelling techniques. Eight model-based economic analyses of school-based physical activity programmes were identified. The majority of these studies concluded that the interventions had a high probability of being cost-effective or even cost saving based on the national-specific thresholds. Although most studies did provide a description of the models, details on the methodological choices were not always transparent. Moreover, evidence on the effectiveness and inclusion of all relevant cost categories were found to be challenging. Different modelling methodologies have been used to assess the cost-effectiveness of school-based physical activity programmes. Only few studies have evaluated the long-term cost-effectiveness, and they have all challenging methodological issues.

摘要：目前已开发出大量旨在推广体育活动的校园干预方案。由于难以获取干预效果与成本等长期后果的观测数据，建模技术为相关研究提供了可行路径。本研究旨在系统梳理针对校园体育活动项目的经济评估中所采用的各类建模方法，识别该领域关键的方法学选择、现存挑战以及证据缺失的研究方向。本次研究通过文献检索筛选了近十年内发表的所有相关研究，纳入研究的分析重点聚焦于核心方法学维度，涵盖成本、干预效果及建模技术三个方面。最终共纳入八项针对校园体育活动项目的基于模型的经济评估研究。其中绝大多数研究基于本国特定的成本阈值判定，该类干预方案具有较高的成本效益比，甚至可实现成本节约。尽管多数研究对模型进行了描述，但方法学选择的细节往往未完全公开透明。此外，获取干预效果的相关证据以及覆盖所有相关成本类别均存在一定难度。目前已有多种不同的建模方法被用于评估校园体育活动项目的成本效益，仅有少量研究评估了该类项目的长期成本效益，且这些研究均面临方法学层面的挑战。