Modeling the cost effectiveness of child care policy changes in the U.S.

Wright, Davene R., Kenney, Erica L., Giles, Catherine M., Long, Michael W., Ward, Zachary J., Resch, Stephen C., Moodie, Marj L., Carter, Robert C., Wang, Y. Claire, Sacks, Gary, Swinburn, Boyd A., Gortmaker, Steven L. and Cradock, Angie L. 2015, Modeling the cost effectiveness of child care policy changes in the U.S., American journal of preventive medicine, vol. 49, no. 1, pp. 135-147, doi: 10.1016/j.amepre.2015.03.016.

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Title Modeling the cost effectiveness of child care policy changes in the U.S.
Author(s) Wright, Davene R.
Kenney, Erica L.
Giles, Catherine M.
Long, Michael W.
Ward, Zachary J.
Resch, Stephen C.
Moodie, Marj L.ORCID iD for Moodie, Marj L. orcid.org/0000-0001-6890-5250
Carter, Robert C.ORCID iD for Carter, Robert C. orcid.org/0000-0002-1586-5619
Wang, Y. Claire
Sacks, GaryORCID iD for Sacks, Gary orcid.org/0000-0001-9736-1539
Swinburn, Boyd A.
Gortmaker, Steven L.
Cradock, Angie L.
Journal name American journal of preventive medicine
Volume number 49
Issue number 1
Start page 135
End page 147
Total pages 13
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-07
ISSN 1873-2607
Summary INTRODUCTION: Child care facilities influence diet and physical activity, making them ideal obesity prevention settings. The purpose of this study is to quantify the health and economic impacts of a multi-component regulatory obesity policy intervention in licensed U.S. child care facilities. METHODS: Two-year costs and BMI changes resulting from changes in beverage, physical activity, and screen time regulations affecting a cohort of up to 6.5 million preschool-aged children attending child care facilities were estimated in 2014 using published data. A Markov cohort model simulated the intervention's impact on changes in the U.S. population from 2015 to 2025, including short-term BMI effects and 10-year healthcare expenditures. Future outcomes were discounted at 3% annually. Probabilistic sensitivity analyses simulated 95% uncertainty intervals (UIs) around outcomes. RESULTS: Regulatory changes would lead children to watch less TV, get more minutes of moderate and vigorous physical activity, and consume fewer sugar-sweetened beverages. Within the 6.5 million eligible population, national implementation could reach 3.69 million children, cost $4.82 million in the first year, and result in 0.0186 fewer BMI units (95% UI=0.00592 kg/m(2), 0.0434 kg/m(2)) per eligible child at a cost of $57.80 per BMI unit avoided. Over 10 years, these effects would result in net healthcare cost savings of $51.6 (95% UI=$14.2, $134) million. The intervention is 94.7% likely to be cost saving by 2025. CONCLUSIONS: Changing child care regulations could have a small but meaningful impact on short-term BMI at low cost. If effects are maintained for 10 years, obesity-related healthcare cost savings are likely.
Language eng
DOI 10.1016/j.amepre.2015.03.016
Field of Research 111104 Public Nutrition Intervention
111712 Health Promotion
160508 Health Policy
Socio Economic Objective 920207 Health Policy Economic Outcomes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30074130

Document type: Journal Article
Collections: Faculty of Health
Population Health
2018 ERA Submission
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