Cost-effectiveness of interventions promoting physical activity

Falk Müller-Riemenschneider ^1*, Thomas Reinhold ¹ and Stefan N Willich ¹

¹ Charité University Medical Centre, Germany

^* To whom correspondence should be addressed. E-mail: falk.mueller-riemenschneider{at}charite.de.

Accepted 13 October 2008

Abstract

Background: Sedentary and inactive lifestyle continue to increase and is associated with a substantial economic burden in most industrialised countries. To implement effective physical activity interventions on a broad population basis, their cost-effectiveness needs to be evaluated.

Objective: To evaluate the cost-effectiveness of physical activity interventions targeted at healthy adults and to identify cost-effective intervention components.

Design: Systematic review.

Methods and data sources: The search strategy in electronic databases identified relevant literature published until June 2008. We included studies investigating the cost-effectiveness of interventions aimed to promote physical activity behaviour in healthy adults. Two researchers independently assessed publications according to pre-defined inclusion criteria and with regard to methodological quality. Study characteristics and pre-defined outcome measures were extracted and costs per participant to become sufficiently active were compared between interventions.

Results: Out of 6543 identified publications, 8 studies investigating 11 intervention strategies met the inclusion criteria. There was substantial heterogeneity in study quality, intervention strategies and intervention effects. Behavioural interventions were able to promote physical activity for about 800 Euros per year and participant meeting recommended levels of physical activity. Environmental interventions and interventions targeted at General Practitioners seemed to have the potential to be substantially more cost-effective.

Discussion: There was evidence that current physical activity intervention strategies can be cost-effective means of resource allocation. But despite the growing literature on physical activity promotion, appropriate cost-effectiveness analyses are rare and the generalisability or presented findings is limited. Further research is warranted to investigate the cost-effectiveness of behavioural and environmental intervention strategies.