北京东城区儿童肥胖综合干预的成本效果

  目的  评价以学校为基础的儿童肥胖综合干预的成本效果, 为制定并在大规模人群中推广高效、经济的儿童肥胖干预措施提供科学依据。  方法  采用整群随机对照试验的方法, 选取北京市东城区12所小学三至五年级1 889名学生, 随机分为干预组(6所小学930名学生)和对照组(6所小学959名学生)。对干预组学生进行为期1年的以学校为基础的儿童肥胖综合干预, 包括制定肥胖相关的学校政策、开展健康教育活动、加强体育锻炼、促进健康饮食。采用社会角度的成本分析方法, 评估干预项目的物资和人力成本。计算学生肥胖相关知识、每周不少于1 h中高等强度身体活动天数、摄入含糖饮料的学生比例的增量成本-效果比率。  结果  干预项目的物资成本为46 376.24元, 人力成本为46 197.32元, 合计为92 573.56元, 每名干预学生的人均成本为99.54元。学生肥胖相关知识的增量成本-效果比率为52.39%, 每周不少于1 h中高等强度身体活动天数的增量成本-效果比率为71.61%, 摄入含糖饮料的学生比例的增量成本-效果比率为2.26%。  结论  以学校为基础的儿童肥胖综合干预项目在增加学生肥胖相关知识及改善学生的饮食运动行为方面, 具有较好的成本效果。

Cost-effectiveness analysis of comprehensive intervention for childhood obesity in Dongcheng District,Beijing

  Objective  To evaluate the cost-effectiveness of a school-based comprehensive intervention for childhood obesity and to provide scientific basis for formulating and promoting efficient and economic intervention measures for childhood obesity.  Methods  In a cluster randomized controlled trial, 12 primary schools (1 889 students from grade 3 to 5) in Dongcheng District in Beijing were selected and randomly assigned to the intervention (6 schools, 930 students) and control group (6 schools, 959 students). Students in the intervention group received a one-year school-based comprehensive intervention for childhood obesity, including development of school-level policies, health education activities, improvement of physical activity, and improvement of healthy diet. A cost analysis method from a social perspective was used to evaluate the implementation costs of the intervention. Cost-effectiveness analysis was used by calculating incremental cost-effectiveness ratio (ICER) on obesity-related knowledge, number of days completing no less than 60 minutes of moderate-to-vigorous physical activity (MVPA) per week, students consuming sugar-sweetened beverage.  Results  The material cost and human cost were 46 376.24 yuan and 46 197.32 yuan, respectively. The total cost of the intervention was 92 573.56 yuan and the average cost was 99.54 yuan per student in the intervention group. ICER on obesity-related knowledge, number of days completing no less than 60 minutes of MVPA per week, percentage of students consuming sugar-sweetened beverage were 52.39%, 71.61% and 2.26%, respectively.  Conclusion  The school-based comprehensive intervention for childhood obesity shows a good cost-effectiveness promoting students' obesity-related knowledge, as well as dietary and physical activity behaviors.