J Public Health Manag Pract 2017 Jul/Aug;23(4):364-369
Department of Family & Community Medicine, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (Dr Moore); Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, Georgia (Dr Heboyan); Cerus Consulting, LLC, Winston-Salem, North Carolina (Ms Oniffrey); American Institutes for Research, Chapel Hill, North Carolina (Dr Brinkley); Durham Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina (Ms Andrews); and Community & Clinical Connections for Prevention and Health Branch, Chronic Disease and Injury Section-North Carolina Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina (Ms Kolbe).
Context: American youth are insufficiently active, and minigrant programs have been developed to facilitate implementation of evidence-based interventions in communities. However, little is known about the cost-effectiveness of targeted minigrant programs for the implementation of physical activity (PA) promoting strategies for youth.
Objective: To determine the cost-effectiveness of a minigrant program to increase PA among youth.
Design: Twenty community grantees were pair-matched and randomized to receive funding at the beginning of year 1 (2010-2011) or year 2 (2011-2012) to implement interventions to increase PA in youth. Costs were calculated by examining financial reports provided by the granting organization and grantees.
Setting: Twenty counties in North Carolina.
Participants: A random sample of approximately 800 fourth- to eighth-grade youth (per year) from the approximately 6100 youth served by the 20 community-based interventions.
Main Outcome Measure: Cost-effectiveness ratios (CERs) were calculated at the county and project levels to determine the cost per child-minute of moderate-to-vigorous PA (MVPA) increased by wave. Analyses were conducted utilizing cost data from 20 community grantees and accelerometer-derived PA from the participating youth.
Results: Of the 20 participating counties, 18 counties displayed increased youth MVPA between at least 2 waves of observation. Of those 18 counties, the CER (US dollars/MVPA minutes per day) ranged from $0.02 to $1.86 (n = 13) in intervention year 1, $0.02 to $6.19 (n = 15) in intervention year 2, and $0.02 to $0.58 (n = 17) across both years.
Conclusion: If utilized to implement effectual behavior change strategies, minigrants can be a cost-effective means of increasing children's MVPA, with a low monetary cost per minute of MVPA.
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