Davene R Wright1, Erica L Kenney2, Catherine M Giles2, Michael W Long2, Zachary J Ward3, Stephen C Resch3, Marj L Moodie4, Robert C Carter4, Y Claire Wang5, Gary Sacks6, Boyd A Swinburn6, Steven L Gortmaker2, Angie L Cradock2. 1. Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington. Electronic address: davene.wright@seattlechildrens.org. 2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 3. Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 4. Deakin Health Economics, Deakin Population Health, Deakin University, Melbourne, Victoria, Australia. 5. Department of Health Policy and Management, Columbia Mailman School of Public Health, New York, New York. 6. WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia.
Abstract
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.
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.
Authors: Lori A J Scott-Sheldon; Larry V Hedges; Chris Cyr; Deborah Young-Hyman; Laura Kettel Khan; Mackenzie Magnus; Heather King; Sonia Arteaga; John Cawley; Christina D Economos; Debra Haire-Joshu; Christine M Hunter; Bruce Y Lee; Shiriki K Kumanyika; Lorrene D Ritchie; Thomas N Robinson; Marlene B Schwartz Journal: Child Obes Date: 2020-09 Impact factor: 2.992
Authors: Kelsey A Vercammen; Johannah M Frelier; Mary Kathryn Poole; Erica L Kenney Journal: J Public Health (Oxf) Date: 2020-05-26 Impact factor: 2.341
Authors: Danielle L Lee; Raquel Traseira; Sophia Navarro; Natasha Frost; Sara E Benjamin-Neelon; Angie L Cradock; Ken Hecht; Lorrene D Ritchie Journal: Public Health Rep Date: 2020-11-09 Impact factor: 2.792