A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs

Johanna M van Dongen, Karin I Proper, Marieke F van Wier, Allard J van der Beek, Paulien M Bongers, Willem van Mechelen, Maurits W van Tulder

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

OBJECTIVE: The aim of this study was to appraise and summarize the evidence on the cost-effectiveness of worksite physical activity and/or nutrition programs.

METHODS: We searched EMBASE, MEDLINE, SportDiscus, PsycInfo, NIOSHTIC-2, NHSEED, HTA, and Econlit for studies published up to 14 January 2011. Additionally, we searched for articles by reviewing references, searching authors' databases, and contacting authors of included studies. Two researchers independently selected articles. Articles had to include a cost-effectiveness and/or cost-utility analysis comparing a worksite physical activity and/or nutrition program to usual care or an abridged version of the program. Data were extracted on study characteristics and results. Two researchers independently assessed the risk of bias using the Consensus on Health Economic Criteria list (CHEC-list).

RESULTS: Ten studies (18 programs) were included. More than 50% of the studies fulfilled 11 (58%) of the 19 CHEC-list items. From various perspectives, worksite nutrition and worksite physical activity and nutrition programs (N=6) were more costly and more effective in reducing body weight than usual care. When only intervention costs were considered, most worksite nutrition (N=4/5) and worksite physical activity and nutrition programs (N=5/6) were more costly and more effective in reducing cholesterol level and cardiovascular disease risks, respectively.

CONCLUSIONS: The cost-effectiveness of more costly and more effective programs depends on the "willingness to pay" for their effects. It is unknown how much decision-makers are willing to pay for reductions in body weight, cholesterol level, and cardiovascular disease risks. Therefore, conclusions about the cost-effectiveness of worksite physical activity and/or nutrition programs cannot be made. There is substantial need for improvement of the methodological quality of studies and particular emphasis should be placed on the handling of uncertainty.

Original languageEnglish
Pages (from-to)393-408
Number of pages16
JournalScandinavian Journal of Work, Environment and Health
Volume38
Issue number5
DOIs
Publication statusPublished - Sep 2012

Keywords

  • Cost-Benefit Analysis
  • Diet
  • Humans
  • Motor Activity
  • Observer Variation
  • Occupations

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