Abstract
Objective
To examine the cost and cost-effectiveness of implementing Students for Nutrition
and eXercise (SNaX), a 5-week middle school–based obesity-prevention intervention
combining school-wide environmental changes, multimedia, encouragement to eat healthy
school cafeteria foods, and peer-led education.
Methods
Five intervention and 5 control middle schools (mean enrollment, 1520 students) from
the Los Angeles Unified School District participated in a randomized controlled trial
of SNaX. Acquisition costs for materials and time and wage data for employees involved
in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness
was determined using the ratio of variable costs to program efficacy outcomes.
Results
The costs of implementing the program over 5 weeks were $5433.26 per school in fixed
costs and $2.11 per student in variable costs, equaling a total cost of $8637.17 per
school, or $0.23 per student per day. This investment yielded significant increases
in the proportion of students served fruit and lunch and a significant decrease in
the proportion of students buying snacks. The cost-effectiveness of the program, per
student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per
additional full-priced lunch served, $2.11 per additional reduced-price/free lunch
served, and $1.69 per reduction in snacks sold.
Conclusions
SNaX demonstrated the feasibility and cost-effectiveness of a middle school–based
obesity-prevention intervention combining school-wide environmental changes, multimedia,
encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost
is modest and unlikely to be a significant barrier to adoption for many schools considering
its implementation.
Keywords
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Article info
Publication history
Published online: July 28, 2015
Accepted:
July 26,
2015
Received:
May 16,
2015
Footnotes
Dr Ladapo's work is supported by a K23 Career Development Award (K23 HL116787) from the National Heart, Lung, and Blood Institute (NHLBI). There are no other financial disclosures to report. The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
