Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study (Preprint)

BACKGROUND Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. OBJECTIVE We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps. METHODS We used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs. RESULTS The modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention. CONCLUSIONS A mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.

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Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study

JMIR mhealth and uhealth ◽

10.2196/18014 ◽

2020 ◽

Vol 8 (6) ◽

pp. e18014

Author(s):

Anja Mizdrak ◽

Kendra Telfer ◽

Artur Direito ◽

Linda J Cobiac ◽

Tony Blakely ◽

...

Keyword(s):

Physical Activity ◽

Cost Effectiveness ◽

Mass Media ◽

Health Gain ◽

Cost Effective ◽

Health Impacts ◽

Mass Media Campaign ◽

Media Campaign ◽

Smartphone Apps ◽

Health Gains

Background Physical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds. Objective We aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps. Methods We used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs. Results The modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention. Conclusions A mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.

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The cost-effectiveness of a mass media campaign to promote smartphone apps for weight loss: an updated modeling study (Preprint)

10.2196/preprints.29291 ◽

2021 ◽

Author(s):

Amanda C Jones ◽

Leah Grout ◽

Wilson Nick ◽

Nhung Nghiem ◽

Christine L Cleghorn

Keyword(s):

Weight Loss ◽

Cost Effectiveness ◽

Mass Media ◽

Health System ◽

Adult Population ◽

Health Gain ◽

Mass Media Campaign ◽

Media Campaign ◽

Smartphone Apps ◽

Promote Weight Loss

UNSTRUCTURED Background Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of apps at promoting weight loss, governments may seek to encourage the uptake of such apps as an opportunity for reducing excess weight among the population. However, the cost and potential cost-effectiveness are important considerations. Our study used a modeling approach to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high quality smartphone apps for weight loss in New Zealand. Methods We used an established proportional multistate life table model that simulates the 2011 New Zealand (NZ) adult population over the lifetime, sub-grouped by age, sex, and ethnicity (Māori [Indigenous]/non-Māori). The key risk factor was BMI. The model compared business-as-usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years; QALYs) and in health system costs (health system perspective). The difference in total health system costs was the net sum of interventions costs and downstream cost offsets due to altered disease rates. A discount rate of 3% was applied to health gains and health system costs. Multiple scenario and sensitivity analyses were also conducted, including an equity adjustment. Results Across the remaining lifetime of the modeled 2011 NZ population, the mass media campaign to promote weight loss apps usage had an estimated overall health gain of 181 (95% uncertainty interval [UI]: 113, 270) QALYs and health care costs of NZ$ -606,000 (95%UI: -2,540,000, 907,000). The mean health care costs were negative, representing an overall savings to the health system and a likely cost-saving intervention. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequalities arising from high BMI. Conclusions A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the NZ adult population is expected to yield an overall gain in health and to be cost-saving to the health system. While other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost-savings (eg, fiscal policies, food reformulation), governments may choose to include strategies to promote health app usage as complementary measures.

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The cost-effectiveness of a mass media campaign to promote smartphone apps for weight loss: an updated modeling study (Preprint)

JMIR Formative Research ◽

10.2196/29291 ◽

2021 ◽

Author(s):

Amanda C Jones ◽

Leah Grout ◽

Wilson Nick ◽

Nhung Nghiem ◽

Christine L Cleghorn

Keyword(s):

Weight Loss ◽

Cost Effectiveness ◽

Mass Media ◽

Mass Media Campaign ◽

Media Campaign ◽

Smartphone Apps ◽

The Cost ◽

Modeling Study

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“Follow the Whistle: Physical Activity Is Calling You”: Evaluation of Implementation and Impact of a Portuguese Nationwide Mass Media Campaign to Promote Physical Activity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218062 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8062

Author(s):

Marlene Nunes Silva ◽

Cristina Godinho ◽

Marta Salavisa ◽

Katherine Owen ◽

Rute Santos ◽

...

Keyword(s):

Physical Activity ◽

Mass Media ◽

Self Efficacy ◽

Best Practice ◽

Adult Population ◽

Mass Media Campaign ◽

Media Campaign ◽

Online Questionnaire ◽

Intermediate Outcomes ◽

The Impact

To raise perceived capability (C), opportunity (O) and motivation (M) for physical activity (PA) behaviour (B) among adults, the Portuguese Directorate-General of Health developed a mass media campaign named “Follow the Whistle”, based on behaviour change theory and social marketing principles. Comprehensive formative and process evaluation suggests this media-led campaign used best-practice principles. The campaign adopted a population-wide approach, had clear behavioural goals, and clear multi-strategy implementation. We assessed campaign awareness and initial impact using pre (n = 878, 57% women) and post-campaign (n = 1319, 58% women) independent adult population samples via an online questionnaire, comprising socio-demographic factors, campaign awareness and recall, and psychosocial and behavioural measures linked to the COM-B model. PA was assessed with IPAQ and the Activity Choice Index. The post-campaign recall was typical of levels following national campaigns (24%). Post-campaign measures were higher for key theory-based targets (all p < 0.05), namely self-efficacy, perceived opportunities to be more active and intrinsic motivation. The impact on social norms and self-efficacy was moderated by campaign awareness. Concerning PA, effects were found for vigorous activity (p < 0.01), but not for incidental activity. Overall the campaign impacted key theory-based intermediate outcomes, but did not influence incidental activity, which highlights the need for sustained and repeated campaign efforts.

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