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

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.

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

2020 ◽  
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.

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

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.

scholarly journals Health Benefits and Cost-Effectiveness From Promoting Smartphone Apps for Weight Loss: Multistate Life Table Modeling (Preprint)

2018 ◽  
Author(s):  
Christine Cleghorn ◽  
Nick Wilson ◽  
Nisha Nair ◽  
Giorgi Kvizhinadze ◽  
Nhung Nghiem ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Mass Media ◽  
Health System ◽  
Life Table ◽  
Total Population ◽  
Smartphone App ◽  
Smartphone Apps ◽  
The Mass Media ◽  
Multistate Life Table

BACKGROUND Obesity is an important risk factor for many chronic diseases. Mobile health interventions such as smartphone apps can potentially provide a convenient low-cost addition to other obesity reduction strategies. OBJECTIVE This study aimed to estimate the impacts on quality-adjusted life-years (QALYs) gained and health system costs over the remainder of the life span of the New Zealand population (N=4.4 million) for a smartphone app promotion intervention in 1 calendar year (2011) using currently available apps for weight loss. METHODS The intervention was a national mass media promotion of selected smartphone apps for weight loss compared with no dedicated promotion. A multistate life table model including 14 body mass index–related diseases was used to estimate QALYs gained and health systems costs. A lifetime horizon, 3% discount rate, and health system perspective were used. The proportion of the target population receiving the intervention (1.36%) was calculated using the best evidence for the proportion who have access to smartphones, are likely to see the mass media campaign promoting the app, are likely to download a weight loss app, and are likely to continue using this app. RESULTS In the base-case model, the smartphone app promotion intervention generated 29 QALYs (95% uncertainty interval, UI: 14-52) and cost the health system US $1.6 million (95% UI: 1.1-2.0 million) with the standard download rate. Under plausible assumptions, QALYs increased to 59 (95% UI: 27-107) and costs decreased to US $1.2 million (95% UI: 0.5-1.8) when standard download rates were doubled. Costs per QALY gained were US $53,600 for the standard download rate and US $20,100 when download rates were doubled. On the basis of a threshold of US $30,000 per QALY, this intervention was cost-effective for Māori when the standard download rates were increased by 50% and also for the total population when download rates were doubled. CONCLUSIONS In this modeling study, the mass media promotion of a smartphone app for weight loss produced relatively small health gains on a population level and was of borderline cost-effectiveness for the total population. Nevertheless, the scope for this type of intervention may expand with increasing smartphone use, more easy-to-use and effective apps becoming available, and with recommendations to use such apps being integrated into dietary counseling by health workers.

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

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.

Cost-effectiveness of the Victorian sugary drink public education mass media campaign: a modelled analysis

2019 ◽  
Vol 13 (3) ◽  
pp. 247
Author(s):  
Nikki McCaffrey ◽  
Belinda Morley ◽  
Alison McAleese ◽  
Victoria Brown ◽  
Anita Lal ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Public Education ◽  
Mass Media ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Sugary Drink

Abstract MP12: Comparing Effectiveness of Mass Media Campaigns vs. Price Reductions Targeting Fruit and Vegetable Intake on US Cvd Mortality and Race Disparities

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Jonathan Pearson-Stuttard ◽  
Piotr Bandosz ◽  
Colin D Rehm ◽  
Ashkan Afshin ◽  
Jose Penalvo ◽  
...  
Keyword(s):  
Mass Media ◽  
Population Level ◽  
Effect Sizes ◽  
Price Reduction ◽  
Mass Media Campaign ◽  
Media Campaign ◽  
Fruit And Vegetable ◽  
Race Disparities ◽  
The Us ◽  
Cvd Mortality

Introduction: Cardiovascular disease (CVD) accounts for over 800,000 US deaths annually, with substantial disparities by race. Poor diet is a leading CVD risk factor, including low intake of fruit and vegetable (F&V). Few data exist regarding the potential population level impact and effect on race disparities of policies aimed at increasing F&V intake. Aim: To estimate CVD mortality reductions, including by race, potentially achievable by price reduction and mass media campaign interventions in the US population up to 2030. Methods: We developed a US IMPACT Food Policy Model to compare three contrasting policies targeting F&V intake: A - a national mass media campaign (MMC); B and C - a universal F&V price reduction of 10 and 30% respectively. The MMC assumed unequal coverage by age, gender and race, and duration of either 1 or 15 years. Data sources included the National Vital Statistics System, SEER single year population estimates, the US Bureau 2012 National Population projections and NHANES. We used US population and CVD projections to 2030, F&V mortality effect sizes and best evidence effect sizes for each policy. We modelled cumulative deaths prevented or postponed and life years gained (LYG) by age, gender, race and CVD subtype from 2015 to 2030. Results were tested in a probabilistic sensitivity analysis using Monte Carlo simulation. Results: Scenario A (MMC) could result in 27,000 (95% CI: 21,000-33,000) to 85,000 (83,000-89,000) fewer deaths dependent upon media campaign duration (from 1 to 15 years), gaining up to 1,280,000 LYGs (1,250,000-1,320,000) by 2030. Approximately 62% of deaths prevented would be CHD; and 53% would be in men, with 20% being saved in year 1. Scenario B (10% price decrease) could prevent approximately 90,000 deaths (71,000-114,000) and gain 1,450,000 LYGs (1,180,000-1,740,000) by 2030. Scenario C (30% price decrease) could prevent some 270,000 deaths (215,000-338,000) by 2030, representing a 3.9% reduction in expected CVD mortality. Price reduction policies would have equitable effects in non-hispanic whites vs. blacks. In comparison, a MMC would be ~ 35% less effective in preventing CVD deaths in non-Hispanic blacks. Conclusions: Price reduction policies (10 or 30%) and a nationwide MMC would each effectively reduce US CVD mortality. A 30% price reduction policy would save most lives and do so most equitably. Deaths prevented via a MMC might reduce substantially after year 1 and also increase disparities. These results inform potential fiscal and population level strategies to reduce CVD mortality in the US.

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