复杂工作场所营养教育与环境饮食改善干预措施的成本分析
A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions.
作者信息
Fitzgerald Sarah, Kirby Ann, Murphy Aileen, Geaney Fiona, Perry Ivan J
机构信息
Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
Department of Economics, Aras na Laoi, University College Cork, Cork, Ireland.
出版信息
BMC Public Health. 2017 Jan 9;17(1):49. doi: 10.1186/s12889-016-3988-7.
BACKGROUND
The workplace has been identified as a priority setting to positively influence individuals' dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer's perspective.
METHODS
Cost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace.
RESULTS
The combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist's time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs).
CONCLUSIONS
Within multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary interventions.
TRIAL REGISTRATION
Current Controlled Trials: ISRCTN35108237 . Date of registration: The trial was retrospectively registered on 02/07/2013.
背景
工作场所已被确定为一个优先设置领域，以对个人的饮食行为产生积极影响。然而，关于实施和开展工作场所饮食干预措施的成本，现有证据不足。本研究旨在从雇主的角度对工作场所营养教育和环境饮食改善干预措施进行成本分析。
方法
成本数据来自一项工作场所饮食干预试验——“工作场所食物选择研究”。微观成本核算方法估算了在爱尔兰科克的四个跨国制造工作场所实施和开展为期1年的干预措施的相关成本。这些工作场所被分配到以下组之一：对照组、仅营养教育组、仅环境饮食改善组以及营养教育与环境饮食改善相结合组。四个工作场所共招募了850名员工。为便于比较，将每个工作场所的总成本按500名员工进行标准化。
结果
联合干预措施的总成本最高，为31,108欧元。营养教育干预措施的总成本为28,529欧元。环境饮食改善干预措施的总成本为3689欧元。对照工作场所的总成本为零。每名员工的年均成本为：联合干预措施：62欧元，营养教育：57欧元，环境改善：7欧元，对照：零欧元。营养师的时间是所有干预措施的主要成本贡献因素（占总成本的53%至75%）。
结论
在多成分干预措施中，与环境改善策略相比，实施和开展营养教育要素的相对成本较高。相对于对照组，工作场所环境改善策略增加的成本微不足道。研究结果将为雇主和公共卫生政策制定者提供有关实施和推广饮食干预措施的经济可行性的信息。
试验注册
当前受控试验：ISRCTN35108237。注册日期：该试验于2013年7月2日进行回顾性注册。
Zotero 插件