Anokye Nana, Mansfield Louise, Kay Tess, Sanghera Sabina, Lewin Alex, Fox-Rushby Julia
Department of Clinical Sciences, Health Economics Research Group, Institute of Environment, Health and Societies (IEHS), Brunel University, London, Middlesex, UK.
Department of Life Sciences, Sport, Health and Wellbeing Research Group, Welfare, Health and Wellbeing, IEHS, BUL, London, UK.
BMJ Open. 2018 Dec 19;8(12):e024132. doi: 10.1136/bmjopen-2018-024132.
An effectiveness and cost-effectiveness analyses of two-staged community sports interventions; taster sports sessions compared with portfolio of community sport sessions.
Quasi-experiment using an interrupted time series design.
Community sports projects delivered by eight lead partners in London Borough of Hounslow, UK.
Inactive people aged 14 plus years (n=246) were recruited between May 2013 and February 2014.
Community sports interventions delivered in two stages, 6-week programme of taster sport sessions (stage 1) and 6-week programme of portfolio of community sporting sessions delivered by trained coaches (stage 2).
(a) Change in days with ≥30 min of self-reported vigorous intensity physical activity (PA), moderate intensity PA, walking and sport; and (b) change in subjective well-being and EQ5D5L quality-adjusted life-years (QALYs).
Interrupted time series analysis evaluated the effectiveness of the two-staged sports programmes. Cost-effectiveness analysis compares stage 2 with stage 1 from a provider's perspective, reporting outcomes of incremental cost per QALY (2015/2016 price year). Uncertainty was assessed using deterministic and probabilistic sensitivity analyses.
Compared with stage 1, counterfactual change at 21 days in PA was lower for vigorous (log odds: -0.52; 95% CI -1 to -0.03), moderate PA (-0.50; 95% CI 0.94 to 0.05) and sport(-0.56; 95% CI -1.02 to -0.10). Stage 2 increased walking (0.28; 95% CI 0.3 to 0.52). Effect overtime was similar. Counterfactual change at 21 days in well-being was positive particularly for 'happiness' (0.29; 95% CI 0.06 to 0.51). Stage 2 was more expensive (£101 per participant) but increased QALYs (0.001; 95% CI -0.034 to 0.036). Cost per QALY for stage 2 was £50 000 and has 29% chance of being cost-effective (£30 000 threshold).
Community-based sport interventions could increase PA among inactive people. Less intensive sports sessions may be more effective and cost-effective.
对两阶段社区体育干预措施进行效果和成本效益分析；将体验式体育课程与社区体育课程组合进行比较。
采用中断时间序列设计的准实验。
由英国豪恩斯洛伦敦自治市的八个主要合作伙伴开展的社区体育项目。
2013年5月至2014年2月招募了年龄在14岁及以上的不活跃人群（n = 246）。
社区体育干预分两个阶段进行，第一阶段是为期6周的体验式体育课程，第二阶段是由训练有素的教练提供的为期6周的社区体育课程组合。
（a）自我报告的剧烈强度身体活动（PA）、中等强度PA、步行和运动时间≥30分钟的天数变化；（b）主观幸福感和EQ5D5L质量调整生命年（QALYs）的变化。
中断时间序列分析评估了两阶段体育项目的效果。成本效益分析从提供者的角度比较了第二阶段和第一阶段，报告了每QALY的增量成本结果（2015/2016价格年）。使用确定性和概率敏感性分析评估不确定性。
与第一阶段相比，PA在21天时的反事实变化对于剧烈运动（对数优势：-0.52；95%CI -1至-0.03）、中等强度PA（-0.50；95%CI 0.94至0.05）和运动（-0.56；95%CI -1.02至-0.10）较低。第二阶段增加了步行时间（0.28；95%CI 0.3至0.52）。随时间的效果相似。幸福感在21天时的反事实变化为正，尤其是对于“快乐”（0.29；95%CI 0.06至0.51）。第二阶段成本更高（每位参与者101英镑），但增加了QALYs（0.001；95%CI -0.034至0.036）。第二阶段每QALY的成本为50000英镑，具有29%的成本效益可能性（阈值为30000英镑）。
基于社区的体育干预措施可增加不活跃人群的PA。强度较低的体育课程可能更有效且更具成本效益。
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