Vrije Universiteit Brussel, Department of Movement and Sport Sciences Pleinlaan 2, 1050 Brussel, Belgium.
Scand J Work Environ Health. 2020 Mar 1;46(2):127-142. doi: 10.5271/sjweh.3871. Epub 2019 Dec 10.
Objective The workplace is an ideal setting to implement public health strategies, but economic justification for such interventions is needed. Therefore, we performed a critical appraisal and synthesis of health economic evaluations (HEE) of workplace interventions aiming to increase physical activity (PA) and/or decrease sedentary behavior (SB). Methods A comprehensive search filter was developed using appropriate guidelines, such as the Peer Review of Electronic Search Strategies (PRESS) checklist, and published search algorithms. Six databases and hand searches were used to identify eligible studies. Full HEE of workplace interventions targeting PA/SB were included. Methodological quality was assessed using the Consensus Health Economic Criteria (CHEC) list. Two researchers independently performed all procedures. Hedges' g was calculated to compare intervention effects. Outcomes from HEE were recalculated in 2017 euros and benefit-standardized. Results Eighteen HEE were identified that fulfilled on average 68% of the CHEC list criteria. Most studies showed improvements in PA/SB, but effects were small and thus, their relevance is questionable. Interventions were heterogeneous, no particular intervention type was found to be more effective. HEE were heterogeneous regarding methodological approaches and the selection of cost categories was inconsistent. Indirect costs were the main cost driver. In all studies, effects on costs were subject to substantial uncertainty. Conclusions Due to small effects and uncertain impact on costs, the economic evidence of worksite PA/SB-interventions remains unclear. Future studies are needed to determine effective strategies. The HEE of such interventions should be developed using guidelines and validated measures for productivity costs. Additionally, studies should model the long-term costs and effects because of the long pay-back time of PA/SB interventions.
目的 工作场所是实施公共卫生策略的理想场所，但需要对这些干预措施进行经济论证。因此，我们对旨在增加身体活动（PA）和/或减少久坐行为（SB）的工作场所干预措施的健康经济评估（HEE）进行了批判性评价和综合分析。
方法 使用适当的指南（如同行评审电子搜索策略（PRESS）清单和已发表的搜索算法）开发了全面的搜索筛选器。使用六个数据库和手工搜索来确定合格的研究。纳入了针对 PA/SB 的工作场所干预措施的全 HEE。使用共识健康经济标准（CHEC）清单评估方法学质量。两名研究人员独立进行了所有程序。计算 Hedge's g 以比较干预效果。从 HEE 中得出的结果以 2017 年欧元重新计算，并进行效益标准化。
结果 确定了 18 项符合 CHEC 清单标准平均 68%的 HEE。大多数研究显示 PA/SB 有所改善，但效果较小，因此其相关性值得怀疑。干预措施具有异质性，没有发现特定的干预类型更有效。HEE 在方法学方法和成本类别的选择上存在差异，不一致。间接成本是主要的成本驱动因素。在所有研究中，成本效果都存在很大的不确定性。
结论 由于效果较小且对成本的影响不确定，工作场所 PA/SB 干预措施的经济证据仍不清楚。需要进一步的研究来确定有效的策略。此类干预措施的 HEE 应使用指南和经过验证的生产力成本措施进行开发。此外，由于 PA/SB 干预措施的回报时间较长，研究应建立长期成本和效果模型。
