Brian K. Chen JD, PhD , Michael W. Beets PhD , Sarah Burkart PhD , Christopher D. Pfledderer PhD , Elizabeth Adams PhD , R. Glenn Weaver PhD , Bridget Armstrong PhD , Keith Brazendale PhD , Xuanxuan Zhu MS , Alexander McLain PhD
{"title":"防止弱势家庭儿童夏季体重增加的免费夏令营代金券项目的成本效益。","authors":"Brian K. Chen JD, PhD , Michael W. Beets PhD , Sarah Burkart PhD , Christopher D. Pfledderer PhD , Elizabeth Adams PhD , R. Glenn Weaver PhD , Bridget Armstrong PhD , Keith Brazendale PhD , Xuanxuan Zhu MS , Alexander McLain PhD","doi":"10.1016/j.amepre.2025.108081","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Summer day camps can mitigate summer weight gain by providing a structured daily environment that promotes healthy behaviors, but summer day camps are often cost prohibitive to families with low income. This study evaluated the cost effectiveness of providing free summer day camps to disadvantaged children to prevent summer weight gain.</div></div><div><h3>Methods</h3><div>A total of 422 children from a low-income school district in South Carolina were recruited and randomly assigned to receive 8–10 weeks of free summer day camps or to experience summer as usual in 2021–2023. The incremental cost-effectiveness ratio was calculated by dividing summer day camp cost by the difference between the intervention and control groups in changes in BMI z-scores from the start to end of summer. Incremental cost-effectiveness ratios at varied doses of summer day camp participation were also calculated. Sensitivity analyses were conducted using nonparametric bootstrapping of trial-based BMI z-score outcomes, matched with summer day camp costs from across the country. The probability of cost effectiveness was assessed over a range of potential costs at which policymakers may be willing to support.</div></div><div><h3>Results</h3><div>The summer day camp voucher program averted 0.0917 BMI z-score gain relative to the controls at a cost of $1,307, yielding an incremental cost-effectiveness ratio of $1,463 per 0.1 BMI z-score averted per child. Attending summer day camp 5 days per week, representing the highest dose, yielded the highest cost effectiveness. Sensitivity analyses showed that the bootstrapped incremental cost-effectiveness ratios averaged $2,187 per 0.1 BMI z-score averted, with 80% being <$3,500 per 0.1 BMI z-score averted.</div></div><div><h3>Conclusions</h3><div>The voucher program is likely cost effective, with 80% probability of cost effectiveness if policymakers are willing to pay $3,500 per 0.1 BMI z-score averted.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 6","pages":"Article 108081"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Cost Effectiveness of a Free Summer Day Camp Voucher Program to Prevent Summer Weight Gain Among Children From Disadvantaged Households\",\"authors\":\"Brian K. Chen JD, PhD , Michael W. Beets PhD , Sarah Burkart PhD , Christopher D. Pfledderer PhD , Elizabeth Adams PhD , R. Glenn Weaver PhD , Bridget Armstrong PhD , Keith Brazendale PhD , Xuanxuan Zhu MS , Alexander McLain PhD\",\"doi\":\"10.1016/j.amepre.2025.108081\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Summer day camps can mitigate summer weight gain by providing a structured daily environment that promotes healthy behaviors, but summer day camps are often cost prohibitive to families with low income. This study evaluated the cost effectiveness of providing free summer day camps to disadvantaged children to prevent summer weight gain.</div></div><div><h3>Methods</h3><div>A total of 422 children from a low-income school district in South Carolina were recruited and randomly assigned to receive 8–10 weeks of free summer day camps or to experience summer as usual in 2021–2023. The incremental cost-effectiveness ratio was calculated by dividing summer day camp cost by the difference between the intervention and control groups in changes in BMI z-scores from the start to end of summer. Incremental cost-effectiveness ratios at varied doses of summer day camp participation were also calculated. Sensitivity analyses were conducted using nonparametric bootstrapping of trial-based BMI z-score outcomes, matched with summer day camp costs from across the country. The probability of cost effectiveness was assessed over a range of potential costs at which policymakers may be willing to support.</div></div><div><h3>Results</h3><div>The summer day camp voucher program averted 0.0917 BMI z-score gain relative to the controls at a cost of $1,307, yielding an incremental cost-effectiveness ratio of $1,463 per 0.1 BMI z-score averted per child. Attending summer day camp 5 days per week, representing the highest dose, yielded the highest cost effectiveness. 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The Cost Effectiveness of a Free Summer Day Camp Voucher Program to Prevent Summer Weight Gain Among Children From Disadvantaged Households
Introduction
Summer day camps can mitigate summer weight gain by providing a structured daily environment that promotes healthy behaviors, but summer day camps are often cost prohibitive to families with low income. This study evaluated the cost effectiveness of providing free summer day camps to disadvantaged children to prevent summer weight gain.
Methods
A total of 422 children from a low-income school district in South Carolina were recruited and randomly assigned to receive 8–10 weeks of free summer day camps or to experience summer as usual in 2021–2023. The incremental cost-effectiveness ratio was calculated by dividing summer day camp cost by the difference between the intervention and control groups in changes in BMI z-scores from the start to end of summer. Incremental cost-effectiveness ratios at varied doses of summer day camp participation were also calculated. Sensitivity analyses were conducted using nonparametric bootstrapping of trial-based BMI z-score outcomes, matched with summer day camp costs from across the country. The probability of cost effectiveness was assessed over a range of potential costs at which policymakers may be willing to support.
Results
The summer day camp voucher program averted 0.0917 BMI z-score gain relative to the controls at a cost of $1,307, yielding an incremental cost-effectiveness ratio of $1,463 per 0.1 BMI z-score averted per child. Attending summer day camp 5 days per week, representing the highest dose, yielded the highest cost effectiveness. Sensitivity analyses showed that the bootstrapped incremental cost-effectiveness ratios averaged $2,187 per 0.1 BMI z-score averted, with 80% being <$3,500 per 0.1 BMI z-score averted.
Conclusions
The voucher program is likely cost effective, with 80% probability of cost effectiveness if policymakers are willing to pay $3,500 per 0.1 BMI z-score averted.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.