Dollahite J, Kenkel D, Thompson CS. An economic evaluation of the expanded food and nutrition education program.
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2008;
40:134-143. [PMID:
18457781 DOI:
10.1016/j.jneb.2007.08.011]
[Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 08/19/2007] [Accepted: 08/21/2007] [Indexed: 05/26/2023]
Abstract
OBJECTIVE
To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology.
DESIGN
Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program.
SETTING
Cooperative Extension, 35 counties.
PARTICIPANTS
5730 low-income participants.
INTERVENTION
Series of 6 or more food and nutrition lessons.
MAIN OUTCOME MEASURES
Cost (program and participant); health benefits in quality adjusted life years (QALYs); and monetized benefits: society's willingness to pay for QALYs, and benefits of avoiding or delaying health care costs and loss of productivity.
ANALYSIS
Cost-effectiveness estimated from behavior change and QALY weights. Cost-benefit ratios estimated from costs and monetized benefits. Sensitivity analyses provided ranges where lack of agreement exists around parameters' values.
RESULTS
Cost was $892/graduate. Cost-effectiveness was 245 QALYs saved, at $20863/QALY (sensitivity 42-935 QALYs, $5467-$130311 per QALY). Societal willingness to pay benefit-to-cost ratio was $9.58:$1.00 (sensitivity $1.44-$41.92:$1:00); narrow governmental benefit-to-cost ratio was $0.82:$1.00 (sensitivity $0.08-$4.33:$1:00).
CONCLUSIONS AND IMPLICATIONS
Outcome data indicate that food and nutrition behavior changes resulting from the Program are likely to improve future health and reduce health care costs. Cost-effectiveness is estimated to be as great as for many current health interventions.
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