RESUMEN
OBJECTIVE: To assess the cost-effectiveness a school-based intervention designed to reduce overweight/obesity and other cardiovascular risk factors in children. METHODS: Standard cost effectiveness analysis methods and two perspectives (societal and institutional) were used. A cluster-randomized controlled trial with 10 intervention schools (691 children) and 10 control schools (718 children) was performed. Net costs were calculated by subtracting the usual after-school care cost from intervention costs. The effectiveness of the intervention was measured as the reduction in health outcomes compared with the control group. RESULTS: The intervention costs totaled 125,469.75, representing 269.83 /year/child. The usual after-school care was estimated at 844,56 /year/child. Intervention children showed a decrease in triceps skinfold thickness (-1.25mm, 95% CI: -1.82 to -0.67; P<.001). Intervention children with body mass index (BMI) between the percentiles 25 and 75 showed a decrease in the percentage of body fat (-0.59%; 95% CI: -1.03 to -0.67; P<.001), and those with a BMI>P75 showed a decrease in triceps skinfold thickness (-1.87mm; 95%CI: -3.43 to -0.32; P<.001), and percentage of body fat (-0.67%; 95%CI: -1.32 to -0.01; P<.05). CONCLUSIONS: This type of after-school program for recreational physical activity to prevent obesity are likely to be a cost-effective use of public funds and warrant careful consideration by policy makers and program planners.
Asunto(s)
Terapia por Ejercicio/economía , Sobrepeso/prevención & control , Terapia Recreativa/economía , Servicios de Salud Escolar/economía , Adiposidad , Índice de Masa Corporal , Niño , Análisis Costo-Beneficio , Terapia por Ejercicio/organización & administración , Femenino , Financiación Gubernamental , Humanos , Masculino , Ejercicios de Estiramiento Muscular , Obesidad/economía , Obesidad/epidemiología , Obesidad/prevención & control , Sobrepeso/economía , Sobrepeso/epidemiología , Evaluación de Programas y Proyectos de Salud , Terapia Recreativa/organización & administración , Entrenamiento de Fuerza , Servicios de Salud Escolar/organización & administración , Grosor de los Pliegues Cutáneos , España/epidemiologíaRESUMEN
This article offers a glimpse into the lives and activities of some of the patients, volunteers and staff in the Saskatchewan mental health system during the period of deinstitutionalization. Drawing on her own experience as a patient in psychiatric wards as well as ongoing research in the history of mental health, it features the role of Regina Volunteer Visitors in Saskatchewan Hospital, Weyburn and examines the importance of occupational and recreational therapies and activities in improving the lives of the patients in that institution. It emphasizes the perspectives of patients and volunteers who actively worked to develop recreational activities, with the intention of helping individuals connect with the surrounding communities. The views and perspectives presented here are drawn from a variety of historical and oral interview sources, including views from visitors to the asylum and patients who lived within its walls. The author has also been a consumer of mental health services, and spent time in the Provincial Mental Hospital in North Battleford. The article therefore makes an important contribution to enhancing our understanding of the social history of deinstitutionalization, not only for its unique source base, but also because those sources have been examined and explained to readers through the perspectives of a former patient herself. This article draws significant attention to the changing opportunities for patients as they interacted with the women's volunteer groups, as well as to how the changes brought about by the encroaching deinstitutionalization, care in the community, and decisions from "above" affected the individuals on the ground.