Economically viable population-based interventions to promote physical activity behavior based on a systematic review

OBJECTIVE: Physical inactivity contributes to substantial public health and economic burdens. This study reviews the cost-effectiveness of population-based physical activity interventions. The literature search focused on studies that have successfully promoted physical activity behavior based on valid measurement. METHODS: The systematic literature search was conducted across five electronic databases in January 2021. To facilitate comparison between studies, the results on effect size and cost-effectiveness (incremental cost-effectiveness ratio, ICER) were harmonized. RESULTS: All five studies included in this review were trial-based economic evaluations, of which two studies modeled long-term cost-effectiveness. The included studies were mainly print-based interventions, and their ICER values ranged from 0.15 to 4.14 US$ (2024) per metabolic equivalent of task hour gained (including only intervention costs). The most economically viable intervention utilized computer-tailored physical activity advice in the general population, while three interventions targeted inactive adults. CONCLUSIONS: Only a few intervention studies showed positive effects on physical activity behavior and evaluated their cost-effectiveness at the population level. Future studies should consider accurate cost calculations and reporting, high-quality methods for measuring physical activity behavior, and inter-individual variations. Moreover, unified standardized methods for determining the cost-effectiveness of physical activity interventions are needed.