Original article

Scand J Work Environ Health 2018;44(5):503-511    pdf full text

doi:10.5271/sjweh.3740

Economic evaluation of a randomized controlled trial of an intervention to reduce office workers’ sitting time: the "Stand Up Victoria" trial

by Gao L, Flego A, Dunstan DW, Winkler EAH, Healy GN, Eakin EG, Willenberg L, Owen N, LaMontagne AD, Lal A, Wiesner GH, Hadgraft NT, Moodie ML

Objectives This study aimed to assess the economic credentials of a workplace-delivered intervention to reduce sitting time among desk-based workers.

Methods We performed within-trial cost-efficacy analysis and long-term cost-effectiveness analysis (CEA) and recruited 231 desk-based workers, aged 24–65 years, across 14 worksites of one organization. Multicomponent workplace-delivered intervention was compared to usual practice. Main outcome measures including total device-measured workplace sitting time, body mass index (BMI), self-reported health-related quality of life (Assessment of Quality of Life-8D, AQoL-8D), and absenteeism measured at 12 months.

Results Compared to usual practice, the intervention was associated with greater cost (AU$431/person), benefits in terms of reduced workplace sitting time [-46.8 minutes/8-hour workday, 95% confidence interval (CI): -69.9– -23.7] and increased workplace standing time (42.2 minutes/8-hour workday, 95% CI 23.8–60.6). However, there were no significant benefits for BMI [0.148 kg/m2 (95% CI-1.407–1.703)], QoL-8D [-0.006 (95% CI -0.074–0.063)] and absenteeism [2.12 days (95% CI -2.01–6.26)]. The incremental cost-efficacy ratios (ICER) ranged from AU$9.94 cost/minute reduction in workplace sitting time to AU$13.37/minute reduction in overall sitting time. CEA showed the intervention contributed to higher life year (LY) gains [0.01 (95% CI 0.009–0.011)], higher health-adjusted life year (HALY) gains [0.012 (95% CI 0.0105 – 0.0135)], and higher net costs [AU$344 (95% CI $331–358)], with corresponding ICER of AU$34 443/LY and AU$28 703/HALY if the intervention effects were to be sustained for five-years. CEA results were sensitive to assumptions surrounding intervention-effect decay rate and discount rate.

Conclusions The intervention was cost-effective over the lifetime of the cohort when scaled up to the national workforce and provides important

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