{
  "abstract": "Background In England, by the age of five, obesity affects almost 1 in 10 children. The Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) intervention was successfully implemented in the USA. The costs and consequences of implementing NAPSACC in the UK is unknown.Methods The NAPSACC UK cluster randomised controlled trial evaluated the impact of implementing NAPSACC in early childhood education and care (ECEC) providers, such as nurseries and pre-schools, in England and Scotland. Eligible children were 2-5-year-olds. The intervention arm received two cycles of self-assessment of practice, staff training workshops, and goal and action planning. The control arm continued with usual practice. A cost-consequence analysis was conducted from the public health, ECEC provider and parents/carers perspective. In addition, cost-effectiveness analyses were conducted from the public health and ECEC provider perspective for total physical activity on ECEC days and total energy consumed at the ECEC provider.Results In total, 25 and 27 ECEC providers (clusters) were randomised to the intervention and control arms, respectively. Just over three-quarters (n=19/25) of the intervention ECEC providers completed one or more cycles. Total mean intervention costs per ECEC provider were £2,590 for the first 12 months. A large proportion (86%) of these costs were incurred by the ECEC provider. The intervention had the potential to be cost-effective for reducing calorie intake. If public health and ECEC providers were willing to pay £30 per child to achieve a meaningful reduction in calorie intake (10 kcal per ECEC day), there was a high probability of the intervention being cost-effective. However, the intervention was unlikely to be cost-effective for improving physical activity levels.Conclusion Our results indicate that implementing the intervention in England and Scotland in its current form is unlikely to be cost-effective. The UK’s Clinical Study Registry: ISRCTN33134697.",
  "authors": [
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Madeleine Cochrane"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "William Hollingworth"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Kimberly Hannam"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Jemima Cooper"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Miranda Pallan"
    },
    {
      "affiliations": [
        "MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK"
      ],
      "name": "Sharon Simpson"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Rebecca Langford"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Russell Jago"
    },
    {
      "affiliations": [
        "Pennington Biomedical Research Centre, Louisiana State University System, Baton Rouge, USA"
      ],
      "name": "Corby K Martin"
    },
    {
      "affiliations": [
        "School for Policy Studies, University of Bristol, Bristol, UK"
      ],
      "name": "Zoi Toumpakari"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Laura Johnson"
    },
    {
      "affiliations": [
        "School of Medicine, Cardiff University, Cardiff, UK"
      ],
      "name": "James White"
    },
    {
      "affiliations": [
        "MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK"
      ],
      "name": "Laurence Moore"
    },
    {
      "affiliations": [
        "University of North Carolina, Chapel Hill, USA"
      ],
      "name": "Dianne Ward"
    },
    {
      "affiliations": [
        "Bristol Medical School, University of Bristol, Bristol, UK"
      ],
      "name": "Ruth Kipping"
    }
  ],
  "title": "P01-2 Economic evaluation alongside a cluster randomised controlled trial of a nutrition and physical activity intervention for 2-5-year-olds in England and Scotland",
  "uid": "e52c950b-d726-5b43-98b3-93132bf4b38a"
}