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The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time

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posted on 2023-12-05, 12:14 authored by E Cox, S Walker, CL Edwardson, SJH Biddle, AM Clarke-Cornwell, SA Clemes, MJ Davies, DW Dunstan, H Eborall, MH Granat, LJ Gray, GN Healy, BD Maylor, F Munir, T Yates, G Richardson
Sedentary behaviours continue to increase and are associated with heightened risks of morbidity and mortality. We assessed the cost-effectiveness of SMART Work & Life (SWAL), an intervention designed to reduce sitting time inside and outside of work, both with (SWAL-desk) and without (SWAL-only) a height-adjustable workstation compared to usual practice (control) for UK office workers. Health outcomes were assessed in quality-adjusted life-years (QALY) and costs in pound sterling (2019–2020). Discounted costs and QALYs were estimated using regression methods with multiply imputed data from the SMART Work & Life trial. Absenteeism, productivity and wellbeing measures were also evaluated. The average cost of SWAL-desk was £228.31 and SWAL-only £80.59 per office worker. Within the trial, SWAL-only was more effective and costly compared to control (incremental cost-effectiveness ratio (ICER): £12,091 per QALY) while SWAL-desk was dominated (least effective and most costly). However, over a lifetime horizon, both SWAL-only and SWAL-desk were more effective and more costly than control. Comparing SWAL-only to control generated an ICER of £4985 per QALY. SWAL-desk was more effective and costly than SWAL-only, generating an ICER of £13,378 per QALY. Findings were sensitive to various worker, intervention, and extrapolation-related factors. Based on a lifetime horizon, SWAL interventions appear cost-effective for office-workers conditional on worker characteristics, intervention cost and longer-term maintenance in sitting time reductions.

Funding

SMArT Work: Stand More AT Work

National Institute for Health Research

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Citation

Cox E, Walker S, Edwardson CL, Biddle SJH, Clarke-Cornwell AM, Clemes SA, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Maylor BD, Munir F, Yates T, Richardson G. The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time. Int J Environ Res Public Health. 2022 Nov 11;19(22):14861. doi: 10.3390/ijerph192214861. PMID: 36429578; PMCID: PMC9690649.

Author affiliation

Diabetes Research Centre, University of Leicester; Department of Health Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

International Journal of Environmental Research and Public Health

Volume

19

Issue

22

Pagination

14861

Publisher

MDPI AG

issn

1661-7827

eissn

1660-4601

Acceptance date

2022-11-09

Copyright date

2022

Available date

2022-11-11

Spatial coverage

Switzerland

Language

eng

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