PDF(Pubmed)
Abstract：
BACKGROUND: Chronic diseases, or non-communicable diseases (NCD), are conditions of long duration and often influenced and contributed by complex interactions of several variables, including genetic, physiological, environmental, and behavioral factors. These conditions contribute to death, disability, and subsequent health care costs. Primary and secondary school settings provide an opportunity to deliver relatively low cost and effective interventions to improve public health outcomes. However, there lacks systematic evidence on the cost-effectiveness of these interventions.
METHODS: We systematically searched four databases (PubMed/Medline, Cochrane, Embase, and Web of Science) for published studies on the cost-effectiveness of chronic-disease interventions in school settings. Studies were eligible for inclusion if they assessed interventions of any chronic or non-communicable disease, were conducted in a school setting, undertook a full cost-effectiveness analysis and were available in English, Spanish, or French.
RESULTS: Our review identified 1029 articles during our initial search of the databases, and after screening, 33 studies were included in our final analysis. The most used effectiveness outcome measures were summary effectiveness units such as quality-adjusted life years (QALYs) (22 articles; 67%) or disability-adjusted life years (DALYs) (4 articles; 12%). The most common health condition for which an intervention targets is overweight and obesity. Almost all school-based interventions were found to be cost-effective (30 articles; 81%).
CONCLUSIONS: Our review found evidence to support a number of cost-effective school-based interventions targeting NCDs focused on vaccination, routine physical activity, and supplement delivery interventions. Conversely, many classroom-based cognitive behavioral therapy for mental health and certain multi-component interventions for obesity were not found to be cost-effective.
METHODS: We systematically searched four databases (PubMed/Medline, Cochrane, Embase, and Web of Science) for published studies on the cost-effectiveness of chronic-disease interventions in school settings. Studies were eligible for inclusion if they assessed interventions of any chronic or non-communicable disease, were conducted in a school setting, undertook a full cost-effectiveness analysis and were available in English, Spanish, or French.
RESULTS: Our review identified 1029 articles during our initial search of the databases, and after screening, 33 studies were included in our final analysis. The most used effectiveness outcome measures were summary effectiveness units such as quality-adjusted life years (QALYs) (22 articles; 67%) or disability-adjusted life years (DALYs) (4 articles; 12%). The most common health condition for which an intervention targets is overweight and obesity. Almost all school-based interventions were found to be cost-effective (30 articles; 81%).
CONCLUSIONS: Our review found evidence to support a number of cost-effective school-based interventions targeting NCDs focused on vaccination, routine physical activity, and supplement delivery interventions. Conversely, many classroom-based cognitive behavioral therapy for mental health and certain multi-component interventions for obesity were not found to be cost-effective.
摘要：
背景：慢性病，或非传染性疾病（NCD），是持续时间长的条件，经常受到几个变量复杂相互作用的影响和贡献，包括遗传,生理,环境,和行为因素。这些条件有助于死亡，残疾,以及随后的医疗费用。中小学环境提供了一个机会，可以提供相对低成本和有效的干预措施，以改善公共卫生结果。然而,缺乏有关这些干预措施的成本效益的系统证据.
方法：我们系统地搜索了四个数据库(PubMed/Medline，科克伦,Embase,和WebofScience）有关学校环境中慢性病干预措施的成本效益的已发表研究。如果研究评估了任何慢性或非传染性疾病的干预措施，则有资格纳入研究。是在学校环境中进行的，进行了全面的成本效益分析，并以英文提供，西班牙语,或者法语。
结果：我们的评论在我们最初搜索数据库时发现了1029篇文章，经过筛选,33项研究包括在我们的最终分析中。最常用的有效性结果指标是汇总有效性单位，例如质量调整生命年（QALYs）（22篇；67％）或残疾调整生命年（DALYs）（4篇；12％）。干预目标最常见的健康状况是超重和肥胖。发现几乎所有基于学校的干预措施都具有成本效益（30篇文章；81％）。
结论：我们的综述发现有证据支持针对非传染性疾病的一些成本有效的学校干预措施，重点是疫苗接种，常规体力活动,并补充交付干预措施。相反，许多基于课堂的心理健康认知行为疗法和某些针对肥胖的多组分干预措施均未发现具有成本效益.
方法：我们系统地搜索了四个数据库(PubMed/Medline，科克伦,Embase,和WebofScience）有关学校环境中慢性病干预措施的成本效益的已发表研究。如果研究评估了任何慢性或非传染性疾病的干预措施，则有资格纳入研究。是在学校环境中进行的，进行了全面的成本效益分析，并以英文提供，西班牙语,或者法语。
结果：我们的评论在我们最初搜索数据库时发现了1029篇文章，经过筛选,33项研究包括在我们的最终分析中。最常用的有效性结果指标是汇总有效性单位，例如质量调整生命年（QALYs）（22篇；67％）或残疾调整生命年（DALYs）（4篇；12％）。干预目标最常见的健康状况是超重和肥胖。发现几乎所有基于学校的干预措施都具有成本效益（30篇文章；81％）。
结论：我们的综述发现有证据支持针对非传染性疾病的一些成本有效的学校干预措施，重点是疫苗接种，常规体力活动,并补充交付干预措施。相反，许多基于课堂的心理健康认知行为疗法和某些针对肥胖的多组分干预措施均未发现具有成本效益.
