Cost-effectiveness of community-based minigrants to increase physical activity in youth

Context: American youth are insufficiently active, andminigrant programs have been developed to facilitate implementation of evidence-based interventions in communities. However, little is known about the cost-effectiveness of targeted minigrant programs for the implementation of physical activity (PA) promoting strategies for youth. Objective: To determine the cost-effectiveness of a minigrant program to increase PA among youth. Design: Twenty community grantees were pair-matched and randomized to receive funding at the beginning of year 1 (2010-2011) or year 2 (2011-2012) to implement interventions to increase PA in youth. Costs were calculated by examining financial reports provided by the granting organization and grantees. Setting: Twenty counties in North Carolina. Participants: A random sample of approximately 800 fourth- to eighth-grade youth (per year) from the approximately 6100 youth served by the 20 community-based interventions. Main Outcome Measure: Cost-effectiveness ratios (CERs) were calculated at the county and project levels to determine the cost per child-minute of moderate-to-vigorous PA (MVPA) increased by wave. Analyses were conducted utilizing cost data from 20 community grantees and accelerometer-derived PA from the participating youth. Results: Of the 20 participating counties, 18 counties displayed increased youth MVPA between at least 2 waves of observation. Of those 18 counties, the CER (US dollars/MVPAminutes per day) ranged from $0.02 to $1.86 (n = 13) in intervention year 1, $0.02 to $6.19 (n = 15) in intervention year 2, and $0.02 to $0.58 (n = 17) across both years. Conclusion: If utilized to implement effectual behavior change strategies, minigrants can be a cost-effective means of increasing children's MVPA, with a low monetary cost per minute of MVPA.