By Andrew Tan
Hayes A, Tan EJ, Lung T, Brown V, Moodie M, Baur L. A new model for evaluation of interventions to prevent obesity in early childhood. Frontiers in Endocrinology 2019: forthcoming. https://doi.org/10.3389/fendo.2019.00132
Why we studied this topic
Childhood obesity is a serious public health issue. In Australia, 1 in 4 children is already affected by overweight or obesity at the time of school entry. Governments around the world have recognized this problem through investment in the prevention of pediatric obesity, yet few interventions in early childhood have been subjected to economic evaluation. Information on cost-effectiveness is vital to decisions about program implementation.
A challenge in evaluating preventive interventions in early childhood is to capture long-term costs and outcomes beyond the duration of an intervention, as the benefits of early obesity prevention will not be realized until some years into the future. However, decisions need to be made in the present, and modeling is one way to inform such decisions.
What this paper adds
We developed a new health economic model (the Early Prevention of Obesity in CHildhood (EPOCH) model) for evaluating childhood obesity interventions; and to validate the epidemiologic predictions. The EPOCH model can predict downstream costs and health outcomes in relation to simulated BMI. With the model, interventions can be evaluated singly or in combination by successively applying BMI reductions representing intervention effects at the appropriate age.
What was surprising
To the best of our knowledge, the EPOCH model is the first micro-simulation model to predict BMI and obesity trajectories over childhood and adolescence. An internal validation exercise revealed that the model was reasonably accurate in its predictions of average BMI and obesity trajectories, and was able to predict changing BMI distribution from age 4 years through to age 15 years.
What it means for policy/ practice
The EPOCH model assist policy makers in identifying: when is it best to intervene in childhood; what are the most cost-effective approaches and which population groups will benefit most from interventions.