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Cost-effectiveness of Community-Based Minigrants to Increase Physical Activity in Youth

Moore, Justin B. PhD, MS; Heboyan, Vahé PhD; Oniffrey, Theresa M. MPH, EMT-P; Brinkley, Jason PhD; Andrews, Sara M. MPH, MAT, RD; Kolbe, Mary Bea MPH, RD

Journal of Public Health Management & Practice: July/August 2017 - Volume 23 - Issue 4 - p 364–369
doi: 10.1097/PHH.0000000000000486
Research Full Report

Context: American youth are insufficiently active, and minigrant 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/MVPA minutes 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.

Department of Family & Community Medicine, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston–Salem, North Carolina (Dr Moore); Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, Georgia (Dr Heboyan); Cerus Consulting, LLC, Winston–Salem, North Carolina (Ms Oniffrey); American Institutes for Research, Chapel Hill, North Carolina (Dr Brinkley); Durham Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina (Ms Andrews); and Community & Clinical Connections for Prevention and Health Branch, Chronic Disease and Injury Section–North Carolina Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina (Ms Kolbe).

Correspondence: Justin B. Moore, PhD, MS, Department of Family & Community Medicine, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston–Salem, NC 27157 (

This work was supported by a grant (RWJ 67126) from the Active Living Research program of the Robert Wood Johnson Foundation. Additional support was provided by the North Carolina Department of Health and Human Services.

The authors have no other relevant financial disclosures related to the content of this article.

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