Conceptual Framework for Standard Economic Evaluation of Physical Activity Programs in Primary Prevention

Economic evaluations of primary prevention physical activity programs have gained importance because of scarce resources in
health-care-systems. A concept for economic evaluation should be based on the efficacy of physical activity, the standard
methods of economic evaluation and the aims of public health. Previous publications have examined only parts of these components
and have not developed a comprehensive conceptual framework; it is the objective of this article to develop such a framework.
The derived method should aid decision makers and staff members of intervention programs in reviewing and conducting an economic
evaluation. A literature search of articles was done using six electronic databases. Referenced works for standard methods
and more comprehensive approaches for evaluation of preventive programs were studied. The newly developed conceptual framework
for economic evaluation includes: (1) the type of physical activity program; (2) features of a selected study population;
(3) the outcome dimension comprising exercise efficacy, reach, recruitment, response rate, maintenance, compliance and adverse
health effects plus the social impact; and (4) the cost dimension consisting of program development costs, program implementation
costs including the implementation, recruitment, program, participants’ time costs and savings resulting from the health effects
of the intervention. Cost-effectiveness also depends on the methodology, such as the chosen perspective, data collection,
valuation methods and discounting. If an intervention is not considered cost-effective, it is necessary to check each dimension
to find possible failures in order to learn for future interventions. A more detailed economic evaluation is of utmost importance
for improved comparability and transferability.