The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time

Edward Cox (), Simon Walker, Charlotte L. Edwardson, Stuart J. H. Biddle, Alexandra M. Clarke-Cornwell, Stacy A. Clemes, Melanie J. Davies, David W. Dunstan, Helen Eborall, Malcolm H. Granat, Laura J. Gray, Genevieve N. Healy, Benjamin D. Maylor, Fehmidah Munir, Thomas Yates and Gerry Richardson
Additional contact information
Edward Cox: Centre for Health Economics, University of York, York YO10 5DD, UK
Simon Walker: Centre for Health Economics, University of York, York YO10 5DD, UK
Charlotte L. Edwardson: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
Stuart J. H. Biddle: Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia
Alexandra M. Clarke-Cornwell: School of Health & Society, University of Salford, Salford M6 6PU, UK
Stacy A. Clemes: NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
Melanie J. Davies: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
David W. Dunstan: Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
Helen Eborall: Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
Malcolm H. Granat: School of Health & Society, University of Salford, Salford M6 6PU, UK
Laura J. Gray: Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
Genevieve N. Healy: School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia
Benjamin D. Maylor: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
Fehmidah Munir: School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
Thomas Yates: Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
Gerry Richardson: Centre for Health Economics, University of York, York YO10 5DD, UK

IJERPH, 2022, vol. 19, issue 22, 1-14

Abstract: Sedentary behaviours continue to increase and are associated with heightened risks of morbidity and mortality. We assessed the cost-effectiveness of SMART Work & Life (SWAL), an intervention designed to reduce sitting time inside and outside of work, both with (SWAL-desk) and without (SWAL-only) a height-adjustable workstation compared to usual practice (control) for UK office workers. Health outcomes were assessed in quality-adjusted life-years (QALY) and costs in pound sterling (2019–2020). Discounted costs and QALYs were estimated using regression methods with multiply imputed data from the SMART Work & Life trial. Absenteeism, productivity and wellbeing measures were also evaluated. The average cost of SWAL-desk was £228.31 and SWAL-only £80.59 per office worker. Within the trial, SWAL-only was more effective and costly compared to control (incremental cost-effectiveness ratio (ICER): £12,091 per QALY) while SWAL-desk was dominated (least effective and most costly). However, over a lifetime horizon, both SWAL-only and SWAL-desk were more effective and more costly than control. Comparing SWAL-only to control generated an ICER of £4985 per QALY. SWAL-desk was more effective and costly than SWAL-only, generating an ICER of £13,378 per QALY. Findings were sensitive to various worker, intervention, and extrapolation-related factors. Based on a lifetime horizon, SWAL interventions appear cost-effective for office-workers conditional on worker characteristics, intervention cost and longer-term maintenance in sitting time reductions.

Keywords: cost-effectiveness; SMART; sedentary behaviour; healthy habits; standing desks (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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