***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children . The intervention was modelled on the LEAP ( live , eat and play ) trial , a r and omised controlled trial conducted by the Centre for Community Child Health , Melbourne , Australia in 2002 - 2003 . This study was undertaken as part of the assessing cost-effectiveness ( ACE ) in obesity project which evaluated , using consistent methods , 13 interventions targeting unhealthy weight gain in children and adolescents . METHOD A logic pathway was used to model the effects of the intervention compared to no intervention on body mass index ( BMI ) and health outcomes ( disability-adjusted life years-DALYs ) . Disease costs and health benefits were tracked until the cohort of eligible children reached the age of 100 years or death . Simulation-modelling techniques were used to present a 95 % uncertainty interval around the cost-effectiveness ratio . The intervention was also assessed against a series of filters ( ' equity ' , ' strength of evidence ' , ' acceptability ' , ' feasibility ' , sustainability ' and ' side-effects ' ) to incorporate additional factors that impact on re source allocation decisions . RESULTS The intervention , as modelled , reached 9685 children aged 5 - 9 years with a BMI z-score of > or=3.0 , and cost $ AUD6.3 M ( or $ AUD4.8 M excluding time costs ) . It result ed in an incremental saving of 2300 BMI units which translated to 511 DALYs . The cost-offsets stemming from the intervention totalled $ AUD3.6 M , result ing in a net cost per DALY saved of $ AUD4670 ( dominated ; $ 0.1 M ) ( dominated means intervention costs more for less effect ) . CONCLUSION Compared to a ' no intervention ' control group , the intervention was cost-effective under current assumptions , although the uncertainty intervals were wide . A key question related to the long-term sustainability of the small incremental weight loss reported , based on the 9-month follow-up results for LEAP BACKGROUND Effective programmes to help children manage their weight are required . ' Families for Health ' focuses on a parenting approach , design ed to help parents develop their parenting skills to support lifestyle change within the family . Families for Health version 1 showed sustained reductions in mean body mass index ( BMI ) z-score after 2 years in a pilot project . OBJECTIVE The aim was to evaluate its effectiveness and cost-effectiveness in a r and omised controlled trial ( RCT ) . DESIGN The trial was a multicentre , investigator-blind RCT , with a parallel economic and process evaluation , with follow-up at 3 and 12 months . R and omisation was by family unit , using a 1 : 1 allocation by telephone registration , stratified by three sites , with a target of 120 families . SETTING Three sites in the West Midl and s , Engl and , UK . PARTICIPANTS Children aged 6 - 11 years who were overweight ( ≥ 91st centile BMI ) or obese ( ≥ 98th centile BMI ) , and their parents/carers . Recruitment was via referral or self-referral . INTERVENTIONS Families for Health version 2 is a 10-week , family-based community programme with parallel groups for parents and children , addressing parenting , lifestyle , social and emotional development . Usual care was the treatment for childhood obesity provided within each locality . MAIN OUTCOME MEASURES Joint primary outcome measures were change in children 's BMI z-score and incremental cost per quality -adjusted life-year ( QALY ) gained at 12 months ' follow-up ( QALYs were calculated using the European Quality of Life-5 Dimensions Youth version ) . Secondary outcome measures included changes in children 's waist circumference , percentage body fat , physical activity , fruit/vegetable consumption and quality of life . Parents ' BMI and mental well-being , family eating/activity , parent-child relationships and parenting style were also assessed . The process evaluation documented recruitment , reach , dose delivered , dose received and fidelity , using mixed methods . RESULTS The study recruited 115 families ( 128 children ; 63 boys and 65 girls ) , with 56 families r and omised to the Families for Health arm and 59 to the ' usual-care ' control arm . There was 80 % retention of families at 3 months ( Families for Health , 46 families ; usual care , 46 families ) and 72 % retention at 12 months ( Families for Health , 44 families ; usual care , 39 families ) . The change in BMI z-score at 12 months was not significantly different in the Families for Health arm and the usual-care arm [ 0.114 , 95 % confidence interval ( CI ) -0.001 to 0.229 ; p = 0.053 ] . However , within-group analysis showed that the BMI z-score was significantly reduced in the usual-care arm ( -0.118 , 95 % CI -0.203 to -0.034 ; p = 0.007 ) , but not in the Families for Health arm ( -0.005 , 95 % CI -0.085 to 0.078 ; p = 0.907 ) . There was only one significant difference between groups for secondary outcomes . The economic evaluation , taking a NHS and Personal Social Services perspective , showed that mean costs 12 months post r and omisation were significantly higher for Families for Health than for usual care ( £ 998 vs. £ 548 ; p < 0.001 ) . The mean incremental cost-effectiveness of Families for Health was estimated at £ 552,175 per QALY gained . The probability that the Families for Health programme is cost-effective did not exceed 40 % across a range of thresholds . The process evaluation demonstrated that the programme was implemented , as planned , to the intended population and any adjustments did not deviate widely from the h and book . Many families waited more than 3 months to receive the intervention . Facilitators ' , parents ' and children 's experiences of Families for Health were largely positive and there were no adverse events . Further analysis could explore why some children show a clinical ly significant benefit while others have a worse outcome . CONCLUSIONS Families for Health  was neither effective nor cost-effective for the management of obesity in children aged 6 - 11 years , in comparison with usual care . Further exploration of the wide range of responses in BMI z-score in children  following the Families for Health and usual-care interventions is warranted , focusing on children who had a clinical ly significant benefit and those who showed a worse outcome with treatment . Further research could focus on the role of parents in the prevention of obesity , rather than treatment . TRIAL REGISTRATION Current Controlled Trials IS RCT N45032201 . FUNDING This project was funded by the National Institute for Health Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 21 , No. 1 . See the NIHR Journals Library website for further project information Background The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development . However , no information on the cost-effectiveness of interventions in China is available . The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity . We hypothesized the integrated intervention which combined nutrition education and physical activity ( PA ) is more cost-effective than the same intensity of single intervention . Methods And Findings : A multi-center r and omized controlled trial conducted in six large cities during 2009 - 2010 . A total of 8301 primary school students were categorized into five groups and followed one academic year . Nutrition intervention , PA intervention and their shared common control group were located in Beijing . The combined intervention and its ’ control group were located in other 5 cities . In nutrition education group , ‘ nutrition and health classes ’ were given 6 times for the students , 2 times for the parents and 4 times for the teachers and health workers . " Happy 10 " was carried out twice per day in PA group . The comprehensive intervention was a combination of nutrition and PA interventions  . BMI and BAZ increment was 0.65 kg/m2 ( SE 0.09 ) and 0.01 ( SE 0.11 ) in the combined intervention , respectively , significantly lower than that in its ’ control group ( 0.82±0.09 for BMI , 0.10±0.11 for BAZ ) . No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its ’ control , which is the same case in the nutrition intervention . The single intervention has a relative lower intervention costs compared with the combined intervention . Labor costs in Guangzhou , Shanghai and Jinan was higher compared to other cities . The cost-effectiveness ratio was $ 120.3 for BMI and $ 249.3 for BAZ in combined intervention , respectively . Conclusions The school-based integrated obesity intervention program was cost-effectiveness for children in urban China . Trial Registration Chinese Clinical Trial Registry ChiCTR-PRC-09000402 URL : BACKGROUND A school-based obesity prevention study ( Medical College of Georgia FitKid Project ) started in the fall of 2003 in 18 elementary schools . Half of the schools were r and omized to an after-school program that included moderate-to-vigorous physical activity , healthy snacks , homework assistance , and academic enrichment .  All third grade rs were invited to enroll . The objective of this study was to assess the cost-effectiveness ( CE ) of the first-year intervention . METHODS St and ard CE analysis methods and a societal perspective were used . Program delivery costs incurred during the first-year intervention and the usual after-school care costs that would occur in the absence of the intervention were estimated ( in 2003 dollars ) . Net intervention costs were calculated by subtracting the usual after-school care costs from the intervention costs . The effectiveness of the intervention was measured as percent body fat ( % BF ) reduction compared with a control condition . The CE was assessed as the net intervention cost divided by the effectiveness of the intervention . RESULTS The intervention costs totaled $ 174,070 , $ 558/student , or $ 956/student who attended > or = 40 % of the intervention sessions . The usual after-school care costs were estimated at $ 639/student . Students who attended > or = 40 % of the intervention reduced % BF by 0.76 % ( 95 % confidence interval : -1.42 to -0.09 ) at an additional cost of $ 317/student . CONCLUSIONS Subjects who attended > or = 40 % of the intervention achieved a significant reduction in % BF at a relatively low cost . School-based obesity prevention programs of this type are likely to be a cost-effective use of public funds and warrant careful consideration by policy makers and program planners Abstract Background Few school-based interventions have been successful in reducing physical activity decline and preventing overweight and obesity in adolescent population s. As a result , few cost effectiveness analyses have been reported . The aim of this paper is to report the cost and cost effectiveness of the Physical Activity 4 Everyone ( PA4E1 ) intervention which was a multi-component intervention implemented in secondary schools located in low-income communities .  Cost effectiveness was assessed using both the physical activity and weight status trial outcomes . Methods Intervention and Study Design : The PA4E1 cluster r and omised controlled trial was implemented in 10 Australian secondary schools ( 5 intervention : 5 control ) and consisted of intervention schools receiving seven physical activity promotion strategies and six additional strategies that supported school implementation of the intervention components . Costs associated with physical activity strategies , and intervention implementation strategies within the five intervention schools were estimated and compared to the costs of usual physical activity practice s of schools in the control group . The total cost of implementing the intervention was estimated from a societal perspective , based on the number of enrolled students in the target grade at the start of the intervention ( Grade 7 , n = 837 ) . Economic Outcomes : The economic analysis outcomes were cost and incremental cost effectiveness ratios for the following : minutes of moderate-to-vigorous physical activity ( MVPA ) per day gained , MET hours gained per person/day ; Body Mass Index ( BMI ) unit avoided ; and 10 % reduction in BMI z-score . Results The intervention cost AUD $ 329,952 over 24 months , or AUD$394 per student in the intervention group . This result ed in a cost effectiveness ratio of AUD$56 ( $ 35–$147 ) per additional minute of MVPA , AUD$1 ( $ 0.6–$2.7 ) per MET hour gained per person per day , AUD$1408 ( $ 788–$6,570 ) per BMI unit avoided , and AUD$563 ( $ 282–$3,942 ) per 10 % reduction in BMI z-score . Conclusion PA4E1 is a cost effective intervention for increasing the physical activity levels and reducing unhealthy weight gain in adolescence , a period in which physical activity typically declines . Additional modelling could explore the potential economic impact of the intervention on morbidity and mortality . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12612000382875 OBJECTIVE : Family-based , behavioral treatment has been shown to be an effective intervention for the management of pediatric obesity .  The goal of this study was to compare the cost-effectiveness of two protocol s for the delivery of family-based behavioral treatment . REA SEARCH METHODS AND PROCEDURES : Thirty-one families with obese children were r and omized to groups in which families were provided mixed treatment incorporating both group and individualized treatment vs 
    Output:
    
The majority , particularly “ behavioural and policy ” preventive interventions , were cost-effective , even cost-saving .