Dr. Justin Moore Discusses “Cost-effectiveness of Community-based Minigrants to Increase Physical Activity in Youth”

Justin B. Moore, PhD, MS, FACSM

At JPHMP, our mission is to advance and disseminate impactful, practice-based evidence to inform initiatives and policies to improve population health. The public health researchers, academics, policy makers, and practitioners who contribute content to the journal support this mission and strive to improve public health for all communities through their research.

We sat down with Justin Moore, PhD, associate editor of the Journal of Public Health Management and Practice, to discuss the article, Cost-effectiveness of Community-Based Minigrants to Increase Physical Activity in Youth.”

JPHMP Direct: You are the lead author of this article, which explores the challenge of ensuring American children get an appropriate amount of physical activity. How significant is this problem?

Justin Moore: Very significant. A lot of attention has been focused on physical activity as it relates to obesity, and for good reason. However, while the benefits of physical activity include prevention of obesity in youth, they are much greater than that and encompass psychological, cardiometabolic, and social benefits that are independent of the effect on obesity.

Direct: You consider the cost-effectiveness of community-led physical activity intervention programs significant. Can you explain why the return on investment in this space is so important?

Moore: Economic austerity is currently the name of the game as it relates to public health. As such, getting the best “bang for the buck” is paramount and should be, even in less lean times. Therefore, we can’t afford to waste meager public health resources on programs or policies that have a low return on investment.

Direct: The community grantees of the Eat Smart, Move More program could have requested up to $20,000 dollars. How did they put those funds to use?

Moore: Many ways. I would refer you to supplemental Figure 1 of an earlier paper in JPHMP: Moore JB, Brinkley J, Morris SF, Oniffrey TM, Kolbe MB. (2016) Effectiveness of Community-Based Minigrants to Increase Physical Activity and Decrease Sedentary Time in Youth. J Public Health Manag Pract. 22(4):370-8.

Direct: Once the data were collected from the twenty North Carolina counties measuring the physical activity of children in grades 4 through 8, what kinds of insights did the data provide regarding the cost-effectiveness of these programs?

Moore: Honestly, there weren’t a lot of discernable patterns in terms of what they did. However, communities that had strong partnerships between their health department and community organizations appeared to perform better. This suggests that groups that know their target audience, pick evidence-based programs, and work well together are most effective.

Direct: With promising cost-effectiveness rations (CERs), it’s fair to say that community-based minigrants are a cost-effective way to augment the level of physical activity in America’s youth. In your opinion, how should public health officials best leverage this finding?

Moore: By increasing funding for state and local health departments to expand these minigrant programs.

Direct: What result or aspect of this research was most surprising to you?

Moore: I was surprised by the return on investment. These minigrant programs are really a good use of taxpayer funds since all our kids benefit at a much lower price than medication or highly structured programs.

Direct: Knowing these programs can be cost-effective, what advice would you give to a community interested in developing a similar program?

Moore: First, invest in community-based physical activity promotion. Second, don’t fund the entirety of any program. The latter may sound counterintuitive, but we want to seed partnerships, not purchase an existing program. The former tends to continue to grow after the funding is gone.

Direct: The results showed an overall increase in moderate-to-vigorous physical activity of 2.3 minutes per day across all 30 participating counties. Can you explain the real-world implications of such an increase?

Moore: At an individual level, it’s not a lot more time per week. However, at a population level, it could mean that millions more children are achieving the recommended 60 minutes of physical activity daily, which has been empirically shown to have health benefits.

Direct: Is there value to be gleaned from the two counties that received community-based minigrants that exhibited no increase in physical activity across the youth population sampled?

Moore: Possibly, but it would require more study. Unfortunately, the funding for this project has expired and the minigrant program was discontinued a couple of years ago.

Direct: Any final thoughts regarding the cost-effectiveness of community-based minigrants as it pertains to youth physical activity intervention?

Moore: I think we can do better by increasing the effectiveness. We’re working on a follow-up project, so stay tuned.

To read the abstract for this article, visit http://journals.lww.com/jphmp/Citation/2017/07000/Cost_effectiveness_of_Community_Based_Minigrants.7.aspx. *Subscribe to the journal to read the full article.

About Justin B. Moore, PhD, MS

Dr. Moore is the Associate Editor of the Journal of Public Health Management and Practice and an Associate Professor in the Department of Family & Community Medicine of the Wake Forest School of Medicine at the Wake Forest Baptist Medical Center in Winston-Salem, NC, USA. Follow him on Twitter and Instagram.

Dr. Moore is a graduate of Texas A&M University – Corpus Christi (BS), the University of Mississippi (MS), and the University of Texas at Austin (PhD). He also holds a certificate of competencies in Epidemiology from the University of Michigan School of Public Health.

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