AUTHOR=Oosterhoff Marije , van Schayck Onno C. P. , Bartelink Nina H. M. , Bosma Hans , Willeboordse Maartje , Winkens Bjorn , Joore Manuela A. 

TITLE=The Short-Term Value of the “Healthy Primary School of the Future” Initiative: A Social Return on Investment Analysis

JOURNAL=Frontiers in Public Health

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00401

DOI=10.3389/fpubh.2020.00401

ISSN=2296-2565

ABSTRACT=<p><bold>Background:</bold> This study examines the social return on investment (SROI) of the “Healthy Primary School of the Future” initiative after 2 years.</p><p><bold>Methods:</bold> Healthy Primary Schools of the Future (HPSF) provide a healthy lunch and daily structured physical activity sessions, whereas Physical Activity Schools (PAS) focus on physical activity only. We evaluated the 2-years investments and effects (<italic>N</italic> = 1,676 children) of both school environments (four schools) compared to control schools (four schools). Investments and outcomes were grouped within the healthcare, education, household &amp; leisure, and labor &amp; social security sector. Outcomes that could be expressed in monetary terms were used for the calculation of social return on investment.</p><p><bold>Results:</bold> HPSF and PAS created outcomes for the healthcare sector by favorable changes in health behaviors, body mass index [both significant], and medical resource use [not significant]. Outcomes for the education sector included a favorable impact on perceived social behaviors and school satisfaction, and absenteeism from school [latter not significant], and more engagement with the community was experienced. The per child investments, €859 (HPSF) and €1017 (PAS), generated a benefit of €8 (HPSF) and €49 (PAS) due to reduced school absenteeism and medical resource use.</p><p><bold>Conclusions:</bold> Within 2 years of intervention implementation, the HPSF initiative created outcomes in several sectors, but the benefits did not outweigh the investments. Follow-up assessments as well as modeling long-term outcomes are needed to assess the total value of the interventions. Until then, the SROI framework can inform strategies for obtaining stakeholder support and intervention implementation.</p><p><bold>Trial registration:</bold> The study was registered in the <ext-link ext-link-type="uri" xlink:href="https://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> database on 14 June 2016 (NCT02800616).</p>