CHOICES: CHildhood Obesity Intervention Cost-Effectiveness Study

Stopping the obesity epidemic with cost-effective interventions

CHOICES LogoThe Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) is working to help reverse the US obesity epidemic by identifying the most cost-effective childhood obesity interventions.

Adults and children in the US consume more calories from foods and beverages than they are expending. Over the past few decades, this trend has created an obesity epidemic.

Identifying what works to prevent childhood obesity has become a priority for public health researchers, policymakers, and the general public.

Little attention has been paid, however, to identifying solutions that not only work, but that deliver the best results for the dollars invested in them. Some interventions can even produce cost savings. Identifying these cost-effective interventions is the goal of  the CHOICES project.

Project Description

CHOICES is a collaboration between the Harvard School of Public Health, Columbia University and research partners at Deakin and Queensland University in Australia. Over a three-year period, the CHOICES Research Team will assess the comparative-effectiveness and cost-effectiveness of approximately 40 interventions aimed at reducing childhood obesity, including policy changes and interventions that have been identified as being effective, promising or prevalent.


In order to develop a cost-effectiveness model for obesity prevention in the United States, the Harvard Prevention Research Team will generate cost-effectiveness estimates for 40 of the most relevant childhood obesity prevention interventions, many of which are in wide-spread use, but have never been fully evaluated to determine their comparative-effectiveness and cost-effectiveness.

The cost-effectiveness analyses will be conducted in two sequential phases, allowing for the opportunity to add new interventions to those being evaluated after the first year. The analyses will be completed for each of the 40 selected interventions, using comparable methods for assessing costs, effectiveness, and both short- and longer-term measures of cost-effectiveness. The third year of the project will be reserved for dissemination of findings generated from the assessments to decision makers, researchers and practitioners.

Intervention Selection

Interventions to be evaluated may include policy-based, family-oriented and community-based approaches, as well as innovative uses of media and health communication methods and more traditional school curriculum- and community-based programs. The range of interventions to be studied will include those that:

  • have sufficient research evidence available to analyze,
  • have the potential to reduce obesity in kids,
  • are most widely implemented and/or  familiar to policy makers and program leadership,
  • applicable to a range of ages, from early childhood to adolescents, and
  • have the potential for broad implementation, i.e., can be applied to local, community, state and national levels.

Several implementation considerations will also be reviewed, including impact on equity of sensitive populations, feasibility of implementation, sustainability of impact and overall population reach.

Stakeholder Engagement

Engagement of experts in childhood obesity prevention is integral to the success of the project as they will help to:

  • lay the groundwork for the research,
  • ensure that the focus of the research is of use to the field of obesity prevention research
  • identify and prioritize strategies with the highest impact on obesity, and
  • advise dissemination efforts in academic journals and conferences as well as through an interactive CHOICES website.

The Harvard School of Public Health Prevention Research Center is a member of the Prevention Research Centers Program, supported by the Centers for Disease Control and Prevention cooperative agreement number 1-U48-DP-001946.