Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Project

Project DescriptionKids running in a field

The Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Project is a collaboration among researchers at the Harvard T.H. Chan School of Public Health and the Milken Institute School of Public Health at The George Washington University.  The CHOICES team is also collaborating with the Association of State and Territorial Health Officials (ASTHO), National Association of County and City Health Officials (NACCHO), Big Cities Health Coalition (BCHC), and a variety of state and local health agencies in a series of Learning Collaborative Partnerships (LCPs).

The CHOICES Project is working to help reverse the U.S. obesity epidemic by identifying the most cost-effective childhood obesity interventions. Adults and children in the U.S. 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. CHOICES is focused on identifying these cost-effective interventions.

The CHOICES research team has generated cost-effectiveness estimates for more than 40 of the most widely promoted or implemented childhood obesity prevention interventions, many of which have never been fully evaluated for comparative- or cost-effectiveness. CHOICES’ research identifies cost-effective childhood obesity intervention strategies within four key settings:

  • School
  • Early Care and Out of School Time
  • Clinical/Treatment
  • Community

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Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Project logo

Principal Investigators: Steven Gortmaker, PhD and Angie Cradock, ScD, MPE
Full Website:
Funder: The JPB Foundation
Contact: Jenny Reiner (Project Manager)

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Peer-Reviewed Publications

Ward ZJ, Willett WC, Hu FB, Pacheco LS, Long MW, Gortmaker SL. Excess mortality associated with elevated body weight in the USA by state and demographic subgroup: A modelling study. eClinicalMedicine. 2022 Apr;48.

Kenney EL, Mozaffarian RS, Long MW, Barrett JL, Cradock AL, Giles CM, Ward ZJ, Gortmaker SL. Limiting Television to Reduce Childhood Obesity: Cost-Effectiveness of Five Population StrategiesChild Obes. 2021 May 10. doi: 10.1089/chi.2021.0016. Epub ahead of print. PMID: 33970695.

Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sexPLOS ONE. 2021 Mar;16(3): e0247307. doi:10.1371/journal.pone.0247307.

Kenney EL, Barrett JL, Bleich SN, Ward ZJ, Cradock AL, Gortmaker SL. Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends. Health Aff. 2020;39(7). doi:10.1377/hlthaff.2020.00133

Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax CN, Long MW, Gortmaker SL. Projected U.S. State-Level Prevalence of Adult Obesity and Severe ObesityN Engl J Med. 2019;381:2440-50. doi: 10.1056/NEJMsa1909301

Kenney EL, Cradock AL, Long MW, Barrett JL, Giles CM, Ward ZJ, Gortmaker SL. Cost-effectiveness of water promotion strategies in schools for preventing childhood obesity and increasing water intake. Obesity. 2019;27(12):2037-2045. doi:10.1002/oby.22615.

Long MW, Polacsek M, Bruno P, Giles CM, Ward ZJ, Cradock AL, Gortmaker SL. Cost-Effectiveness Analysis and Stakeholder Evaluation of 2 Obesity Prevention Policies in Maine, USJournal of Nutrition Education and Behavior. 2019 Aug [Epub ahead of print], pii: S1499-4046(19)30922-4.

Daepp MIG, Gortmaker SL, Wang YC, Long MW, Kenney EL. WIC Food Package Changes: Trends in Childhood Obesity PrevalencePediatrics. 2019;143(5):e20182841.

Ward Z, Long M, Resch S, Giles C, Cradock A, Gortmaker S. Simulation of Growth Trajectories of Childhood Obesity into AdulthoodN Engl J Med. 2017 Nov 30;377(22):2145-2153.

Sharifi M, Franz C, Horan CM, Giles C, Long M, Ward Z, Resch S, Marshall R, Gortmaker S, Taveras E. Cost-Effectiveness of a Clinical Childhood Obesity InterventionPediatrics. 2017; 140(5):e20162998.

Cradock AL, Barrett JL, Kenney EL, Giles CM, Ward ZJ, Long MW, Resch SC, Pipito AA, Wei ER, Gortmaker SL. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhoodPrev Med. 2016 Oct 20. pii: S0091-7435(16)30339-5.

Long MW, Ward ZJ, Resch SC, Cradock AL, Wang YC, Giles CM, Gortmaker SL. State-level estimates of childhood obesity prevalence in the United States corrected for report biasInternational Journal of Obesity. 2016 Aug 30.

Blondin KJ, Giles CM, Cradock AL, Gortmaker SL, Long MW. US States’ Childhood Obesity Surveillance Practices and Recommendations for Improving Them, 2014-2015Prev Chronic Dis. 2016;13:160060.

Dietz WH, Gortmaker SL. New Strategies to Prioritize Nutrition, Physical Activity, and Obesity InterventionsAm J Prev Med. 2016 Apr 26. pii: S0749-3797(16)30069-1.

Ward ZJ, Long MW, Resch SC, Gortmaker SL, Cradock AL, Giles C, Hsiao A, Wang YC. Redrawing the US Obesity Landscape: Bias-Corrected Estimates of State-Specific Adult Obesity PrevalencePLoS ONE. 2016; 11(3): e0150735.

Gortmaker SL, Wang YC, Long MW, Giles CM, Ward ZJ, Barrett JL, Kenney EL, Sonneville KR, Afzal AS, Resch SC, Cradock AL. Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement. Health Aff. 2015 Nov 1;34(11):1932-9.