Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES)

ACHD was selected to join the CHOICES Learning Collaborative Partnership in 2018. This year-long process brings together health agencies and the expertise of the CHOICES team to build capacity among local decision-makers to use cost-effectiveness analysis to identify childhood obesity prevention strategies that offer the best value for money. This partnership process helps to cultivate alliances and support for future childhood obesity prevention planning.


The CHOICES microsimulation model predicts what will happen in the future if we do not implement childhood obesity prevention strategies. We created a virtual population of people who look like real people in Allegheny County. We projected their growth over time, taking into account trends from health and behavior data and population growth. We predict future obesity rates 10 years later, as well as future obesity related health care costs. We compare what happens if we implement these strategies versus what happens if we do nothing.

To create the model, ACHD spoke with real experts for the two strategies of Active PE and Afterschool Snack Policies. Active PE experts included Physical Education (PE) teachers, education researchers, and school administration. Afterschool experts included out of school time program staff and directors. These experts met with the CHOICES Team at two in-person site visits and spoke with ACHD staff about their experiences with PE and food served during out of school time programs. Conversations and data from experts, along with Live Well Allegheny Community Partners helped to build the model.


Active PE

The first strategy that ACHD modeled with the CHOICES Team focused on Active PE in Live Well Allegheny Schools. We modeled what would happen if school districts committed 50% of physical education (PE) class to moderate to vigorous physical activity. This strategy included implementing an evidence-based program called SPARK PE. SPARK PE includes on-site workshops led to train PE teachers on strategies and curricula to implement Active PE, providing equipment and instructional materials needed to maintain Active PE, and oversight of implementation and monitoring from an Allegheny County PE coordinator.

For more information about this strategy and model results, check out our Active PE Brief.

Healthy Snacks in Out of School Time

The second strategy that ACHD modeled with the CHOICES Team focused on a healthy snack policy with Allegheny Partners for Out of School Time (APOST) and Healthy Out of School Time (HOST). We modeled what would happen if APOST and HOST implemented a policy that does not allow children to bring in their own snacks to afterschool programs and only offers healthy food and/or beverage choices that are part of federal reimbursable meal programs and support good nutrition. This strategy had two scenarios: when foods and beverages/sugary drinks are prohibited and when just beverages/sugary drinks are prohibited.

For more information about this strategy and model results, check out our Healthy Snacks Policy Brief.