%0 Journal Article %J Am J Prev Med %D 2015 %T Modeling the Cost Effectiveness of Child Care Policy Changes in the U.S %A Wright, Davene R %A Kenney, Erica L %A Giles, Catherine M %A Long, Michael W %A Ward, Zachary J %A Resch, Stephen C %A Moodie, Marj L %A Carter, Robert C %A Wang, Y Claire %A Sacks, Gary %A Swinburn, Boyd A %A Gortmaker, Steven L %A Cradock, Angie L %K Child Care %K Child Health %K Child, Preschool %K Cohort Studies %K Cost-Benefit Analysis %K Health Expenditures %K Health Policy %K Humans %K Models, Economic %K Obesity %K United States %X INTRODUCTION: Child care facilities influence diet and physical activity, making them ideal obesity prevention settings. The purpose of this study is to quantify the health and economic impacts of a multi-component regulatory obesity policy intervention in licensed U.S. child care facilities. METHODS: Two-year costs and BMI changes resulting from changes in beverage, physical activity, and screen time regulations affecting a cohort of up to 6.5 million preschool-aged children attending child care facilities were estimated in 2014 using published data. A Markov cohort model simulated the intervention's impact on changes in the U.S. population from 2015 to 2025, including short-term BMI effects and 10-year healthcare expenditures. Future outcomes were discounted at 3% annually. Probabilistic sensitivity analyses simulated 95% uncertainty intervals (UIs) around outcomes. RESULTS: Regulatory changes would lead children to watch less TV, get more minutes of moderate and vigorous physical activity, and consume fewer sugar-sweetened beverages. Within the 6.5 million eligible population, national implementation could reach 3.69 million children, cost $4.82 million in the first year, and result in 0.0186 fewer BMI units (95% UI=0.00592 kg/m(2), 0.0434 kg/m(2)) per eligible child at a cost of $57.80 per BMI unit avoided. Over 10 years, these effects would result in net healthcare cost savings of $51.6 (95% UI=$14.2, $134) million. The intervention is 94.7% likely to be cost saving by 2025. CONCLUSIONS: Changing child care regulations could have a small but meaningful impact on short-term BMI at low cost. If effects are maintained for 10 years, obesity-related healthcare cost savings are likely. %B Am J Prev Med %V 49 %P 135-47 %8 2015 Jul %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26094234?dopt=Abstract %R 10.1016/j.amepre.2015.03.016