Population-wide strategies to combat physical inactivity face a critical question: which interventions deliver measurable health gains without breaking public health budgets? The economic viability of exercise promotion programs has remained largely unmeasured, leaving policymakers without clear guidance on resource allocation for activity interventions.
A comprehensive analysis of cost-effective physical activity programs reveals that computer-tailored exercise advice emerges as the most economically efficient approach, with incremental costs ranging from $0.15 to $4.14 per metabolic equivalent task hour gained. Five rigorously evaluated interventions demonstrated both behavioral success and economic feasibility, with print-based programs dominating the landscape of proven strategies. The most successful intervention targeted general populations rather than exclusively inactive adults, suggesting broader reach may enhance cost-effectiveness ratios.
This finding challenges conventional wisdom that personalized, high-touch interventions necessarily provide better value. Computer-tailored programs leverage technology to deliver individualized guidance at scale, potentially explaining their superior economic performance. The research landscape remains surprisingly sparse, with only five studies meeting rigorous criteria for both behavioral effectiveness and economic evaluation at population scale. This scarcity reflects the complexity of measuring long-term physical activity changes while accurately capturing intervention costs across diverse populations. The predominance of print-based interventions may reflect the timing of these studies, conducted before widespread digital health adoption. Current cost-effectiveness thresholds suggest that interventions under $5 per activity hour gained represent excellent public health investments, particularly given physical inactivity's estimated annual economic burden exceeding $50 billion in healthcare costs alone. Future programs should prioritize standardized measurement protocols to enable meaningful cross-intervention comparisons.
