Research on the sustainable development of physical education students' exercise in colleges and universities / Pesquisa sobre o desenvolvimento sustentável do exercício de estudantes de educação física em faculdades e universidades / Investigación sobre el desarrollo sostenible del ejercicio de estudiantes de educación física en colegios y universidades

ABSTRACT Introduction: The essence of sustainable development is ecological civilization. The entire modern development, including sports in colleges and universities, is built based on resource conservation, enhanced environmental support capabilities, and a virtuous ecological environment cycle to achieve sustainable economic and social development. Objective: Looking at the development history of sports in Chinese colleges and universities for more than 50 years, there have been many successful experiences in human resource development, and there are also many problems that need to be solved. Methods: The author took 442 people from 4 provinces as the survey object, researched and discussed the evaluation indicators of the sustainable development of sports in colleges and universities. After factor analysis and professional theoretical research, a total of 15 indicators in 5 categories were established: science and technology, moral education, system Standard category, economic, competitive development category, external input category, and the coach training system category that eliminates "inbreeding." Results: The author found in the research that both sports and non-sports families in China are unwilling to engage in sports and college sports for their children. The main reasons are traditional ideological issues, sports social status issues, and athletes' education issues. Among them, coaches, the "inbreeding" training system is one of the main reasons that affect the sports talent resources of colleges and universities in China. Conclusions: There can be at least five types of evaluation indicators for the sustainable development of sports in Chinese colleges and universities: science and technology and ethics education, institutional norms, economic and competitive development, external investment, and a coach training system that eliminates inbreeding. The income of sports families is generally lower than that of non-sports families, and their education level is also lower. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Antecedentes: A essência do desenvolvimento sustentável é a civilização ecológica Todo o desenvolvimento moderno, incluindo esportes universitários, é baseado na economia de recursos, fortalecimento da capacidade de suporte ambiental e realização do desenvolvimento econômico e social sustentável do ciclo ecológico e ambiental. Objetivo: revisar o curso de desenvolvimento de educação física da universidade chinesa por mais de 50 anos, há muitas experiências bem-sucedidas no desenvolvimento de recursos humanos e muitos problemas a serem resolvidos. Métodos: 442 pessoas de 4 províncias foram investigadas para conhecer o índice de avaliação do desenvolvimento sustentável da educação física universitária. Por meio da análise fatorial e da pesquisa da teoria profissional, foram determinados 15 índices de cinco categorias principais: ciência e tecnologia, educação moral, normas institucionais, economia, desenvolvimento competitivo, insumos externos e eliminação da consanguinidade. Resultados: as famílias esportivas e não esportivas não estão dispostas a permitir que seus filhos participem de atividades esportivas universitárias, sendo os principais motivos as ideias tradicionais, o status social do esporte e a educação dos atletas. Entre eles, o sistema de treinamento "consanguíneo" de treinadores é um dos principais motivos que afetam os recursos de talentos esportivos das universidades chinesas. Conclusão: O índice de avaliação do desenvolvimento sustentável da educação física nas universidades chinesas pode ser dividido em pelo menos cinco categorias: educação científica e ética, normas institucionais, desenvolvimento econômico e competitivo, investimento externo, eliminação do sistema endógamo de treinamento de treinadores. A renda das famílias que praticam esportes é geralmente menor do que a das não praticantes, e o nível de educação também é baixo. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Antecedentes: la esencia del desarrollo sostenible es la civilización ecológica. Todo el desarrollo moderno, incluidos los deportes universitarios, se basa en el ahorro de recursos, el fortalecimiento de la capacidad de apoyo ambiental y la realización del desarrollo económico y social sostenible del ciclo ecológico y ambiental. Objetivo: revisar el curso de desarrollo de la educación física universitaria en China durante más de 50 años, hay muchas experiencias exitosas en el desarrollo de los recursos humanos, y hay muchos problemas que resolver. Métodos: 442 personas de 4 provincias fueron investigadas para conocerel índice de evaluación del desarrollo sostenible de la educación física universitaria. A través del análisis factorial y la investigación de la teoría profesional, se han determinado 15 índices de cinco categorías principales: ciencia y tecnología, educación moral, normas institucionales, economía, desarrollo competitivo, insumos externos y eliminación de la endogamia. Resultados: tanto las familias deportivas como las no deportivas no están dispuestas a que sus hijos participen en actividades deportivas universitarias. Las principales razones son las ideas tradicionales, la condición social deportiva y la educación de los atletas. Entre ellas, el sistema de formación de "endogamia" de los entrenadores es una de las principales razones que afectan a los recursos de talentos deportivos de las universidades chinas. Conclusión: el índice de evaluación del desarrollo sostenible de la educación física en las universidades de China puede dividirse en al menos cinco categorías: educación científica y ética, normas institucionales, desarrollo económico y competitivo, inversión externa, eliminación del sistema de formación de entrenadores endogámico. Los ingresos de las familias deportivas son generalmente inferiores a los de las familias no deportivas, y el nivel de educación también es bajo. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Associations between demographic characteristics and physical activity practices in Nevada schools.

Schools are important settings for not only providing and promoting children's physical activity (PA) but also for reducing PA disparities. We investigated associations between school-level demographic characteristics (racial/ethnic and socioeconomic composition, urban-rural status, and student-to-teacher ratio) and 16 PA-promoting practices in 347 Nevada public elementary, middle, and high schools in 2014. We found that low-cost and easy-to-implement practices are most prevalent. There is relative demographic equity in ten of 16 PA practices and significant differences in six PA practices in Nevada schools. Schools with comparatively larger percentages of Black students are the most disadvantaged, as they have the fewest PA-supportive practices in place. Higher percent black was associated with lower odds of providing classroom activity breaks (AOR=0.632, 95% CI=0.453-0.881) and bike racks (AOR=0.60, 95% CI=0.362-0.996), greater odds of withholding recess/PE for disciplinary reasons (AOR=1.377, 95% CI=1.006-1.885), and lower odds of having recess supervisors who are trained to promote PA (AOR=0.583, 95% CI=0.374-0.909). Schools with greater percentages of Hispanic students have lower odds of providing before-school PA programs (AOR=0.867, 95% CI=0.761-0.987), whereas schools with greater percentages of low-SES students have greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Higher student-to-teacher ratio was also associated with greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Urban-rural status was unrelated to all PA practices.

A Community-Engaged Approach to Translating Research into Practice: A Physical Education Story.

BACKGROUND: The National Institutes of Health's Clinical and Translational Sciences Award program emphasizes the need to speed up the process of putting evidence-based practices into place. One strategy they promote is community engagement; however, few studies describe a process for meaningfully engaging communities in the translation process. OBJECTIVE: This article describes steps taken by a university- community partnership to create a plan for implementing evidence-based physical education (PE) practices in rural schools. This partnership's efforts resulted in the acquisition of a $1.86 million grant to implement the plan. METHODS: Qualitative data collected during the planning process were analyzed using content analysis. RESULTS: Key steps included undertaking a baseline assessment of community needs, reviewing and selecting evidence-based practices, developing a multilevel, community-driven action plan and establishing its feasibility with community stakeholders. LESSONS LEARNED: These steps could be applied to other health topics across a variety of settings. Several strategies that made the process successful are described. Recommendations are made for expanding the roles of Clinical and Translational Science Awards (CTSAs) and local health foundations in supporting community-engaged translational research. CONCLUSIONS: University-community partnerships have the potential to create plans and obtain large-scale funding for translating evidence-based research into practice.

The effects of school physical education grants on obesity, fitness, and academic achievement.

OBJECTIVE: Foundations and governments fund a number of programs that provide grants to improve school physical education or other forms of school-based physical activity. The effects of these grant programs are unknown. We evaluate the effects of Texas Fitness Now, a program in which the state of Texas granted $37 million to improve physical education in high-poverty middle schools over the 4 school years from 2007-08 to 2010-11. The stated goals of Texas Fitness Now were to reduce obesity, increase fitness, and raise academic achievement. METHOD: We summarize how Texas Fitness Now funds were spent and estimate the impact of Texas Fitness Now using a fixed-effects longitudinal model that exploits changes in schools' eligibility over time. Changes in eligibility occurred when eligibility expanded to new schools after year 2 and when the program was terminated after year 4. RESULTS: Most Texas Fitness Now funds were spent on sports and fitness equipment. Smaller amounts were spent on anti-obesity curricula. Texas Fitness Now improved strength and flexibility, especially among girls, but it did not improve BMI or academic achievement, and it had mixed effects on aerobic capacity. The fitness benefits were not lost in the year after the program ended, perhaps because schools kept the equipment that they had bought during their years of eligibility. CONCLUSION: The results of Texas Fitness Now were typical for an intervention that relied almost exclusively on physical activity. Programs that improve BMI as well as fitness tend to have a more fully developed nutrition component.

PETE Doctoral Institutions: Programs, Faculty, and Doctoral Students.

PURPOSE: The present study of doctoral physical education teacher education (D-PETE) programs was part of a longitudinal study that provided an extensive description of demographics including: (a) doctoral program characteristics, (b) faculty, and (c) doctoral students/graduates. METHOD: This trend study incorporated 3 data sets (2005-2006, 2008-2009, and 2011-2012) that described the characteristics of D-PETE programs. Academic heads of D-PETE programs provided demographic information on their doctoral students, faculty, and institutional characteristics for the 2005-2006, 2008-2009, and 2011-2012 academic years and selected summary data from 1996-1997 through 2011-2012. RESULTS/CONCLUSION: As a result of this longitudinal data collection, the following trends were revealed. First, there was a decrease in the number of D-PETE programs and an increase of nontenured and part-time pedagogy faculty. Second, initial teacher licensure programs remained in existence at the vast majority of D-PETE programs. Third, funding for doctoral students at D-PETE programs was decreasing. Fourth, racial composition of doctoral graduates and current doctoral students remained largely skewed toward Caucasians. Fifth, there was a slight decline in the percentage of doctoral graduates entering higher education, but employment rates were exceptionally high. Sixth, non-U.S. doctoral students and ABDs were marketable in the United States.

Cost Effectiveness of an Elementary School Active Physical Education Policy.

INTRODUCTION: Many American children do not meet recommendations for moderate to vigorous physical activity (MVPA). Although school-based physical education (PE) provides children with opportunities for MVPA, less than half of PE minutes are typically active. The purpose of this study is to estimate the cost effectiveness of a state "active PE" policy implemented nationally requiring that at least 50% of elementary school PE time is spent in MVPA. METHODS: A cohort model was used to simulate the impact of an active PE policy on physical activity, BMI, and healthcare costs over 10 years for a simulated cohort of the 2015 U.S. population aged 6-11 years. Data were analyzed in 2014. RESULTS: An elementary school active PE policy would increase MVPA per 30-minute PE class by 1.87 minutes (95% uncertainty interval [UI]=1.23, 2.51) and cost $70.7 million (95% UI=$51.1, $95.9 million) in the first year to implement nationally. Physical activity gains would cost $0.34 per MET-hour/day (95% UI=$0.15, $2.15), and BMI could be reduced after 2 years at a cost of $401 per BMI unit (95% UI=$148, $3,100). From 2015 to 2025, the policy would cost $235 million (95% UI=$170 million, $319 million) and reduce healthcare costs by $60.5 million (95% UI=$7.93 million, $153 million). CONCLUSIONS: Implementing an active PE policy at the elementary school level could have a small impact on physical activity levels in the population and potentially lead to reductions in BMI and obesity-related healthcare expenditures over 10 years.

School-based program options to promote physical activity: a response.

This commentary is a response to PM-14-1065R1 and addresses issues raised regarding research presented in PM-14-443.

How can schools help youth increase physical activity? An economic analysis comparing school-based programs.

OBJECTIVE: For optimal health, physical activity should be an integral and routine part of daily life. Youth spend a significant amount of time at school yet rarely achieve the recommended 60 min of moderate and vigorous physical activity in physical education (PE) classes or recess. This study assessed the following types of school-based opportunities to improve physical activity for youth: after-school programs, before-school programs, PE classes, extended-day PE, and short physical activity breaks during the school day. METHOD: An economic analysis conducted in 2013 compared school-based approaches to increasing physical activity. Analysis factors included costs, reach, effects on physical activity gains, cost-effectiveness, and other potentially augmenting benefits. RESULTS: Two programs were significantly superior in terms of reach and cost per student: (1) extending the school day with mandatory PE participation and (2) offering short (10-minute) physical activity breaks during regular classroom hours. After-school program costs per student are high and the programs have a smaller reach, but they offer benefits (such as childcare) that may justify their higher costs. Before-school programs did not appear feasible. CONCLUSION: Incorporating short physical activity breaks into the existing school day would be a cost-effective way to increase school-based activity. This type of program is inexpensive and has broad reach. Inserting activity breaks throughout the day is appropriate, especially when youth are otherwise largely sedentary.

Correlates of state enactment of elementary school physical education laws.

OBJECTIVE: To describe variation in U.S. state elementary school physical education (PE) policies and to assess associations between state PE policy enactment and education funding, academic achievement, sociodemographic disadvantage, and political characteristics. METHODS: U.S. state laws regarding school PE time, staffing, curriculum, fitness assessment, and moderate-to-vigorous physical activity (MVPA) in 2012 were classified as strong/specific, weak/nonspecific, or none based on codified law ratings within the Classification of Laws Associated with School Students (C.L.A.S.S.). Laws were merged with state-level data from multiple sources. Logistic regression was used to determine associations between state characteristics and PE laws (N=51). RESULTS: Laws with specific PE and MVPA time requirements and evidence-based curriculum standards were more likely in states with low academic performance and in states with sociodemographically disadvantaged populations. School day length was positively associated with enacting a PE curriculum that referenced evidence-based standards. School funding and political characteristics were not associated with PE laws. CONCLUSIONS: Limited time and high-stake testing requirements force schools to prioritize academic programs, posing barriers to state passage of specific PE laws. To facilitate PE policy enactment, it may be necessary to provide evidence on how PE policies can be implemented within existing time and staffing structures.

Socioeconomic disparities in elementary school practices and children's physical activity during school.

PURPOSE: To examine school socioeconomic status (SES) in relation to school physical activity-related practices and children's physical activity. DESIGN: A cross-sectional design was used for this study. SETTING: The study was set in 97 elementary schools (63% response rate) in two U.S. regions. SUBJECTS: Of the children taking part in this study, 172 were aged 10.2 (standard deviation (SD) = 1.5) years; 51.7% were girls, and 69.2% were White non-Hispanic. MEASURES: School physical education (PE) teachers or principals responded to 15 yes/no questions on school physical activity-supportive practices. School SES (low, moderate, high) was derived from the percent of students eligible for free and reduced-price lunch. Children's moderate to vigorous physical activity (MVPA) during school was measured with accelerometers. ANALYSIS: School level analyses involved linear and logistic regression; children's MVPA analyses used mixed effects regression. RESULTS: Low-SES schools were less likely to have a PE teacher and had fewer physical activity-supportive PE practices than did high-SES schools (p < .05). Practices related to active travel to school were more favorable at low-SES schools (p < .05). Children attending high-SES schools had 4.4 minutes per day more of MVPA during school than did those at low-SES schools, but this finding was not statistically significant (p = .124). CONCLUSION: These findings suggest that more low- and moderate-SES elementary schools need PE teachers in order to reduce disparities in school physical activity opportunities and that PE time needs to be supplemented by classroom teachers or other staff to meet guidelines.

Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program.

OBJECTIVE: Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH. METHODS: We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers. RESULTS: The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs. DISCUSSION: The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.

Economic burden of physical activity-related injuries in Dutch children aged 10-12.

BACKGROUND: Injuries in children occur most often in physical activity-related activities. A lot of these injuries result in direct and indirect costs. A detailed overview of the economic burden of those injuries in children is lacking. METHOD: A prospective study was conducted with 996 children in Dutch primary schools to describe the economic burden of injuries that occur during organised sports, leisure time and physical education (PE) class activities. Injuries were continuously monitored by PE teachers during the school year 2006-2007. An injury was recorded if it occurred during PE class, leisure time or organised sports activity and caused the child to at least stop the current activity. If an injury was recorded, parents received a cost diary to report the direct and indirect costs of the child's injury. Costs were collected from a societal perspective. RESULTS: During one school year, a total of 119 injuries were reported by 104 children. The mean total costs as a result of an injury were €188 ± 317. The mean direct costs as a result of an injury were much higher than the mean indirect costs (€131 ± 213 and €57 ± 159, respectively). The highest costs were found for upper extremity and leisure time injuries. CONCLUSION: Physical activity-related injuries are common in children and result in medical costs. Injuries that lead to the highest costs are those that occur during leisure time activities and upper extremity injuries. Intervention programmes for children to prevent upper extremity injuries and leisure time activity injuries may reduce direct (ie, healthcare) and indirect costs. TRIAL REGISTRATION: ISRCTN78846684.

Universidade, profissão Educação Física e o mercado de trabalho / University, Physical Education as profession and the labor marketing

Os propósitos centrais do artigo são: (i) delimitar a importância da universidade na progressiva construção social e política da profissão Educação Física; (ii) apresentar um mapeamento dos ramos de atividade econômica onde se concentram as oportunidades de emprego e das diferenças regionais no que se refere aos níveis salariais médios dos profissionais da EF; e (iii) colocar em discussão a tensão que se estabelece entre a formação profissional oferecida nas universidades brasileiras e as demandas predominantes no mercado de trabalho. Pretende-se mostrar que a regulamentação da profissão produziu uma divisão entre duas “identidades profissionais” no interior da Educação Física, o que reforçou a segmentação deste mercado de trabalho altamente competitivo e marcado por situações muito desiguais. Além disso, procura-se enfatizar que o mercado de trabalho para os profissionais da Educação Física é menos estruturado que o destinado aos licenciados. E que a regulamentação da profissão procurou criar uma reserva de mercado, mas não foi suficiente para estruturar este amplo e diversificado mercado de trabalho, difundir um padrão de emprego adequado e elevar os níveis de remuneração.

The main purposes of this paper are: (i) to delimitate the importance of the university in the progressive social and political construction of Physical Education as a profession; (ii) to present the sectors of economic activity where are concentrated the opportunities of employment and to show the regional differences about the average wages of the Physical Education workers; and (iii) to discuss the tension relationship between the professional education from the Brazilian universities and the major demands in labor marketing. I intent to suggest that the professional regulation produced a division between two “professional identities” inside Physical Education, and it reinforced the segmentation in this competitive labor marketing, where are much different occupational situations. Beside, I intent to show that the Physical Education labor marketing isn’t organized like the Education labor marketing. The professional regulation tries to create exclusive labor marketing, but it isn’t able to organize this wide and unequal labor marketing, to diffuse an appropriate employment standard and to increase the wages level.

Uptake and effectiveness of the Children's Fitness Tax Credit in Canada: the rich get richer.

BACKGROUND: The Government of Canada implemented a Children's Fitness Tax Credit (CFTC) in 2007 which allows a non-refundable tax credit of up to $500 to register a child in an eligible physical activity (PA) program. The purposes of this study were to assess whether the awareness, uptake, and perceived effectiveness of this tax credit varied by household income among Canadian parents. METHODS: An internet-based panel survey was conducted in March 2009 with a representative sample of 2135 Canadians. Of those, parents with children aged 2 to 18 years of age (n = 1004) were asked if their child was involved in organized PA programs (including dance and sports), the associated costs to register their child in these programs, awareness of the CFTC, if they had claimed the CFTC for the tax year 2007, and whether they planned to claim it in the upcoming year. Parents were also asked if they believed the CFTC has lead to their child being more involved in PA programs. RESULTS: Among parents, 54.4% stated their child was in organized PA and 55.5% were aware of the CFTC. Parents in the lowest income quartile were significantly less aware and less likely to claim the CFTC than other income groups. Among parents who had claimed the CFTC, few (15.6%) believed it had increased their child's participation in PA programs. CONCLUSIONS: More than half of Canadian parents with children have claimed the CFTC. However, the tax credit appears to benefit the wealthier families in Canada.

National plan for physical activity: education sector.

BACKGROUND: Schools must play a central role in combating the prevalence of overweight and obesity among children and youths. This cannot be achieved without more robust policy and funding programs at both federal and state levels. METHODS: Reviews of meta-analyses were used to assess the efficacy of improving PA/MVPA through interventions in school physical education programs. Individual research studies were reviewed to assess the efficacy of improving PA/MVPA in preschool settings, recess, and classroom activity breaks. Legislation at the federal and state levels was reviewed along with surveillance and accountability mechanisms at the state level. RESULTS: Physical education interventions produce improvements in PA/MVPA if protocols relating to use of time are followed. PA/MVPA in recess can be increased through careful planning for attractive activity opportunities on carefully designed playgrounds. Classroom activity breaks provide important PA/MVPA daily and improve student on-task behavior. CONCLUSIONS: Federal legislation is needed to provide guidelines and financial support for states to improve the quantity and quality of PA in school programs. States need to develop clear expectations for quantity and quality of PA programs in schools, surveillance systems to monitor district compliance in meeting those expectations, and an accountability system aimed at ensuring that state expectations are being met with assistance for districts that do not meet expectations.

Profiles of service utilization and the resultant economic impact in preschoolers with attention deficit/hyperactivity disorder.

OBJECTIVE: To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined. METHODS: The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups. RESULTS: Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT. CONCLUSIONS: A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.

Cost-utility of an 8-month aquatic training for women with fibromyalgia: a randomized controlled trial.

INTRODUCTION: Physical therapy in warm water has been effective and highly recommended for persons with fibromyalgia, but its efficiency remains largely unknown. Should patients or health care managers invest in this therapy? The aim of the current study was to assess the cost-utility of adding an aquatic exercise programme to the usual care of women with fibromyalgia. METHODS: Costs to the health care system and to society were considered in this study that included 33 participants, randomly assigned to the experimental group (n = 17) or a control group (n = 16). The intervention in the experimental group consisted of a 1-h, supervised, water-based exercise sessions, three times per week for 8 months. The main outcome measures were the health care costs and the number of quality-adjusted life-years (QALYs) using the time trade-off elicitation technique from the EuroQol EQ-5D instrument. Sensitivity analyses were performed for variations in staff salary, number of women attending sessions and time spent going to the pool. The cost effectiveness acceptability curves were created using a non-parametric bootstrap technique. RESULTS: The mean incremental treatment costs exceeded those for usual care per patient by euro 517 for health care costs and euro 1,032 for societal costs. The mean incremental QALY associated with the intervention was 0.131 (95% CI: 0.011 to 0.290). Each QALY gained in association with the exercise programme cost an additional euro 3,947/QALY (95% CI: 1,782 to 47,000) for a health care perspective and euro 7,878/QALY (3,559 to 93,818) from a societal perspective. The curves showed a 95% probability that the addition of the water-based programme is a cost-effective strategy if the ceiling of inversion is euro 14,200/QALY from a health care perspective and euro 28,300/QALY from a societal perspective. CONCLUSION: The addition of an aquatic exercise programme to the usual care regime for fibromyalgia in women is cost effective in terms of both health care costs and societal costs. However, the characteristics of facilities (distance from the patients' homes and number of patients that can be accommodated per session) are major determinants to consider before investing in such a programme. TRIAL REGISTRATION: Current controlled trials ISRCTN53367487.