Summary
What do they do? Self-Help describes a six-week Sun-style Tai Chi for Arthritis and Fall Prevention course. We model a prospective, separately specified 24-week therapeutic TJQMBB course for high-fall-risk older adults. These are not interchangeable programs. More
Why this approach interests us
- Small-group balance training may improve health at a relatively low cost when it reaches older adults at high fall risk.
Our main reservations
- The proposed curriculum is not verified locally, and the external paper has a consequential utility/QALY ambiguity.
What do you get for your dollar?
Our central independent bridge is $2.4M per better life (10 QALYs). A different reading of the published QALY result yields $600K with the same local assumptions. We would investigate a trial-matched course, not assume the existing six-week service has that effect.
- central estimate
- $2.4M — per 10 QALYs; independent endpoint bridge
- alternative unit reading
- $600K — Using .04 directly as integrated QALYs
- course allowance
- $600 — Analyst planning cost; not a provider quote
- funding room
- Unverified — Expired CalFresh grant is not current capacity
1. What do they do?
Self-Help describes a six-week Sun-style Tai Chi for Arthritis and Fall Prevention course. We model a prospective, separately specified 24-week therapeutic TJQMBB course for high-fall-risk older adults. These are not interchangeable programs.
Recruit the intended risk group
The reference involved older people with prior falls or impaired mobility. General social exercise participants may have less scope for benefit.
Specify delivery
Two classes weekly for 24 weeks, qualified instruction and safety screening require an actual local delivery plan.
Measure incremental health
Compare with realistic existing exercise and care. The trial comparison was stretching, not no activity.
Scope of this review. The January–March 2026 CalFresh closeout grant covered mixed activities and wind-down. Its consumer targets are not completed six-month courses or a current funding gap.
2. Monitoring and information sharing
670 older adults at high fall risk in Oregon
External randomized active-comparator trial. Therapeutic tai ji quan reduced falls compared with stretching.
Our assessment. Different curriculum from the current local Sun-style course; no separate injury benefits added to utility.
Same trial
External six-month economic evaluation. Reports a .04 difference with inconsistent utility/QALY terminology.
Our assessment. Payer cost-effectiveness is not marginal philanthropic cost-effectiveness.
Relatively well older adults
Separate Sun-style randomized trial. Did not establish a fall reduction.
Our assessment. Risk selection and curriculum fidelity can erase expected benefit.
3. Qualitative assessment
Small-group balance training may improve health at a relatively low cost when it reaches older adults at high fall risk.
Key reservations
- A trial-matched course is prospective, not verified current delivery.
- Unit interpretation changes the central estimate fourfold.
- Costs, local transfer and additionality are assumptions.
- Null or adverse effects remain possible.
Benefits not included in our estimate
- Additional fall-injury, mortality or healthcare-savings gains on top of health utility
- Current six-week Sun-style service treated as the 24-week trial
- Expired CalFresh closeout budget interpreted as current funding room
4. What do you get for your dollar?
Central scenario: $2.4M per 10 QALYs.
We make an independent endpoint-utility hypothesis and assume gradual onset over a rounded six months. This is not a reproduction or correction of the published economic analysis.
A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.
How we calculate the estimate
DOLLARS PER BETTER LIFE: 10 × $600 ÷ (.04 × .5 years × .5 onset × .5 transfer × .5 additionality)
$2,400,000 per 10 QALYs
Model inputs and assumptions
- Course planning allowance
- 600 (range: 300 / 600 / 1200). 48 classes × two paid preparation/delivery hours × $60 / 15 participants + $200 support = $584, rounded to $600. Assumed occupancy, wage and support—not a provider quote. Licensing, room and transport need pricing. Explicit analyst calibration.
- Hypothesized endpoint utility gain
- 0.04 (range: 0.06 / 0.04 / 0.01). Independent calibration of .04, not a securely verified endpoint coefficient: Li/Harmer prose describes utility difference but its methods multiply by duration and table labels .04 incremental QALYs. Our duration/onset assumptions are not a correction to that paper. Explicit analyst calibration.
- Modeled follow-up horizon
- 0.5 (range: 0.5 / 0.5 / 0.5). Rounded six-month horizon (0.5 year), not exactly 24/52 years. No persistence beyond follow-up. Explicit analyst calibration.
- Benefit onset over follow-up
- 0.5 (range: 0.5 / 0.5 / 0.25). 50% assumes linear growth from zero to the hypothesized endpoint. Judgment, not adherence. No second attendance adjustment. Explicit analyst calibration.
- Local fidelity and population retention
- 0.5 (range: 0.75 / 0.5 / 0.25). 50% subjective retention for proposed curriculum, high-risk recruitment and realistic local alternatives. Reference comparison is stretching, not no exercise or current Sun-style tai chi. Explicit analyst calibration.
- Additional funded capacity
- 0.5 (range: 0.75 / 0.5 / 0.25). 50% assumed net added places after replacement funding. No verified current offer. Explicit analyst calibration.
Illustrative $100,000: 0.417 additional QALYs; actual capacity unverified
- Favorable positive: $355.56K per 10 QALYs. 2.81 QALYs per $100,000
- Central analyst estimate: $2.4M per 10 QALYs. 0.417 QALYs per $100,000
- Unfavorable positive: $153.6M per 10 QALYs. 0.00651 QALYs per $100,000
Uncertainty. Null or harm remains possible. The favorable/unfavorable combinations are analyst scenarios, not a confidence interval. No finite positive price exists at zero or negative benefit.
The published units materially change the answer.
If .04 is used directly as the paper's integrated QALYs, with the same cost/transfer/additionality and no extra duration/onset, the central price is $600,000 per 10 QALYs. Our independent endpoint bridge gives $2.4M. Neither is a measured local effect.
ALTERNATIVE INTEGRATED-QALY READING: 10 × $600 ÷ (.04 × .5 × .5)
$600,000 per 10 QALYs
QALY conversion assumptions
Methods describe duration weighting and the table calls .04 QALYs; prose describes utility scores. Additional duration and onset are our hypothesis, not a demonstrated necessary adjustment. Neither reading establishes a sub-$100K opportunity.
5. Funding and previous grants
No current quote, trial-matched implementation commitment or verified added places.
The 50% additionality assumption is not verified funding room. An expired contract does not establish what a gift buys now.
This review does not establish a verified marginal funding offer or a complete history of grants.
We have not verified a suitable donation route for this reviewed activity. Confirm the legal recipient and intended allocation before donating.
6. Sources
- Tai Chi service. Self-Help for the Elderly. Six-week Sun-style Tai Chi for Arthritis and Fall Prevention; not verified TJQMBB. Published: Undated current page; retrieved: 2026-09-07.
- CalFresh Healthy Living closeout grant. San Francisco Human Services Agency. January–March 2026 mixed exercise/wind-down budget, not current course price. Published: 2026-01-07 commission item; retrieved: 2026-09-07.
- Therapeutic tai ji quan randomized trial. Li et al.. 670 high-fall-risk older adults; 24-week intervention versus stretching. Published: 2018; retrieved: 2026-09-07.
- Trial economic evaluation. Li and Harmer et al.. Utility/QALY wording ambiguity; not a local marginal-donation ICER. Published: 2019-01-10; retrieved: 2026-09-07.
- Tai Chi fall-prevention randomized trial. Day et al.. Disconfirming Sun-style evidence in relatively well older adults. Published: 2015; retrieved: 2026-09-07.
Annual expenses: years and sources
Average annual expenses (three consecutive fiscal years): $32,376,728. Organization size is separate from the modeled cost-effectiveness of a donation.
Self-help For The Elderly
Whole legal entity Form 990 Part IX total functional expenses; latest original reconstructed filings checked, fiscal-end year from printed reporting dates. Older fallback rows from IRS extracted API.
Latest original filings checked; ProPublica extracted API lags these original returns.