Costs to Implement a Pediatric Weight Management Program Across 3 Distinct Contexts

Abstract

Background: The Connect for Health program is an evidence-based program that aligns with national recommendations for pediatric weight management and includes clinical decision support, educational handouts, and community resources. As implementation costs are a major driver of program adoption and maintenance decisions, we assessed the costs to implement the Connect for Health program across 3 health systems that primarily serve low-income communities with a high prevalence of childhood obesity. Methods: We used time-driven activity-based costing methods. Each health system (site) developed a process map and a detailed report of all implementation actions taken, aligned with major implementation requirements (eg, electronic health record integration) or strategies (eg, providing clinician training). For each action, sites identified the personnel involved and estimated the time they spent, allowing us to estimate the total costs of implementation and breakdown costs by major implementation activities. Results: Process maps indicated that the program integrated easily into well-child visits. Overall implementation costs ranged from $77,103 (Prisma Health) to $84,954 (Denver Health) to $142,721 (Massachusetts General Hospital). Across implementation activities, setting up the technological aspects of the program was a major driver of costs. Other cost drivers included training, engaging stakeholders, and audit and feedback activities, though there was variability across systems based on organizational context and implementation choices. Conclusions: Our work highlights the major cost drivers of implementing the Connect for Health program. Accounting for context-specific considerations when assessing the costs of implementation is crucial, especially to facilitate accurate projections of implementation costs in future settings.

Evaluating the Implementation of the Connect for Health Pediatric Weight Management Program

“…MGH and Prisma Health had physicians interact with the tools, and their uptake is consistent with the literature regarding the adoption of clinical decision-support tools . Denver Health’s high uptake supported the importance of a team-based care approach, stakeholder engagement, and providing clinician and staff training, which they did extensive engagement and training …”

“…41 Denver Health's high uptake supported the importance of a teambased care approach, stakeholder engagement, and providing clinician and staff training, which they did extensive engagement and training. 20 The previous Connect for Health RCT found that the clinical decision support tools, family educational materials, and text messaging program improved child BMI. 11 In this study, we did not find a change in child BMI, which may be explained by the COVID-19 pandemic and its resultant impacts and related policies.…”

“…The Connect for Health program and implementation strategies have been described previously . Briefly, the program consists of family materials that support behavioral change and connect families to resources available in English, Spanish, and Haitian Creole.…”

“…The Connect for Health program and implementation strategies have been described previously. 9,17,20 Briefly, the program consists of family materials that support behavioral change and connect families to resources available in English, Spanish, and Haitian Creole. They include printable family educational materials, social and community-informed text messages, and community resource guides to identify resources within the family's neighborhoods.…”

The Costs of Implementing a Conversation Aid for Uterine Fibroids in Multiple Health Care Settings

“…Despite numerous differences among the remaining studies in this collection, several common themes emerged. Generally, costs are highly variable 26,27 and likely not prohibitive within an overall operational budget. 26,28 Initial costs are increased as preparatory and implementation activities occur, but once launched, ongoing costs may be quite low.…”