Economic Analyses of the Be Fit Be Well Program: A Weight Loss Program for Community Health Centers

Ritzwoller, Debra P.; Glasgow, Russell E.; Sukhanova, Anna; Bennett, Gary G.; Warner, Erica T.; Greaney, Mary L.; Askew, Sandy; Goldman, Julie; Emmons, Karen M.; Colditz, Graham A.

doi:10.1007/s11606-013-2492-3

Cited by 34 publications

(42 citation statements)

References 40 publications

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“…We assessed and assigned intervention costs based on well-established procedures used in previous studies (Gold et al, 1996; Meenan et al, 2009; Meenan et al, 1998; Meenan et al, 2010; Ritzwoller et al, 2013; Ritzwoller, Sukhanova, Gaglio, & Glasgow, 2009; Ritzwoller et al, 2011). Costs included interventionist training, participant recruitment, and intervention delivery.…”

Section: Methodsmentioning

confidence: 99%

An Economic Evaluation of a Weight Loss Intervention Program for People with Serious Mental Illnesses Taking Antipsychotic Medications

Meenan

Stumbo

Yarborough

et al. 2015

Adm Policy Ment Health

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Individuals with serious mental illnesses suffer from obesity and cardiometabolic diseases at high rates, and antipsychotic medications exacerbate these conditions. While studies have shown weight loss and lifestyle interventions can be effective in this population, few have assessed intervention cost-effectiveness. We present results from a 12-month randomized controlled trial that reduced weight, fasting glucose, and medical hospitalizations in intervention participants. Costs per participant ranged from $4,365 to $5,687. Costs to reduce weight by one kilogram ranged from $1,623 to $2,114; costs to reduce fasting glucose by one mg/dL ranged from $467 to $608. Medical hospitalization costs were reduced by $137,500.

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Section: Methodsmentioning

confidence: 99%

An Economic Evaluation of a Weight Loss Intervention Program for People with Serious Mental Illnesses Taking Antipsychotic Medications

Meenan

Stumbo

Yarborough

et al. 2015

Adm Policy Ment Health

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“…Only four trials 64,73,91,92 provide a critical appraisal of their costs. Also presently unclear is the usability of many of the trials' technology.…”

Section: Areas For Future Researchmentioning

confidence: 99%

Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

et al. 2014

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BACKGROUND:The US Preventive Services Task Force recommends screening for and treating obesity. However, there are many barriers to successfully treating obesity in primary care (PC). Technology-assisted weight loss interventions offer novel ways of improving treatment, but trials are overwhelmingly conducted outside of PC and may not translate well into this setting. We conducted a systematic review of technology-assisted weight loss interventions specifically tested in PC settings. METHODS: We searched the literature from January 2000 to March 2014. Inclusion criteria: (1) Randomized controlled trial; (2) trials that utilized the Internet, personal computer, and/or mobile device; and (3) occurred in an ambulatory PC setting. We applied the Cochrane Effective Practice and Organization of Care (EPOC) and Delphi criteria to assess bias and the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) criteria to assess pragmatism (whether trials occurred in the real world versus under ideal circumstances). Given heterogeneity, results were not pooled quantitatively. RESULTS: Sixteen trials met inclusion criteria. Twelve (75 %) interventions achieved weight loss (range: 0.08 kg -5.4 kg) compared to controls, while 5-45 % of patients lost at least 5 % of baseline weight. Trial duration and attrition ranged from 3-36 months and 6-80 %, respectively. Ten (63 %) studies reported results after at least 1 year of follow-up. Interventions used various forms of personnel, technology modalities, and behavior change elements; trials most frequently utilized medical doctors (MDs) (44 %), webbased applications (63 %), and self-monitoring (81 %), respectively. Interventions that included clinician-guiding software or feedback from personnel appeared to promote more weight loss than fully automated interventions. Only two (13 %) studies used publically available technologies. Many studies had fair pragmatism scores (mean: 2.8/4), despite occurring in primary care. DISCUSSION: Compared to usual care, technologyassisted interventions in the PC setting help patients achieve weight loss, offering evidence-based options to PC providers. However, best practices remain undetermined. Despite occurring in PC, studies often fall short in utilizing pragmatic methodology and rarely provide publically available technology. Longitudinal, pragmatic, interdisciplinary, and opensource interventions are needed.

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“…Outcomes are reported in more detail elsewhere 10,22 . In this article we report primarily on implementation outcomes and only secondarily on outcomes of weight loss and SBP reduction, and on behaviors directly related to these outcomes as they pertain to health disparities.…”

Section: Resultsmentioning

confidence: 99%

Use of RE-AIM to address health inequities: Application in a low-income community health center-based weight loss and hypertension self-management program

Glasgow

Askew

Purcell

et al. 2013

Behav. Med. Pract. Policy Res.

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Background While health inequities are well documented, and there are helpful frameworks to understand health disparities, implementation frameworks are also needed to focus the design, evaluation and reporting on interventions targeting populations at increased risk. Purpose Describe how the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) can be used for these purposes and illustrate its application in the context of a randomized, pragmatic weight-loss and hypertension self-management intervention. Methods RE-AIM was used to both plan and evaluate the Be Fit Be Well program for urban community health center patients. Results The RE-AIM framework helped to focus attention on and produce high rates of adoption and reach. Implementation rates varied across components. Weight losses were statistically significant, but not clinically significant. They were robust across a variety of patient characteristics, and the program was relatively low cost. Individual weight losses and blood pressure reductions were maintained throughout the 24-month period, but the program was not sustained at any of the three settings. Conclusion Implementation frameworks such as RE-AIM can help design pragmatic interventions that focus on both the context for disparities reduction and the ultimate goal of public health impact.

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Economic Analyses of the Be Fit Be Well Program: A Weight Loss Program for Community Health Centers

Cited by 34 publications

References 40 publications

An Economic Evaluation of a Weight Loss Intervention Program for People with Serious Mental Illnesses Taking Antipsychotic Medications

An Economic Evaluation of a Weight Loss Intervention Program for People with Serious Mental Illnesses Taking Antipsychotic Medications

Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

Use of RE-AIM to address health inequities: Application in a low-income community health center-based weight loss and hypertension self-management program

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