The efficacy and cost-effectiveness of a community weight management intervention: A randomized controlled trial of the health weight management demonstration

Hersey, James; Khavjou, Olga; Strange, Laura; Atkinson, Richard L.; Blair, Steven N.; Campbell, Susan R.; Hobbs, Connie; Kelly, Bridget; Fitzgerald, Tania; Kish-Doto, Julia; Koch, Matthew; Muñoz, Breda; Peele, Eric; Stockdale, Jason; Augustine, Cynthia; Mitchell, Glenda; Arday, David R.; Kugler, John W.; Dorn, Patricia; Ellzy, James; Julian, Regina; Grissom, Joyce; Britt, Marcia

doi:10.1016/j.ypmed.2011.09.018

Cited by 49 publications

(49 citation statements)

References 32 publications

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“…So, as a more conservative approach, an additional analysis was performed considering a five-year time period resulting in a clearly not cost-effective outcome in both men and women. On the other hand, the use of extensive time horizons in health economic evaluations is quite common [17, 36, 50]. Second, the model is a simplification of real life because model complexity prevented us to for example allow some combinations of disease states.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care

et al. 2014

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BackgroundThere is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders.MethodsA Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters.ResultsAn incremental cost-effectiveness ratio of 27,096€/quality-adjusted life years (QALY) in men, and 40,139€/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357€/QALY) and women (3,766€/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model.ConclusionsAs far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care

et al. 2014

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“…52–54 Our study showcases the long-term health and economic benefit of a low-cost community weight loss program, which has not been adequately assessed so far. However, studies using a modelling approach like the one used here should be carefully interpreted for translation and application in public health decision making.…”

Section: Discussionmentioning

confidence: 92%

Cost effectiveness and return on investment of a scalable community weight loss intervention

Michaud

You

Wilson

et al. 2017

Preventive Medicine

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This study assessed the lifetime health and economic consequences of an efficacious scalable community weight loss program for overweight and obese adults. We applied a state-transition Markov model to project lifetime economic outcome (US dollar) and the degree of disease averted as a result of a weight loss intervention, compared with no intervention, from a payer perspective. Effect sizes of the intervention on weight loss, by sex, race and ethnicity, and body mass index (BMI) of participants, were derived from a 12-month community program. Relative risk of diseases across BMI levels and other parameters were informed by the literature. A return on investment (ROI) analysis was conducted to present the overall cost-benefit of the program. Simulation results showed that among 33,656 participants and at a cost of $2.88 million, the program was predicted to avert (with a corresponding estimated medical costs saved of) 78 cases of coronary heart disease ($28 million), 9 cases of strokes ($971,832), 92 cases of type 2 diabetes ($24 million), 1 case of colorectal cancer ($357,022), and 3 cases of breast cancer ($483,259) over the participant lifetime. The estimated medical costs saved per participant was $1,403 ($1,077 of African American men and $1,532 of Hispanic men), and the ROI was $16.7 ($12.8 for African American men and $18.3 for Hispanic men) for every $1 invested. We concluded that a scalable efficacious community weight loss program provides a cost-effective approach with significant ROI, which will assist informed decisions for future adoption and dissemination.

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“…Both groups received an evidence-based book on healthful eating and regular physical activity and a pedometer. 26 Those randomized into the intervention group received a one-on-one physical activity training session from a trained interventionist to further explain participant expectations. The training session provided an overview of what constitutes physical activity, benefits of physical activity, different types of physical activity, current physical activity recommendations, tips for starting a physical activity program and proper use of the activity log.…”

Section: Randomizationmentioning

confidence: 99%

Results of a nine month home-based physical activity intervention for people living with HIV

Jaggers¹,

Sneed²,

Lobelo³

et al. 2016

Int J Clin Trials

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Background: The purpose of this investigation was to test the feasibility of a home-based moderate-intensity physical activity (MPA) program for people living with HIV/AIDS (PLWHA) currently taking antiretroviral therapy (ART).Methods: 68 participants recruited for a 9-month home-based PA intervention aimed to reduce risk factors of cardiovascular disease for PLWHA taking ART. All participants received an educational weight loss workbook and a pedometer for self-monitoring of physical activity. The intervention group received elastic Therabands® for strength training in addition to telephone based behavioural coaching. Clinical assessments were conducted at baseline and each follow-up which also included psychometric questionnaires and PA levels via the SenseWear® armband accelerometer.Results: Of the 57 completing the study, 29 of those were in the intervention group and 28 were in the standard care group. Results show that the home-based PA intervention was not successful in increasing the total amount of MPA for PLWHA. However there was a trend (p=0.08) of decreasing sedentary time. In a secondary analysis those who increased PA by >10% observed decreases in waist circumference and improved functioning at 18 weeks. None of the changes observed were significant after controlling for all potential confounders. Conclusions: A home-based exercise approach with telephone-based coaching may not be a feasible method for increasing MPA among PLWHA. Slight decreases in sedentary time indicate some positive changes in activity habits. A possible strategy to improve studies similar to this is to incorporate a group based social interaction each week similar to that of a support group.

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The efficacy and cost-effectiveness of a community weight management intervention: A randomized controlled trial of the health weight management demonstration

Cited by 49 publications

References 32 publications

Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care

Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care

Cost effectiveness and return on investment of a scalable community weight loss intervention

Results of a nine month home-based physical activity intervention for people living with HIV

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