Cost-effectiveness of a behavioral weight loss intervention for low-income women: The Weight-Wise Program

Gustafson, Alison; Khavjou, Olga; Stearns, Sally C.; Keyserling, Thomas C.; Gizlice, Ziya; Lindsley, Sara C; K, Bramble; Garcia, Beverly A.; Johnston, Larry F.; Will, Julie C.; Poindexter, Patricia; Ammerman, Alice S.; Samuel‐Hodge, Carmen D.

doi:10.1016/j.ypmed.2009.09.007

Cited by 19 publications

(33 citation statements)

References 35 publications

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“…Algorithms for mapping BMI into life years lost according to age and race profiles have been established[52] and used in cost-effectiveness evaluations of weight loss programs. [53, 54] Because life years gained from the intervention occur in future periods, all costs and outcomes will be discounted to present value terms using a 3% discount rate.…”

Section: Methodsmentioning

confidence: 99%

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach

Yeary

Cornell

Prewitt

et al. 2015

Contemporary Clinical Trials

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Background The positive effects of weight loss on obesity-related risk factors diminish unless weight loss is maintained. Yet little work has focused on the translation of evidence-based weight loss interventions with the aim of sustaining weight loss in underserved populations. Using a community-based participatory approach (CBPR) that engages the strong faith-based social infrastructure characteristic of rural African American communities is a promising way to sustain weight loss in African Americans, who bear a disproportionate burden of the obesity epidemic. Objectives Led by a collaborative community-academic partnership, The WORD aims to change dietary and physical activity behaviors to produce and maintain weight loss in rural, African American adults of faith. Design The WORD is a randomized controlled trial with 450 participants nested within 30 churches. All churches will receive a 16-session core weight loss intervention. Half of the churches will be randomized to receive an additional 12-session maintenance component. Methods The WORD is a cultural adaptation of the Diabetes Prevention Program, whereby small groups will be led by trained church members. Participants will be assessed at baseline, 6, 12, and 18 months. A detailed cost-effectiveness and process evaluation will be included. Summary The WORD aims to sustain weight loss in rural African Americans. The utilization of a CBPR approach and the engagement of the faith-based social infrastructure of African American communities will maximize the intervention's sustainability. Unique aspects of this trial include the focus on weight loss maintenance and the use of a faith-based CBPR approach in translating evidence-based obesity interventions.

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Section: Methodsmentioning

confidence: 99%

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach

Yeary

Cornell

Prewitt

et al. 2015

Contemporary Clinical Trials

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“…37 Comparison with other studies is difficult because of differences in assumptions and model structures, but most published studies found costeffectiveness ratios for diet and exercise interventions similar to ours [38][39][40] unless weight regain was assumed zero. 41 Our study modeled the Australian adult population, but given comparable disease patterns, health care expenditure, prices and culture, the results can be considered indicative for other western countries as well.…”

Section: Comparison Of Results With Other Studiesmentioning

confidence: 92%

Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity

et al. 2011

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Objective: To analyze whether two dietary weight loss interventionsFthe dietary approaches to stop hypertension (DASH) program and a low-fat diet programF would be cost-effective in Australia, and to assess their potential to reduce the disease burden related to excess body weight. Design: We constructed a multi-state life-table-based Markov model in which the distribution of body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. The target population was the overweight and obese adult population in Australia in 2003. We used a lifetime horizon for health effects and costs, and a health sector perspective for costs. We populated the model with data identified from Medline and Cochrane searches, Australian Bureau of Statistics published catalogues, Australian Institute of Health and Welfare, and Department of Health and Ageing. Outcome measures: Disability adjusted life years (DALYs) averted, incremental cost-effectiveness ratios (ICERs) and proportions of disease burden avoided. ICERs under AUS$50 000 per DALY are considered cost-effective. Results: The DASH and low-fat diet programs have ICERs of AUS$12 000 per DALY (95% uncertainty range: Cost-savingF68 000) and AUS$13 000 per DALY (Cost-savingF130 000), respectively. Neither intervention reduced the body weight-related disease burden at population level by more than 0.1%. The sensitivity analysis showed that when participants' costs for time and travel are included, the ICERs increase to AUS$75 000 per DALY for DASH and AUS$49 000 per DALY for the low-fat diet. Modest weight loss during the interventions, post-intervention weight regain and low participation limit the health benefits. Conclusion: Diet and exercise interventions to reduce obesity are potentially cost-effective but have a negligible impact on the total body weight-related disease burden.

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“…Without a control group, we did not undertake a cost-effectiveness analysis, which is another limitation of this study. However, we have previously reported a cost-effectiveness analysis for the group-based intervention format that we tested in Phase II, comparing it with a delayed intervention control group 46. In that study, in which the weight loss intervention was considered cost-effective (assuming weight loss could be sustained over time), weight loss at 6-month follow-up was 3.7 kg in the intervention group, very similar to the weight loss of 3.9 kg observed at the completion of Phase II for our participants with diabetes for our participants with diabetes who received the group-based intervention.…”

Section: Discussionmentioning

confidence: 99%

Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project

Embree

Samuel‐Hodge

Johnston

et al. 2017

BMJ Open Diab Res Care

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ObjectiveTo examine weight change by diabetes status among participants receiving a Mediterranean-style diet, physical activity, and weight loss intervention adapted for delivery in the southeastern USA, where rates of cardiovascular disease (CVD) are disproportionately high.Research design and methodsThe intervention included: Phase I (months 1–6), an individually tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI≥25 kg/m2 offered as 16 weekly group sessions or 5 group sessions and 10 phone calls, or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance intervention for those losing ≥8 pounds with all others receiving a lifestyle maintenance intervention. Weight change was assessed at 6, 12, and 24-month follow-up.ResultsBaseline characteristics (n=339): mean age 56, 77% female, 65% African-American, 124 (37%) with diabetes; mean weight 103 kg for those with diabetes and 95 kg for those without. Among participants with diabetes, average weight change was −1.2 kg (95% CI −2.1 to −0.4) at 6 months (n=92), −1.5 kg (95% CI −2.9 to −0.2) at 12 months (n=96), and −3.7 kg (95% CI −5.2 to −2.1) at 24 months (n=93). Among those without diabetes, weight change was −0.4 kg (95% CI −1.4 to 0.6) at 24 months (n=154).ConclusionsParticipants with diabetes experienced sustained weight loss at 24-month follow-up. High-risk US populations with diabetes may experience clinically important weight loss from this type of lifestyle intervention.Trial registration numberNCT01433484.

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Cost-effectiveness of a behavioral weight loss intervention for low-income women: The Weight-Wise Program

Cited by 19 publications

References 35 publications

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach

The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach

Cost-effectiveness of diet and exercise interventions to reduce overweight and obesity

Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project

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