Cost-effectiveness of a family-based multicomponent outpatient intervention program for children with obesity in Germany

Lier, Liesa Marie; Breuer, Christoph; Ferrari, Nina; Friesen, David; Maisonave, F.; Schmidt, Nikola; Gräf, Christine

doi:10.1016/j.puhe.2020.06.012

Cited by 10 publications

(19 citation statements)

References 42 publications

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“…The height of the children and adolescents was measured barefoot in cm; weight was measured in kg. A calibrated scale and a stadiometer were used for this purpose [ 23 ]. BMI was divided into percentiles according to Kromeyer-Hauschild et al [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Blood pressure was measured oscillometrically three times using an automatic blood pressure monitor after approximately 5–10 min of rest [ 23 ]. The cuff size was chosen so that two-thirds of the upper arm length was covered.…”

Section: Methodsmentioning

confidence: 99%

“…Insulin was determined using human insulin standards (Elecsys Insulin) from Roche Diagnostics, Mannheim [ 36 ]. The homeostatic model assessment (HOMA index) was used as a parameter of insulin sensitivity and was calculated by the following formula [ 23 , 37 ]: HOMA = (insulin [mU/L] × glucose [mmol/L])/22.5. …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Health Risks of Sarcopenic Obesity in Overweight Children and Adolescents: Data from the CHILT III Programme (Cologne)

Sack

Ferrari

Friesen

et al. 2022

JCM

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Sarcopenic obesity is increasingly found in youth, but its health consequences remain unclear. Therefore, we studied the prevalence of sarcopenia and its association with cardiometabolic risk factors as well as muscular and cardiorespiratory fitness using data from the German Children’s Health InterventionaL Trial (CHILT III) programme. In addition to anthropometric data and blood pressure, muscle and fat mass were determined with bioelectrical impedance analysis. Sarcopenia was classified via muscle-to-fat ratio. A fasting blood sample was taken, muscular fitness was determined using the standing long jump, and cardiorespiratory fitness was determined using bicycle ergometry. Of the 119 obese participants included in the analysis (47.1% female, mean age 12.2 years), 83 (69.7%) had sarcopenia. Affected individuals had higher gamma-glutamyl transferase, higher glutamate pyruvate transaminase, higher high-sensitivity C-reactive protein, higher diastolic blood pressure, and lower muscular and cardiorespiratory fitness (each p < 0.05) compared to participants who were ‘only’ obese. No differences were found in other parameters. In our study, sarcopenic obesity was associated with various disorders in children and adolescents. However, the clinical value must be tested with larger samples and reference populations to develop a unique definition and appropriate methods in terms of identification but also related preventive or therapeutic approaches.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Health Risks of Sarcopenic Obesity in Overweight Children and Adolescents: Data from the CHILT III Programme (Cologne)

Sack

Ferrari

Friesen

et al. 2022

JCM

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“…Two of the studies evaluated interventions to reduce obesity/overweight [145] and promote PA [146]. BP reduction was in both studies a secondary outcome.…”

Section: The Economic Impact Of Childhood Obesitymentioning

confidence: 99%

“…BP reduction was in both studies a secondary outcome. The Children's Health Interventional Trial was an 11-month outpatient multidisciplinary family-based program implemented with 248 children with obesity or overweight in Germany [145]. The main focus was reducing weight, but the secondary objectives was the improvement of obesity-related health parameters as BP.…”

Section: The Economic Impact Of Childhood Obesitymentioning

confidence: 99%

Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood

et al. 2021

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Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial infarction are the domain of adulthood, it is evident that the CV continuum begins very early in life. Recognition of risk factors and early stages of CV damage, at a time when these processes are still reversible, and the development of prevention strategies are major pillars in reducing CV morbidity and mortality in the general population. In this review, we will discuss the role of well-known but also novel risk factors linking obesity and increased CV risk from prenatal age to adulthood, including the role of perinatal factors, diet, nutrigenomics, and nutri-epigenetics, hyperuricemia, dyslipidemia, hypertension, and cardiorespiratory fitness. The importance of ‘tracking’ of these risk factors on adult CV health is highlighted and the economic impact of childhood obesity as well as preventive strategies are discussed.

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Cost‐effectiveness of a primary care‐based Healthy Weight Clinic compared with usual care

Sharifi,

Fiechtner,

Barrett

et al. 2024

Obesity

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ObjectiveThe objective of this study was to project the cost‐effectiveness of implementing the Healthy Weight Clinic (HWC), a primary care‐based intervention for 6‐ to 12‐year‐old children with overweight or obesity, at federally qualified health centers (FQHCs) nationally.MethodsWe estimated intervention costs from a health care sector and societal perspective and used BMI change estimates from the HWC trial. Our microsimulation of national HWC implementation among all FQHCs from 2023 to 2032 estimated cost per child and per quality‐adjusted life year (QALY) gained and projected impact on obesity prevalence by race and ethnicity. Probabilistic sensitivity analyses assessed uncertainty around estimates.ResultsNational implementation is projected to reach 888,000 children over 10 years, with a mean intervention cost of $456 (95% uncertainty interval [UI]: $409–$506) per child to the health care sector and $211 (95% UI: $175–$251) to families (e.g., time participating). Assuming effect maintenance, national implementation could result in 2070 (95% UI: 859–3220) QALYs gained and save $14.6 million (95% UI: $5.6–$23.5 million) in health care costs over 10 years, yielding a net cost of $278,000 (95% CI: $177,000–$679,000) per QALY gained. We project greater reductions in obesity prevalence among Hispanic/Latino and Black versus White populations.ConclusionsThe HWC is relatively low‐cost per child and projected to reduce obesity disparities if implemented nationally in FQHCs.

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Cost-effectiveness of a family-based multicomponent outpatient intervention program for children with obesity in Germany

Cited by 10 publications

References 42 publications

Health Risks of Sarcopenic Obesity in Overweight Children and Adolescents: Data from the CHILT III Programme (Cologne)

Health Risks of Sarcopenic Obesity in Overweight Children and Adolescents: Data from the CHILT III Programme (Cologne)

Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood

Cost‐effectiveness of a primary care‐based Healthy Weight Clinic compared with usual care

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