TY - JOUR
T1 - Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans
T2 - A within-trial analysis
AU - Rhodes, Elizabeth C.
AU - Chandrasekar, Eeshwar K.
AU - Patel, Shivani A.
AU - Venkat Narayan, K. M.
AU - Joshua, Thomas Vayalinkara
AU - Williams, Lovoria B.
AU - Marion, Lucy Nelle
AU - Ali, Mohammed K.
N1 - Funding Information:
This work was supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases [grant number R18DK082401 ], National Heart, Lung, And Blood Institute [grant number R01HL125442 ], and Fogarty International Center [grant number R25Tw09337 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. MKA and KMVN are partially supported by the Georgia Center for Diabetes Translation Research funded by the National Institute of Diabetes and Digestive and Kidney Diseases [grant number P30DK111024 ].
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/12
Y1 - 2018/12
N2 - Aims: We assessed costs and cost-effectiveness of implementing Fit Body and Soul (FBAS), a church-based 18-session lifestyle education intervention for African Americans. Methods: We calculated incremental cost-effectiveness ratios (ICER) using data from a cluster randomized controlled trial comparing FBAS with health education (HE) among 604 overweight participants in 20 churches. The ICER was the adjusted difference in costs to deliver FBAS versus HE over the difference in weight change (kilograms [kg]) at one-year follow-up. Costs included those incurred for participant identification and program implementation. We fitted linear mixed-effects regression models, accounting for clustering of participants within churches and for age, sex, and educational attainment. We repeated these analyses for secondary outcomes (waist circumference [cm], physical activity [MET], glucose, blood pressure, and quality of life). Results: Per-person intervention cost of FBAS was $50.39 more than HE ($442.22 vs. $391.83 per-person), and adjusted differences in weight change (1.9 kg [95% CI: 1.0 to 2.8]) and waist circumference (2.4 cm [95% CI: 1.3 to 3.4]) were both significant. FBAS did not result in statistically significant differences in physical activity, glucose, blood pressures, or quality of life. We estimated that compared to HE, FBAS costs an additional $26.52 per kg weight lost and $21.00 per cm reduction in waist circumference. Conclusions: For a modest increase in cost, FBAS led to greater weight and waist reductions among African Americans in a church setting. ClinicalTrials.gov Identifier NCT01730196.
AB - Aims: We assessed costs and cost-effectiveness of implementing Fit Body and Soul (FBAS), a church-based 18-session lifestyle education intervention for African Americans. Methods: We calculated incremental cost-effectiveness ratios (ICER) using data from a cluster randomized controlled trial comparing FBAS with health education (HE) among 604 overweight participants in 20 churches. The ICER was the adjusted difference in costs to deliver FBAS versus HE over the difference in weight change (kilograms [kg]) at one-year follow-up. Costs included those incurred for participant identification and program implementation. We fitted linear mixed-effects regression models, accounting for clustering of participants within churches and for age, sex, and educational attainment. We repeated these analyses for secondary outcomes (waist circumference [cm], physical activity [MET], glucose, blood pressure, and quality of life). Results: Per-person intervention cost of FBAS was $50.39 more than HE ($442.22 vs. $391.83 per-person), and adjusted differences in weight change (1.9 kg [95% CI: 1.0 to 2.8]) and waist circumference (2.4 cm [95% CI: 1.3 to 3.4]) were both significant. FBAS did not result in statistically significant differences in physical activity, glucose, blood pressures, or quality of life. We estimated that compared to HE, FBAS costs an additional $26.52 per kg weight lost and $21.00 per cm reduction in waist circumference. Conclusions: For a modest increase in cost, FBAS led to greater weight and waist reductions among African Americans in a church setting. ClinicalTrials.gov Identifier NCT01730196.
KW - African American
KW - Church
KW - Cost
KW - Diabetes prevention
KW - Lifestyle intervention
KW - Obesity
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U2 - 10.1016/j.diabres.2018.09.016
DO - 10.1016/j.diabres.2018.09.016
M3 - Article
C2 - 30273708
AN - SCOPUS:85055113853
SN - 0168-8227
VL - 146
SP - 85
EP - 92
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
ER -
