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Development and implementation cost analysis of telephone- and Internet-based interventions for the maintenance of weight loss

Published online by Cambridge University Press:  21 July 2009

Richard T. Meenan ,
Victor J. Stevens ,
Kristine Funk ,
Alan Bauck ,
Gerald J. Jerome ,
Lillian F. Lien ,
Lawrence Appel ,
Jack F. Hollis ,
Phillip J. Brantley  and
Laura P. Svetkey
Richard T. Meenan
Affiliation:
Kaiser Permanente Center for Health Research
Victor J. Stevens
Affiliation:
Kaiser Permanente Center for Health Research
Kristine Funk
Affiliation:
Kaiser Permanente Center for Health Research
Alan Bauck
Affiliation:
Kaiser Permanente Center for Health Research
Gerald J. Jerome
Affiliation:
Towson University
Lillian F. Lien
Affiliation:
Duke University Medical Center
Lawrence Appel
Affiliation:
Johns Hopkins Medical Institutions
Jack F. Hollis
Affiliation:
Kaiser Permanente Center for Health Research
Phillip J. Brantley
Affiliation:
Louisiana State University
Laura P. Svetkey
Affiliation:
Duke University Medical Center
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Abstract

Objectives: The Weight Loss Maintenance Trial (WLM) was a multicenter, randomized trial comparing two weight loss maintenance interventions, a personal contact (PC) program with primarily telephone-based monthly contacts, and an Internet-based program (interactive technology, IT), to a self-directed control group, among overweight or obese individuals at high cardiovascular risk. This study describes implementation costs of both interventions as well as IT development costs.

Methods: Resources were micro-costed in 2006 dollars from the primary perspective of a sponsoring healthcare system considering adopting an extant intervention, rather than developing its own. Costs were discounted at 3 percent annually. Length of trial participation was 30 months (randomization during February–November 2004). IT development costs were assessed over 36 months. Univariate and multivariate, including probabilistic, sensitivity analyses were performed.

Results: Total discounted IT development costs over 36 months were $839,949 ($2,414 per IT participant). Discounted 30-month implementation costs for 342 PC participants were $537,242 ($1,571 per participant), and for 348 IT participants, were $214,879 ($617 per participant). Under all plausible scenarios, PC implementation costs exceeded IT implementation costs.

Conclusions: Costs of implementing and operating an Internet-based intervention for weight loss maintenance were substantially less than analogous costs of an intervention using standard phone and in-person contacts and are of a magnitude that would be attractive to many health systems, subject to demonstration of cost-effectiveness.

Keywords

CostWeight lossInternetBehavioral interventionImplementation
Type
Research Reports
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 400 - 410
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1. Appel, LJ, Champagne, CM, Cooper, LS, et al. Effects of comprehensive lifestyle modification on blood pressure control: Main results of the PREMIER clinical trial. JAMA. 2003;289:2083–2093.Google ScholarPubMed
2. Brantley, PJ, Appel, LJ, Hollis, JF, et al. Weight Loss Maintenance (WLM): Design and rationale of a multi-center trial to sustain weight loss. Clin Trials. 2008;5:546–556.CrossRefGoogle ScholarPubMed
3. Centers for Disease Control and Prevention. Overweight and obesity. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. www.cdc.gov/nccdphp/dnpa/obesity/ (accessed August 29, 2008).Google Scholar
4. Centers for Medicare & Medicaid Services. Quarterly index levels in the CMS prospective payment system input price index. Washington, DC: Centers for Medicare & Medicaid Services; 2007.Google Scholar
5. Funk, KL, Elmer, PJ, Stevens, VJ, et al. PREMIER – A trial of lifestyle interventions for blood pressure control: Intervention design and rationale. Health Promot Pract. 2008;9:271–280.CrossRefGoogle ScholarPubMed
6. Glasgow, RE, Nelson, CC, Kearney, KA, et al. Reach, engagement, and retention in an Internet-based weight loss program in a multi-site randomized controlled trial. J Med Internet Res. 2007;9:e11.CrossRefGoogle Scholar
7. Harvey-Berino, J, Pintauro, S, Buzzell, P, Gold, EC. Effect of internet support on the long-term maintenance of weight loss. Obes Res. 2004;12:320–329.CrossRefGoogle ScholarPubMed
8. Harvey-Berino, J, Pintauro, SJ, Gold, EC. The feasibility of using Internet support for the maintenance of weight loss. Behav Modif. 2002;26:103–116.CrossRefGoogle ScholarPubMed
9. Jeffery, RW, Drewnowski, A, Epstein, LH, et al. Long-term maintenance of weight loss: Current status. Health Psychol. 2000;19 (Suppl):5–16.CrossRefGoogle ScholarPubMed
10. Ogden, CL, Carroll, MD, Curtin, LR, et al. . Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;958:1549–1555.CrossRefGoogle Scholar
11. Shiell, A, Donaldson, C, Mitton, C, et al. Health economic evaluation. J Epidemiol Community Health. 2002;56:85–88.CrossRefGoogle ScholarPubMed
12. Stevens, VJ, Funk, KL, Brantley, PJ, et al. Design and implementation of an interactive website to support long-term maintenance of weight loss. J Med Internet Res. 2008;10:e1.CrossRefGoogle ScholarPubMed
13. Svetkey, LP, Stevens, VJ, Brantley, PJ, et al. Comparison of strategies for sustaining weight loss: The Weight Loss Maintenance randomized controlled trial. JAMA. 2008;299:1139–1148.CrossRefGoogle ScholarPubMed
14. Tate, DF, Jackvony, EH, Wing, RR. Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: A randomized trial. JAMA. 2003;289:1833–1836.CrossRefGoogle ScholarPubMed
15. Wadden, TA, Crerand, CE, Brock, J. Behavioral treatment of obesity. Psychiatr Clin North Am. 2005;28:151–170.CrossRefGoogle ScholarPubMed
16. Wing, RR, Tate, DF, Gorin, AA, Raynor, HA, Fava, JL. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355:1563–1571.CrossRefGoogle ScholarPubMed
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