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The cost of a primary care-based childhood obesity prevention intervention

BACKGROUND: United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-...

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Autores principales: Wright, Davene R, Taveras, Elsie M, Gillman, Matthew W, Horan, Christine M, Hohman, Katherine H, Gortmaker, Steven L, Prosser, Lisa A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912346/
https://www.ncbi.nlm.nih.gov/pubmed/24472122
http://dx.doi.org/10.1186/1472-6963-14-44
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author Wright, Davene R
Taveras, Elsie M
Gillman, Matthew W
Horan, Christine M
Hohman, Katherine H
Gortmaker, Steven L
Prosser, Lisa A
author_facet Wright, Davene R
Taveras, Elsie M
Gillman, Matthew W
Horan, Christine M
Hohman, Katherine H
Gortmaker, Steven L
Prosser, Lisa A
author_sort Wright, Davene R
collection PubMed
description BACKGROUND: United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. METHODS: High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. RESULTS: The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. CONCLUSIONS: High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00377767.
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spelling pubmed-39123462014-02-05 The cost of a primary care-based childhood obesity prevention intervention Wright, Davene R Taveras, Elsie M Gillman, Matthew W Horan, Christine M Hohman, Katherine H Gortmaker, Steven L Prosser, Lisa A BMC Health Serv Res Research Article BACKGROUND: United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. METHODS: High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. RESULTS: The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. CONCLUSIONS: High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00377767. BioMed Central 2014-01-29 /pmc/articles/PMC3912346/ /pubmed/24472122 http://dx.doi.org/10.1186/1472-6963-14-44 Text en Copyright © 2014 Wright et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wright, Davene R
Taveras, Elsie M
Gillman, Matthew W
Horan, Christine M
Hohman, Katherine H
Gortmaker, Steven L
Prosser, Lisa A
The cost of a primary care-based childhood obesity prevention intervention
title The cost of a primary care-based childhood obesity prevention intervention
title_full The cost of a primary care-based childhood obesity prevention intervention
title_fullStr The cost of a primary care-based childhood obesity prevention intervention
title_full_unstemmed The cost of a primary care-based childhood obesity prevention intervention
title_short The cost of a primary care-based childhood obesity prevention intervention
title_sort cost of a primary care-based childhood obesity prevention intervention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912346/
https://www.ncbi.nlm.nih.gov/pubmed/24472122
http://dx.doi.org/10.1186/1472-6963-14-44
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