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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-...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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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. |
format | Online Article Text |
id | pubmed-3912346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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