Economic evaluation of a weight control program with e-mail and telephone counseling among overweight employees: a randomized controlled trial

• Main Authors: van Wier Marieke F (Author), Dekkers J (Author), Bosmans Judith E (Author), Heymans Martijn W (Author), Hendriksen Ingrid JM (Author), Pronk Nicolaas P (Author), van Mechelen Willem (Author), van Tulder Maurits W (Author)
• Format: Book
• Published: BMC, 2012-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/1479-5868-9-112; 1479-5868
• Keywords: Body weight; Cost-effectiveness; Cost-utility; Distance counseling; Intervention; Lifestyle; RCT; Workplace health promotion; Nutritional diseases. Deficiency diseases; RC620-627; Public aspects of medicine; RA1-1270
• Source: International Journal of Behavioral Nutrition and Physical Activity, Vol 9, Iss 1, p 112 (2012)

<p>Abstract</p> <p>Background</p> <p>Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the cost-effectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a six-month program with lifestyle counseling aimed at weight reduction in an overweight working population with a two-year time horizon from a societal perspective.</p> <p>Methods</p> <p>A randomized controlled trial comparing a program with two modes of intervention delivery against self-help. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 29.6 (SD 3.5) kg/m²). All groups received self-directed lifestyle brochures. The two intervention groups additionally received a workbook-based program with phone counseling (phone; n=462) or a web-based program with e-mail counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol-5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with six-monthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental cost-effectiveness ratios was estimated by applying non-parametric bootstrapping techniques and graphically plotting the results in cost-effectiveness planes and cost-effectiveness acceptability curves.</p> <p>Results</p> <p>At two years the incremental cost-effectiveness ratio was €1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The cost-utility analysis resulted in €245,243/quality adjusted life year (QALY) and €1337/QALY, respectively. The results from a complete-case analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes.</p> <p>Conclusions</p> <p>Neither intervention mode was proven to be cost-effective compared to self-help.</p> <p>Trial registration</p> <p>ISRCTN04265725</p>