Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans: A within-trial analysis

Elizabeth C. Rhodes, Eeshwar K. Chandrasekar, Shivani A. Patel, K. M. Venkat Narayan, Thomas Vayalinkara Joshua, Lovoria B. Williams, Lucy Nelle Marion, Mohammed K. Ali

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)85-92
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume146
DOIs
StatePublished - Dec 1 2018

Fingerprint

African Americans
Cost-Benefit Analysis
Life Style
Health Education
Costs and Cost Analysis
Waist Circumference
Weights and Measures
Quality of Life
Exercise
Blood Pressure
Glucose
Cluster Analysis
Weight Loss
Randomized Controlled Trials
Education

Keywords

  • African American
  • Church
  • Cost
  • Diabetes prevention
  • Lifestyle intervention
  • Obesity

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans : A within-trial analysis. / Rhodes, Elizabeth C.; Chandrasekar, Eeshwar K.; Patel, Shivani A.; Venkat Narayan, K. M.; Joshua, Thomas Vayalinkara; Williams, Lovoria B.; Marion, Lucy Nelle; Ali, Mohammed K.

In: Diabetes Research and Clinical Practice, Vol. 146, 01.12.2018, p. 85-92.

Research output: Contribution to journalArticle

Rhodes, Elizabeth C. ; Chandrasekar, Eeshwar K. ; Patel, Shivani A. ; Venkat Narayan, K. M. ; Joshua, Thomas Vayalinkara ; Williams, Lovoria B. ; Marion, Lucy Nelle ; Ali, Mohammed K. / Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans : A within-trial analysis. In: Diabetes Research and Clinical Practice. 2018 ; Vol. 146. pp. 85-92.
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abstract = "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.",
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AU - Venkat Narayan, K. M.

AU - Joshua, Thomas Vayalinkara

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AU - Marion, Lucy Nelle

AU - Ali, Mohammed K.

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