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 V. Joshua; Lovoria B. Williams; Lucy Marion; Mohammed K. Ali

doi:10.1016/j.diabres.2018.09.016

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 V. Joshua, Lovoria B. Williams, Lucy Marion, Mohammed K. Ali

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

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 language	English
Pages (from-to)	85-92
Number of pages	8
Journal	Diabetes Research and Clinical Practice
Volume	146
DOIs	https://doi.org/10.1016/j.diabres.2018.09.016
State	Published - Dec 2018

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases [grant number R18DK082401 ], National Heart, Lung, And Blood Institute [grant number R01HL125442 ], and Fogarty International Center [grant number R25Tw09337 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. MKA and KMVN are partially supported by the Georgia Center for Diabetes Translation Research funded by the National Institute of Diabetes and Digestive and Kidney Diseases [grant number P30DK111024 ].

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

African American
Church
Cost
Diabetes prevention
Lifestyle intervention
Obesity

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diabres.2018.09.016

Cite this

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

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.",

keywords = "African American, Church, Cost, Diabetes prevention, Lifestyle intervention, Obesity",

author = "Rhodes, {Elizabeth C.} and Chandrasekar, {Eeshwar K.} and Patel, {Shivani A.} and {Venkat Narayan}, {K. M.} and Joshua, {Thomas V.} and Williams, {Lovoria B.} and Lucy Marion and Ali, {Mohammed K.}",

note = "Funding Information: This work was supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases [grant number R18DK082401 ], National Heart, Lung, And Blood Institute [grant number R01HL125442 ], and Fogarty International Center [grant number R25Tw09337 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. MKA and KMVN are partially supported by the Georgia Center for Diabetes Translation Research funded by the National Institute of Diabetes and Digestive and Kidney Diseases [grant number P30DK111024 ]. Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",

year = "2018",

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doi = "10.1016/j.diabres.2018.09.016",

language = "English",

volume = "146",

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T1 - Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans

T2 - A within-trial analysis

AU - Rhodes, Elizabeth C.

AU - Chandrasekar, Eeshwar K.

AU - Patel, Shivani A.

AU - Venkat Narayan, K. M.

AU - Joshua, Thomas V.

AU - Williams, Lovoria B.

AU - Marion, Lucy

AU - Ali, Mohammed K.

N1 - Funding Information: This work was supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases [grant number R18DK082401 ], National Heart, Lung, And Blood Institute [grant number R01HL125442 ], and Fogarty International Center [grant number R25Tw09337 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. MKA and KMVN are partially supported by the Georgia Center for Diabetes Translation Research funded by the National Institute of Diabetes and Digestive and Kidney Diseases [grant number P30DK111024 ]. Publisher Copyright: © 2018 Elsevier B.V.

PY - 2018/12

Y1 - 2018/12

N2 - 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.

AB - 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.

KW - African American

KW - Church

KW - Cost

KW - Diabetes prevention

KW - Lifestyle intervention

KW - Obesity

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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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