66 N. Pauline St., Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Prev Med. 2013 Oct;57(4):400-2. doi: 10.1016/j.ypmed.2013.06.027. Epub 2013 Jul 2.
Older adults in the U.S. have high rates of obesity. Despite the demonstrated efficacy of lifestyle interventions among older adults, lifestyle interventions are not widely implemented in community settings. Program delivery by lay health educators (LHEs) might support greater dissemination because of lower delivery cost and greater accessibility. We examined the costs of a LHE-delivered translation of the Diabetes Prevention Program (DPP) evidence-based lifestyle intervention for older adults in Arkansas senior centers.
This examination of costs used data from a cluster randomized control trial (conducted 2008-2010) in which 7 senior centers (116 participants) were randomized to implement a LHE-delivered 12-session translation of the DPP lifestyle intervention. We compiled direct lifestyle intervention implementation costs, including training, recruitment, materials, and ongoing intervention implementation support. Weight loss data (at 4-month follow-up) were collected from participants.
Participant weight loss averaged 3.7kg at 4-months. The total estimated cost to implement the lifestyle intervention is $2731 per senior center, or $165 per participant. The implementation cost per kilogram lost is $45.
A LHE-delivered DPP translation in senior centers is effective in achieving weight loss at low cost and offers promise for the dissemination of this evidence-based intervention.
美国的老年人肥胖率很高。尽管生活方式干预对老年人有效,但在社区环境中并未广泛实施生活方式干预。由于成本较低且更便于获取,由非专业健康教育者(LHE)进行的项目交付可能会支持更大规模的推广。我们研究了在阿肯色州老年人中心由 LHE 提供的糖尿病预防计划(DPP)循证生活方式干预翻译的成本。
本成本研究使用了一项群组随机对照试验(2008-2010 年进行)的数据,该试验将 7 个老年人中心(116 名参与者)随机分为实施 LHE 提供的 12 节 DPP 生活方式干预翻译的两组。我们汇总了直接生活方式干预实施成本,包括培训、招募、材料和持续的干预实施支持。从参与者处收集了体重减轻数据(在 4 个月的随访时)。
参与者的体重平均在 4 个月时减轻了 3.7kg。实施生活方式干预的总估计成本为每个老年人中心 2731 美元,或每位参与者 165 美元。每减轻一公斤体重的实施成本为 45 美元。
在老年人中心由 LHE 提供的 DPP 翻译可以有效地实现减肥,且具有以低成本推广这种循证干预的潜力。