Napolitano Melissa A, Bailey Caitlin P, Mavredes Meghan N, Neighbors Charles J, Whiteley Jessica A, Long Michael W, Hayman Laura L, Malin Steven K, DiPietro Loretta
Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Transl Behav Med. 2023 Jun 9;13(6):358-367. doi: 10.1093/tbm/ibac081.
Cost-effectiveness analyses of weight loss programs for university students can inform administrator decision-making. This study quantifies and compares the costs and cost-effectiveness of implementing two digitally-delivered weight loss interventions designed for university populations. Healthy Body Healthy U (HBHU) was a randomized controlled trial comparing TAILORED (personalized) versus TARGETED (generic) weight loss interventions adapted specifically for young adults to a CONTROL intervention. Participants (N = 459; 23.3 ± 4.4 years; mean BMI 31.2 ± 4.4 kg/m2) were recruited from two universities. Implementation costs were examined from a payer (i.e., university) perspective, comparing both the average cost effectiveness ratio (ACER) and the incremental cost effectiveness ratio (ICER) of the two interventions. Cost-effectiveness measures were calculated for changes in body weight, abdominal circumference, HDL cholesterol, systolic and diastolic blood pressure, and HbA1c. The overall 6-month implementation costs were $105.66 per person for the TAILORED intervention and $91.44 per person for the TARGETED intervention. The ACER for weight change was $107.82 for the TAILORED and $179.29 for the TARGETED interventions. The ICER comparing TAILORED with TARGETED for change in body weight was $5.05, and was even lower ($2.28) when including only those with overweight and not obesity. The ICERs for change in abdominal circumference, HDL cholesterol, systolic and diastolic blood pressure, and HbA1c were $3.49, $59.37, $1.57, $2.64, and $47.49, respectively. The TAILORED intervention was generally more cost-effective compared with the TARGETED intervention, particularly among those with overweight. Young adults with obesity may require more resource-intensive precision-based approaches.
大学生减肥项目的成本效益分析可为管理人员的决策提供参考。本研究对实施两种专门为大学生群体设计的数字化减肥干预措施的成本及成本效益进行了量化和比较。“健康身体，健康的你”（HBHU）是一项随机对照试验，将专门为年轻人量身定制的（个性化）与有针对性的（通用型）减肥干预措施与对照干预措施进行比较。参与者（N = 459；23.3±4.4岁；平均BMI 31.2±4.4kg/m²）来自两所大学。从支付方（即大学）的角度审视实施成本，比较了两种干预措施的平均成本效益比（ACER）和增量成本效益比（ICER）。针对体重、腹围、高密度脂蛋白胆固醇、收缩压和舒张压以及糖化血红蛋白的变化计算了成本效益指标。量身定制干预措施的6个月总体实施成本为每人105.66美元，有针对性干预措施为每人91.44美元。量身定制干预措施体重变化的ACER为107.82美元，有针对性干预措施为179.29美元。量身定制与有针对性干预措施体重变化的ICER为5.05美元，仅纳入超重而非肥胖者时更低（2.28美元）。腹围、高密度脂蛋白胆固醇、收缩压和舒张压以及糖化血红蛋白变化的ICER分别为3.49美元、59.37美元、1.57美元、2.64美元和47.49美元。与有针对性干预措施相比，量身定制干预措施总体上更具成本效益，尤其是在超重者中。肥胖的年轻人可能需要更耗费资源的精准方法。
