Online Program

Cost-effectiveness of a community-based, diabetes prevention program targeting a low SES Mexico-origin population

Wednesday, November 6, 2013 : 8:30 a.m. - 8:50 a.m.

Kimberly Wilson, MPIA, Division of Health Promotion and Behavioral Sciences, University of Texas Health Sciences Center School of Public Health, Austin, TX
H. Shelton Brown III, PhD, Division of Management, Policy and Community Health, University of Texas Health Sciences Center School of Public Health, Austin, TX
Elena Bastida, PhD, Health Promotion and Disease Prevention, Florida International University, Miami, FL
Rates of type 2 diabetes in Texas-Mexico border counties (20-39%) exceed national rates. Few community-based interventions have improved outcomes related to risk factors (overweight, sedentary lifestyle, and poor diet) in low-income Mexican-American populations. Further, information on intervention cost-effectiveness is lacking. We evaluate the cost-effectiveness of a 12-week community-based, culturally-relevant intervention aimed at improving dietary and physical activity behaviors, targeting a Mexican-American population in South Texas. We segmented the sample available at follow-up (n=341) into BMI categories and calculated the portion of each group losing 2% and 5% body weight over nine months. We calculated costs on an intent-to-treat basis. We forecasted disease outcomes, quality-adjusted life years (QALYs) gained, and lifetime costs associated with attaining 2% and 5% weight loss goals. We projected outcomes out 10 and 20 years. The sample was predominantly female (81%), born in Mexico (77%), low-income, and middle-aged; 17% were normal weight; 41% were obese. Overall, 34% of the sample experienced at least 2% weight loss and 13% achieved at least 5% weight loss over nine months. The intervention was cost-effective over a 20-year time horizon for all groups in both scenarios with costs per QALY gained of $60,787 (2%) and $62,236 (5%), respectively. It was most cost-effective for the morbidly obese under the 5% / 20-year horizon scenario at $46/QALY. The intervention's 2% weight loss results compare favorably to other community-based weight loss interventions. We demonstrate that culturally-appropriate community weight loss interventions can be highly cost-effective, especially for the morbidly obese.

Learning Areas:

Biostatistics, economics
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Describe key components of a successful, community-based weight loss/maintenance program. Compare the cost-effectiveness of community-based diabetes prevention programs.

Keyword(s): Obesity, Latino Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have carried out cost-effectiveness analyses of multiple diabetes prevention / self-management programs targeting Mexican/Mexican-American populations, on published thus far. My research focuses on disparities in health care access and chronic disease management in Mexican/Mexican-American populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.