International Journal of Behavioral Nutrition and Physical Activity (Sep 2012)

Economic evaluation of a weight control program with e-mail and telephone counseling among overweight employees: a randomized controlled trial

  • van Wier Marieke F,
  • Dekkers J,
  • Bosmans Judith E,
  • Heymans Martijn W,
  • Hendriksen Ingrid JM,
  • Pronk Nicolaas P,
  • van Mechelen Willem,
  • van Tulder Maurits W

DOI
https://doi.org/10.1186/1479-5868-9-112
Journal volume & issue
Vol. 9, no. 1
p. 112

Abstract

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Abstract Background Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the cost-effectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a six-month program with lifestyle counseling aimed at weight reduction in an overweight working population with a two-year time horizon from a societal perspective. Methods A randomized controlled trial comparing a program with two modes of intervention delivery against self-help. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 29.6 (SD 3.5) kg/m2). All groups received self-directed lifestyle brochures. The two intervention groups additionally received a workbook-based program with phone counseling (phone; n=462) or a web-based program with e-mail counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol-5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with six-monthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental cost-effectiveness ratios was estimated by applying non-parametric bootstrapping techniques and graphically plotting the results in cost-effectiveness planes and cost-effectiveness acceptability curves. Results At two years the incremental cost-effectiveness ratio was €1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The cost-utility analysis resulted in €245,243/quality adjusted life year (QALY) and €1337/QALY, respectively. The results from a complete-case analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes. Conclusions Neither intervention mode was proven to be cost-effective compared to self-help. Trial registration ISRCTN04265725

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