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Community Based Intervention01:30

Community Based Intervention

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Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
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Cost-Effectiveness Analysis of a Community-Based Telewellness Weight Loss Program.

Jeffrey S Hoch1,2, Neal D Kohatsu2, Julia Fleuret2

  • 1Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, California.

AJPM Focus
|February 2, 2024
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Summary
This summary is machine-generated.

The Koa Family Program, a telewellness intervention, is a cost-effective weight loss solution for low-income women, costing about $73 per pound lost. This community-based program offers good value compared to other weight management interventions.

Keywords:
Cost-effectivenesslow-incomeobesitytelewellnessweight losswomen

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Area of Science:

  • Public Health
  • Health Economics
  • Behavioral Medicine

Background:

  • Obesity and overweight affect millions of women, particularly those with low incomes, necessitating accessible and effective interventions.
  • Community-based telewellness programs offer a scalable approach to weight management.
  • Previous research demonstrated the Koa Family Program's efficacy in achieving significant weight loss.

Purpose of the Study:

  • To conduct a cost-effectiveness analysis of the Koa Family Program, a telewellness intervention for overweight/obese, low-income women aged 21-45.
  • To compare the incremental costs with the incremental effectiveness (weight loss) of the program.
  • To assess the program's value for money from a funder's perspective.

Main Methods:

  • A prospective 25-week randomized controlled trial (RCT) involving 70 women (BMI 25-40 kg/m²) was used.
  • Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio (ICER) and incremental net benefit (INB).
  • Statistical uncertainty was assessed using willingness-to-pay plots and cost-effectiveness acceptability curves.

Main Results:

  • The average cost per participant ranged from $407.34 to $726.22, with a base case of $564.39.
  • Participants achieved an average weight loss of 7.7 pounds over 25 weeks.
  • The base case ICER was approximately $73 per pound lost, with a 90-95% probability of cost-effectiveness at willingness-to-pay thresholds of $115-$140 per pound.

Conclusions:

  • The Koa Family Program demonstrates good value and cost-effectiveness, comparable to other weight-loss interventions.
  • The program's effectiveness is notable given its focus on a vulnerable, low-income population.
  • Telewellness interventions can be a viable and economical strategy for addressing obesity in underserved communities.