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Cost of a group translation of the Diabetes Prevention Program: healthy living partnerships to prevent diabetes
Lawlor MS, Blackwell CS, Isom SP, Katula JA, Vitolins MZ, Morgan TM, Goff DC Jr
American Journal of Preventive Medicine 2013 Apr;44(4 Suppl 4):S381-S389
clinical trial
1/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Although numerous studies have translated the Diabetes Prevention Program lifestyle intervention into various settings, no study to date has reported a formal cost analysis. PURPOSE: To describe costs associated with the Healthy Living Partnerships to Prevent Diabetes (HELP PD) trial. DESIGN: HELP PD was a 24-month RCT testing the impact of a lifestyle weight-loss intervention administered through a diabetes education program and delivered by community health workers (CHWs) on blood glucose and body weight among prediabetics. SETTING/PARTICIPANTS: In all, 301 participants with prediabetes were randomized in Forsyth County NC. Data reported in these analyses were collected in 2007 to 2011 and analyzed in 2011 to 2012. INTERVENTION: The lifestyle weight-loss group had a 7% weight loss goal achieved and maintained by caloric restriction and increased physical activity. The usual care group received two visits with a registered dietitian and monthly newsletters. MAIN OUTCOME MEASURES: Measures are direct medical costs, direct nonmedical costs, and indirect costs over the 2-year study period. Research costs are excluded. RESULTS: The direct medical cost (in 2010 dollars) to identify one participant was $16.85. Direct medical costs per capita for participants in the usual care group were $142 and $850 for lifestyle weight-loss participants. Per capita direct costs of care outside the study were $7,454 for the usual care group and $5,177 for the lifestyle weight-loss group. Per capita direct nonmedical costs were $12,881 for the usual care group and $13,836 for the lifestyle weight-loss group. The lifestyle weight-loss group in HELP PD cost $850 in direct medical costs for 2 years, compared to $2,631 in direct medical costs for the first 2 years of DPP. CONCLUSIONS: A community-based translation of the DPP can be delivered effectively and with reduced costs. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov NCT00631345.

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