title: The efficacy and cost-effectiveness of a community weight management intervention: a randomized controlled trial of the health weight management demonstration.
abstract: OBJECTIVE
  The study investigated the efficacy and cost-effectiveness of a cognitive-behavioral weight management program, complemented by an interactive Web site and brief telephone/e-mail coaching.
  
  
  METHODS
  In 2006-2007, 1755 overweight, non-active-duty TRICARE beneficiaries were randomized to one of three conditions with increasing intervention intensity: written materials and basic Web access (RCT1), plus an interactive Web site (RCT2), plus brief telephone/e-mail coaching support (RCT3). The study assessed changes in weight, blood pressure, and physical activity from baseline to 6, 12, and 15-18 months. (Study retention was 31% at 12 months.) Average and incremental cost-effectiveness and cost-offset analyses were conducted.
  
  
  RESULTS
  Participants experienced significant weight loss (-4.0%, -4.0%, and -5.3%, respectively, in each RCT group after 12 months and -3.5%, -3.8%, and -5.1%, respectively, after 15 to 18 months), increased physical activity, and decreased blood pressure. Cost-effectiveness ratios were $900 to $1100/quality-adjusted life year (QALY) for RCT1 and RCT2 and $1900/QALY for RCT3. The cost recovery period to the government was 3 years for RCTs 1 and 2 and 6 years for RCT3.
  
  
  CONCLUSIONS
  A relatively inexpensive cognitive-behavioral weight management intervention improved patient outcomes. Extrapolation of savings for the entire TRICARE population would significantly reduce direct medical costs.
authors: RTI International, Research Triangle Park, NC, USA. hersey@rti.org
authors: James C
authors: JC
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mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D019058:Community Networks / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D014481:United States; D014584:User-Computer Interface; D061217:Weight Reduction Programs / Q000191:economics* / Q000592:standards*