title: Examination of costs for a lay health educator-delivered translation of the Diabetes Prevention Program in senior centers.
abstract: OBJECTIVE
  Older adults in the U.S. have high rates of obesity. Despite the demonstrated efficacy of lifestyle interventions among older adults, lifestyle interventions are not widely implemented in community settings. Program delivery by lay health educators (LHEs) might support greater dissemination because of lower delivery cost and greater accessibility. We examined the costs of a LHE-delivered translation of the Diabetes Prevention Program (DPP) evidence-based lifestyle intervention for older adults in Arkansas senior centers.
  
  
  METHODS
  This examination of costs used data from a cluster randomized control trial (conducted 2008-2010) in which 7 senior centers (116 participants) were randomized to implement a LHE-delivered 12-session translation of the DPP lifestyle intervention. We compiled direct lifestyle intervention implementation costs, including training, recruitment, materials, and ongoing intervention implementation support. Weight loss data (at 4-month follow-up) were collected from participants.
  
  
  RESULTS
  Participant weight loss averaged 3.7kg at 4-months. The total estimated cost to implement the lifestyle intervention is $2731 per senior center, or $165 per participant. The implementation cost per kilogram lost is $45.
  
  
  CONCLUSIONS
  A LHE-delivered DPP translation in senior centers is effective in achieving weight loss at low cost and offers promise for the dissemination of this evidence-based intervention.
authors.affiliation: 66 N. Pauline St., Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA. Electronic address: rkrukows@uthsc.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Krukowski
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Pope
authors.forename: Sharhonda
authors.initials: S
authors.lastname: Love
authors.forename: Shelly
authors.initials: S
authors.lastname: Lensing
authors.forename: Holly C
authors.initials: HC
authors.lastname: Felix
authors.forename: T Elaine
authors.initials: TE
authors.lastname: Prewitt
authors.forename: Delia
authors.initials: D
authors.lastname: West
mesh_terms: D000368:Aged; D001131:Arkansas; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000191:economics / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D064407:Senior Centers / Q000191:economics / Q000379:methods; D015431:Weight Loss; D000078329:Workforce
keywords: Aged; Community health workers; Costs and cost analysis; Intervention studies; Obesity