title: Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force.
abstract: BACKGROUND
  Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk.
  
  
  OBJECTIVE
  To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs.
  
  
  METHODS
  Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015.
  
  
  METHODS
  English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes.
  
  
  METHODS
  Dual abstraction and assessment of relevant study details.
  
  
  RESULTS
  Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified.
  
  
  CONCLUSIONS
  Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited.
  
  
  CONCLUSIONS
  Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings.
  
  
  BACKGROUND
  None.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.forename: Shuli
authors.initials: S
authors.lastname: Qu
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.forename: Sajal
authors.initials: S
authors.lastname: Chattopadhyay
authors.forename: Edward W
authors.initials: EW
authors.lastname: Gregg
authors.forename: Ann
authors.initials: A
authors.lastname: Albright
authors.forename: David
authors.initials: D
authors.lastname: Hopkins
authors.forename: Nicolaas P
authors.initials: NP
authors.lastname: Pronk
mesh_terms: D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000517:prevention & control*; D004038:Diet, Reducing / Q000191:economics*; D015444:Exercise; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D019057:Quality-Adjusted Life Years; D012307:Risk Factors