title: Cost effectiveness of a mail-delivered individually tailored physical activity intervention for Latinas vs. a mailed contact control.
abstract: BACKGROUND
  Physical inactivity is high in Latinas, as are chronic health conditions. There is a need for physical activity (PA) interventions that are not only effective but have potential for cost-effective widespread dissemination. The purpose of this paper was to assess the costs and cost effectiveness of a Spanish-language print-based mail-delivered PA intervention that was linguistically and culturally adapted for Latinas.
  
  
  METHODS
  Adult Latinas (N = 266) were randomly assigned to receive mail-delivered individually tailored intervention materials or wellness information mailed on the same schedule (control). PA was assessed at baseline, six months (post-intervention) and 12 months (maintenance phase) using the 7-Day Physical Activity Recall Interview. Costs were calculated from a payer perspective, and included personnel time (wage, fringe, and overhead), materials, equipment, software, and postage costs.
  
  
  RESULTS
  At six months, the PA intervention cost $29/person/month, compared to $15/person/month for wellness control. These costs fell to $17 and $9 at 12 months, respectively. Intervention participants increased their PA by an average of 72 min/week at six months and 94 min/week at 12 months, while wellness control participants increased their PA by an average of 30 min/week and 40 min/week, respectively. At six months, each minute increase in PA cost $0.18 in the intervention group compared to $0.23 in wellness control, which fell to $0.07 and $0.08 at 12 months, respectively. The incremental cost per increase in physical activity associated with the intervention was $0.15 at 6 months and $0.05 at 12 months.
  
  
  CONCLUSIONS
  While the intervention was more costly than the wellness control, costs per minute of increase in PA were lower in the intervention. The print-based mail-delivered format has potential for broad, cost-effective dissemination, which could help address disparities in this at-risk population.
  
  
  BACKGROUND
  NCT01583140; Date of Registration: 03/06/2012; Funding Source of Trial: National Institute of Nursing Research (NINR); Name of Institutional Review Board: Brown University IRB; Date of Approval: 05/19/2009.
authors.affiliation: Department of Family Medicine and Public Health, University of California, 9500 Gilman Dr, San Diego, CA, 92093-0628, USA. blarsen@ucsd.edu.
authors.forename: Britta
authors.initials: B
authors.lastname: Larsen
authors.affiliation: Department of Family Medicine and Public Health, University of California, 9500 Gilman Dr, San Diego, CA, 92093-0628, USA. tgilmer@ucsd.edu.
authors.forename: Todd
authors.initials: T
authors.lastname: Gilmer
authors.affiliation: Department of Health Behavior, School of Public Health at University of Alabama, Birmingham, USA. dpekmezi@uab.edu.
authors.forename: Dori
authors.initials: D
authors.lastname: Pekmezi
authors.affiliation: Departments of Prevention and Community Health & Exercise and Nutrition Sciences, The George Washington University School of Public Health, ., .. mnapolitano@gwu.edu.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Napolitano
authors.affiliation: Department of Family Medicine and Public Health, University of California, 9500 Gilman Dr, San Diego, CA, 92093-0628, USA. bmarcus@ucsd.edu.
authors.forename: Bess H
authors.initials: BH
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003362:Cost-Benefit Analysis; D054521:Cultural Competency; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008875:Middle Aged; D009043:Motor Activity; D011177:Postal Service; D055815:Young Adult