Yvonne C Anderson1, William Leung2, Cameron C Grant3, Tami L Cave4, José G B Derraik5, Wayne S Cutfield6, Nicola M Pereira7, Paul L Hofman8, Trudy A Sullivan9. 1. Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand; Liggins Institute, University of Auckland, Auckland, New Zealand. Electronic address: yvonne.anderson@tdhb.org.nz. 2. Wellington School of Medicine, University of Otago, Wellington, New Zealand. 3. Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Auckland, New Zealand. 4. Liggins Institute, University of Auckland, Auckland, New Zealand. 5. Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. 6. Liggins Institute, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. 7. Child Health Service, Midcentral District Health Board, Palmerston North, New Zealand. 8. Liggins Institute, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand. 9. Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Abstract
OBJECTIVE: To determine whether Whānau Pakari, a home-based, 12-month multi-disciplinary child obesity intervention programme was cost-effective when compared with the prior conventional hospital-based model of care. METHODS: Whānau Pakari trial participants were recruited January 2012-August 2014, and randomised to either a high-intensity intervention (weekly sessions for 12 months with home-based assessments and advice, n=100) or low-intensity control (home-based assessments and advice only, n=99). Trial participants were aged 5-16 years, resided in Taranaki, Aotearoa/New Zealand (NZ), with a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities. Conventional group participants (receiving paediatrician assessment with dietitian input and physical activity/nutrition support, n=44) were aged 4-15 years, and resided in the same or another NZ centre. The change in BMI standard deviation score (SDS) at 12 months from baseline and programme intervention costs, both at the participant level, were used for the economic evaluation. A limited health funder perspective with costs in 2016 NZ$ was taken. RESULTS: The per child 12-month Whānau Pakari programme costs were significantly lower than in the conventional group. In the low-intensity group, costs were NZ$939 (95% CI: 872, 1007) (US$648) lower than the conventional group. In the high-intensity intervention group, costs were NZ$155 (95% CI: 89, 219) (US$107) lower than in the conventional group. BMI SDS reductions were similar in the three groups. CONCLUSIONS: A home-based, multi-disciplinary child obesity intervention had lower programme costs per child, greater reach, with similar BMI SDS outcomes at 12 months when compared with the previous hospital-based conventional model.
RCT Entities:
OBJECTIVE: To determine whether Whānau Pakari, a home-based, 12-month multi-disciplinary childobesity intervention programme was cost-effective when compared with the prior conventional hospital-based model of care. METHODS: Whānau Pakari trial participants were recruited January 2012-August 2014, and randomised to either a high-intensity intervention (weekly sessions for 12 months with home-based assessments and advice, n=100) or low-intensity control (home-based assessments and advice only, n=99). Trial participants were aged 5-16 years, resided in Taranaki, Aotearoa/New Zealand (NZ), with a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities. Conventional group participants (receiving paediatrician assessment with dietitian input and physical activity/nutrition support, n=44) were aged 4-15 years, and resided in the same or another NZ centre. The change in BMI standard deviation score (SDS) at 12 months from baseline and programme intervention costs, both at the participant level, were used for the economic evaluation. A limited health funder perspective with costs in 2016 NZ$ was taken. RESULTS: The per child 12-month Whānau Pakari programme costs were significantly lower than in the conventional group. In the low-intensity group, costs were NZ$939 (95% CI: 872, 1007) (US$648) lower than the conventional group. In the high-intensity intervention group, costs were NZ$155 (95% CI: 89, 219) (US$107) lower than in the conventional group. BMI SDS reductions were similar in the three groups. CONCLUSIONS: A home-based, multi-disciplinary childobesity intervention had lower programme costs per child, greater reach, with similar BMI SDS outcomes at 12 months when compared with the previous hospital-based conventional model.
Authors: Yvonne C Anderson; Cervantée E K Wild; Paul L Hofman; Tami L Cave; Ken J Taiapa; Tania Domett; José G B Derraik; Wayne S Cutfield; Cameron C Grant; Esther J Willing Journal: BMJ Open Date: 2021-05-11 Impact factor: 2.692
Authors: Rehana A Salam; Zahra A Padhani; Jai K Das; Amina Y Shaikh; Zahra Hoodbhoy; Sarah Masroor Jeelani; Zohra S Lassi; Zulfiqar A Bhutta Journal: Nutrients Date: 2020-07-24 Impact factor: 5.717