Cost-effectiveness of Lifestyle Africa: an adaptation of the diabetes prevention programme for delivery by community health workers in urban South Africa

被引:3
作者
Whittington, Melanie D. [1 ]
Goggin, Kathy [2 ,3 ]
Tsolekile, Lungiswa [4 ]
Puoane, Thandi [4 ]
Fox, Andrew T. [3 ]
Resnicow, Ken [5 ]
Fleming, Kandace K. [6 ]
Smyth, Joshua M. [7 ]
Materia, Frank T. [3 ]
Hurley, Emily A. [2 ,3 ]
Vitolins, Mara Z. [8 ]
Lambert, Estelle V. [9 ]
Levitt, Naomi S. [10 ]
Catley, Delwyn [2 ,11 ,12 ]
机构
[1] Univ Kansas, Med Ctr, Dept Populat Hlth, Kansas City, KS USA
[2] Univ Missouri, Kansas City Sch Med, Dept Pediat, Kansas City, MO USA
[3] Childrens Mercy Hosp & Clin, Hlth Serv & Outcomes Res, Kansas City, MO USA
[4] Univ Western Cape, Sch Publ Hlth, Cape Town, South Africa
[5] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI USA
[6] Univ Kansas, Life Span Inst, Lawrence, KS USA
[7] Penn State Univ, Coll Hlth & Human Dev, University Pk, PA USA
[8] Wake Forest Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC USA
[9] Univ Cape Town, Fac Hlth Sci, UCT Res Ctr Hlth Phys Act Lifestyle & Sport HPALS, Div Res Unit Exercise Sci & Sports Med, Cape Town, South Africa
[10] Univ Cape Town, Fac Hlth Sci, Dept Med & Chron Dis Initiat Africa, Cape Town, South Africa
[11] Childrens Mercy Kansas City, Ctr Childrens Hlth Lifestyles & Nutr, Kansas City, MO USA
[12] Childrens Mercy Kansas City, Ctr Childrens Hlth Lifestyles & Nutr, 2401 Gillham Rd, Kansas City, MO 64108 USA
基金
美国国家卫生研究院;
关键词
Economic analysis; HbA1c; lifestyle interventions; low- and middle-income countries; probabilistic sensitivity analysis; DISEASES; OBESITY; BURDEN;
D O I
10.1080/16549716.2023.2212952
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Lifestyle Africa is an adapted version of the Diabetes Prevention Program designed for delivery by community health workers to socioeconomically disadvantaged populations in low- and middle-income countries (LMICs). Results from the Lifestyle Africa trial conducted in an under-resourced community in South Africa indicated that the programme had a significant effect on reducing haemoglobin A1c (HbA1c). Objective To estimate the cost of implementation and the cost-effectiveness (in cost per point reduction in HbA1c) of the Lifestyle Africa programme to inform decision-makers of the resources required and the value of this intervention. Methods Interviews were held with project administrators to identify the activities and resources required to implement the intervention. A direct-measure micro-costing approach was used to determine the number of units and unit cost for each resource. The incremental cost per one point improvement in HbA1c was calculated. Results The intervention equated to 71 United States dollars (USD) in implementation costs per participant and a 0.26 improvement in HbA1c per participant. Conclusions Lifestyle Africa reduced HbA1c for relatively little cost and holds promise for addressing chronic disease in LMIC. Decision-makers should consider the comparative clinical effectiveness and cost-effectiveness of this intervention when making resource allocation decisions.
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页数:9
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