The cost-effectiveness of alternative methods of nutrition education for hypercholesterolemic children

Objectives. This study compared the cost-effectiveness, from the family's perspective, of a parent-child auto-tutorial nutrition education program with that of counseling by a dietitian after identification of hypercholesterolemic children in pediatric offices. Methods. Personnel, parent time, equipment, and laboratory costs associated with the interventions were analyzed. Reductions in dietary fat as a percentage of total calories were analyzed by means of 24-hour dietary recalls and in plasma low-density lipoprotein cholesterol at 3 and 12 months postintervention. Results. Average costs totaled $208.08 for the parent-child auto-tutorial program and $213.28 for counseling. While the parent-child program was somewhat less cost-effective in terms of dietary change, it was more cost-effective in terms of lipid reduction at 3 months, although this advantage disappeared: by 12 months. Conclusions. Modest reductions in fat in the diet and in plasma lipid levels were achieved at costs that also appear modest in comparison with treatment of elevated cholesterol in adulthood. Follow-up interventions may be needed to sustain effects, while longitudinal studies are needed to assess the long-term cost benefit.