TY - JOUR
T1 - A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program
T2 - Combining Reach, Effectiveness, and Cost
AU - Estabrooks, Paul A.
AU - Wilson, Kathryn E.
AU - McGuire, Todd J.
AU - Harden, Samantha M.
AU - Ramalingam, Nithya Priya
AU - Schoepke, Lia
AU - Almeida, Fabio A.
AU - Bayer, Amy L.
N1 - Funding Information:
Funding for this project was provided by the Harold M. Maurer Distinguished Chair in Public Health Research Endowment at the University of Nebraska Medical Center and the Virginia Tech Fralin Center for Translational Obesity Research. Thanks to Dr. Wen You who provided feedback on early drafts of the manuscript to review conceptual clarity and appropriateness of statistical methods, and to Kaiser Permanente Colorado for allowing access to all de-identified participant data and invoices for program implementation costs.
Publisher Copyright:
© 2017, Society of General Internal Medicine.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants. Objective: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics. Design: Longitudinal pre–post quasi-experiment without control. Participants: Enrolled participants in Weigh and Win (WAW), a community-based weight loss program. Intervention: A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach. Main Measures: Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation. Key Results: A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants. Conclusions: Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.
AB - Background: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants. Objective: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics. Design: Longitudinal pre–post quasi-experiment without control. Participants: Enrolled participants in Weigh and Win (WAW), a community-based weight loss program. Intervention: A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach. Main Measures: Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation. Key Results: A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants. Conclusions: Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.
KW - behavioral weight Loss
KW - cost
KW - impact
KW - incentives
KW - public health
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U2 - 10.1007/s11606-016-3971-0
DO - 10.1007/s11606-016-3971-0
M3 - Article
C2 - 28271423
AN - SCOPUS:85014515419
SN - 0884-8734
VL - 32
SP - 24
EP - 31
JO - Journal of general internal medicine
JF - Journal of general internal medicine
ER -