142nd APHA Annual Meeting and Exposition

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An economic assessment of a coaching intervention to increase wellness activities among culturally diverse women: Early results from Utah's UWAG experiment

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 8:50 AM - 9:10 AM

Iris Buder , University of Utah; Department of Economics, Salt Lake City, UT
The obesity epidemic disproportionately affects women and cultural minorities. Minority women have the highest risk of obesity; in Utah, 61.0% of non-Hispanic Black and 57.4% of Hispanic women are overweight or obese compared to 49.8% of non-Hispanic white women (BRFSS 2009-2012). The societal costs of obesity have been estimated at $147-168 billion (direct) and $66-73 billion (indirect) annually.

The objective of this study is to gauge the economic benefits associated with a community-based coaching intervention aimed at increasing nutritious diets and physical activity among women in culturally diverse Utah communities. Little is known about the net economic effects of such targeted community-based interventions. The Office on Women’s Health provided funding for the Coalition for a Healthier Community for Utah Women and Girls (UWAG) in partnership with the Community Faces of Utah (CFU) to establish a wellness coaching program. CFU represents five culturally diverse groups (African, African American, American Indian, Hispanic/Latina, Pacific Islander). Women recruited from these communities are randomized to receive quarterly vs. monthly in-person coaching. Baseline and follow-up data include information on demographic, socioeconomic, biometric, and behavioral characteristics.

Cost-benefit assessments are being constructed by combining intervention costs with the per person effects of the intervention on physical activity and obesity and the associated reduction in direct and indirect costs and improvements in quality-adjusted life years (QALYs). Estimates will be adjusted for age, gender and race/ethnicity. By the time of this presentation, we anticipate having 140 women with 4-month follow-up data, 129 with 8-month data and 97 with 12-month data.

Previous research on similar interventions suggests that cost-effectiveness ratios are between $14,000-69,000 per QALY compared with no intervention. Annual direct medical costs per adult obese woman can exceed $1,000 and increasing quality of life with obesity reduction can be substantial. Our study results will be conservative as they only include the direct effects on recruits and do not capture secondary effects on the children or partners of participants. Our study will extend the literature, demonstrating that wellness coaching interventions conducted through engaged community partnerships may be a critical component to enhancing healthful lifestyles with resulting reductions in net societal cost.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs

Learning Objectives:
List what constitutes indirect and direct costs of obesity. Identify what is meant by quality-adjusted life years. Assess economic benefits associated with a community-based intervention program.

Keyword(s): Obesity, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved with the UWAGs project for a year and a half conducting research on the economic implications of obesity. My job has been to thoroughly conduct a literature review on the costs of obesity as well as analyzing the data provided by the intervention. Another aspect of the project is to analyze the cost-benefit literature and conduct our own research on the cost-effectiveness of the UWAGs intervention project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.