Evidence map›Paper›PMID 31096977›Full record

ArticleBMC health services research2019

Cost-effectiveness of a community-based cardiovascular disease prevention intervention in medically underserved rural areas.

Hua Wang, Donald Kenkel, Meredith L Graham, Lynn C Paul, Sara C Folta, Miriam E Nelson, David Strogatz, Rebecca A Seguin

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02499731 (Strong Hearts, Healthy Communities), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02499731 nacompletednot on this map

Strong Hearts, Healthy Communities: A Rural Community CVD Prevention Program

TypeinterventionalSponsorCornell UniversityRan2014 to 2020Enrolled194ConditionsHeart Disease, Cardiovascular Disease, Sedentary Lifestyle, OverweightArmsStrong Hearts, Healthy Communities, Strong Hearts, Healthy Women
3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hua WangCornell University, 292 Martha Van Rensselaer Hall, Ithaca, NY, 14853, USA. hw227@cornell.edu.
Donald KenkelCornell University, 2310 Martha Van Rensselaer Hall, Ithaca, NY, 14853, USA.
Meredith L GrahamCornell University, 414 Savage Hall, Ithaca, NY, 14853, USA.
Lynn C PaulMontana State University, 322 Reid Hall, Bozeman, MT, 59717, USA.
Sara C FoltaTufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
Miriam E NelsonHampshire College, 893 West St, Amherst, MA, 01002, USA.
David StrogatzBassett Research Institute, One Atwell Rd, Cooperstown, NY, 13326, USA.
Rebecca A SeguinCornell University, 412 Savage Hall, Ithaca, NY, 14853, USA.

Funding

Strong Hearts_Healthy Communities_A Rural Community CVD Prevention ProgramR01HL120702 · NHLBI · CORNELL UNIVERSITY · PI SEGUIN-FOWLER, REBECCA ANNE · 2014 to 2017
$1.6M
National Heart, Lung, and Blood Institute R01 HL120702)NHLBI NIH HHS R01 HL120702
6 · The paper itself

Abstract

backgroundRural women experience health disparities in terms of cardiovascular disease (CVD) risk compared to urban women. Cost-effective CVD-prevention programs are needed for this population. The objective of this study was to conduct cost analysis and cost-effectiveness analyses (CEAs) of the Strong Hearts, Healthy Communities (SHHC) program compared to a control program in terms of change in CVD risk factors, including body weight and quality-adjusted life years (QALYs).

methodsSixteen medically underserved rural towns in Montana and New York were randomly assigned to SHHC, a six-month twice-weekly experiential learning lifestyle program focused predominantly on diet and physical activity behaviors (n = 101), or a monthly healthy lifestyle education-only control program (n = 93). Females who were sedentary, overweight or obese, and aged 40 years or older were enrolled. The cost analysis calculated the total and per participant resource costs as well as participants' costs for the SHHC and control programs. In the intermediate health outcomes CEAs, the incremental costs were compared to the incremental changes in the outcomes. The QALY CEA compares the incremental costs and effectiveness of a national SHHC intervention for a hypothetical cohort of 2.2 million women compared to the status quo alternative.

resultsThe resource cost of SHHC was $775 per participant. The incremental cost-effectiveness ratios from the payer's perspective was $360 per kg of weight loss. Over a 10-year time horizon, to avert per QALY lost SHHC is estimated to cost $238,271 from the societal perspective, but only $62,646 from the healthcare sector perspective. Probabilistic sensitivity analyses show considerable uncertainty in the estimated incremental cost-effectiveness ratios.

conclusionsA national SHHC intervention is likely to be cost-effective at willingness-to-pay thresholds based on guidelines for federal regulatory impact analysis, but may not be at commonly used lower threshold values. However, it is possible that program costs in rural areas are higher than previously studied programs in more urban areas, due to a lack of staff and physical activity resources as well as  availability for partnerships with existing organizations.

trial registrationClinicalTrials.gov identifier NCT02499731 , registered on July 16, 2015.

Indexed as

Cost-Benefit AnalysisAdultAgedCardiovascular DiseasesFemaleHealth BehaviorHumansMedically Underserved AreaMiddle AgedMontanaNew YorkOverweightPreventive Health ServicesQuality-Adjusted Life YearsRisk FactorsRural Health ServicesCardiovascular disease preventionCost-effectiveness analysisEconomic evaluationQuality adjusted life yearsRuralWomen

Identifiers

PMID31096977
PMCPMC6524317

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.