Randomised controlled trial and economic evaluation of a task-based weight management group programme
Abstract Background Obesity is a rising global threat to health and a major contributor to health inequalities. Weight management programmes that are effective, economical and reach underprivileged groups are needed. We examined whether a multi-modal group intervention structured to cater for client...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-04-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-019-6679-3 |
| _version_ | 1817989510220218368 |
|---|---|
| author | Hayden McRobbie Peter Hajek Sarrah Peerbux Brennan C. Kahan Sandra Eldridge Dominic Trépel Steve Parrott Chris Griffiths Sarah Snuggs Katie Myers Smith |
| author_facet | Hayden McRobbie Peter Hajek Sarrah Peerbux Brennan C. Kahan Sandra Eldridge Dominic Trépel Steve Parrott Chris Griffiths Sarah Snuggs Katie Myers Smith |
| author_sort | Hayden McRobbie |
| collection | DOAJ |
| description | Abstract Background Obesity is a rising global threat to health and a major contributor to health inequalities. Weight management programmes that are effective, economical and reach underprivileged groups are needed. We examined whether a multi-modal group intervention structured to cater for clients from disadvantaged communities (Weight Action Programme; WAP) has better one-year outcomes than a primary care standard weight management intervention delivered by practice nurses (PNI). Methods In this randomised controlled trial, 330 obese adults were recruited from general practices in London and allocated (2:1) to WAP (N = 221) delivered over eight weekly group sessions or PNI (N = 109) who received four sessions over eight weeks. Both interventions covered diet, physical activity and self-monitoring. The primary outcome was the change in weight from baseline at 12 months. To indicate value to the NHS, a cost effectiveness analysis estimated group differences in cost and Quality-Adjusted Life-Years (QALYs) related to WAP. Results Participants were recruited from September 2012 to January 2014 with follow-up completed in February 2015. Most participants were not in paid employment and 60% were from ethnic minorities. 88% of participants in each study arm provided at least one recorded outcome and were included in the primary analysis. Compared with the PNI, WAP was associated with greater weight loss overall (− 4·2 kg vs. − 2·3 kg; difference = − 1·9 kg, 95% CI: -3·7 to − 0·1; P = 0·04) and was more likely to generate a weight loss of at least 5% at 12 months (41% vs. 27%, OR = 14·61 95% CI: 2·32 to 91·96, P = 0·004). With an incremental cost-effectiveness ratio (ICER) of £7742/QALY, WAP would be considered highly cost effective compared to PNI. Conclusions The task-based programme evaluated in this study can provide a template for an effective and economical approach to weight management that can reach clients from disadvantaged communities. Trial registration ISRCTN ISRCTN45820471. Registered 12/10/2012 (retrospectively registered). |
| first_indexed | 2024-04-14T00:47:51Z |
| format | Article |
| id | doaj.art-5f506c8ac2d147f2a12ec2f8fd088f10 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-14T00:47:51Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-5f506c8ac2d147f2a12ec2f8fd088f102022-12-22T02:21:55ZengBMCBMC Public Health1471-24582019-04-0119111010.1186/s12889-019-6679-3Randomised controlled trial and economic evaluation of a task-based weight management group programmeHayden McRobbie0Peter Hajek1Sarrah Peerbux2Brennan C. Kahan3Sandra Eldridge4Dominic Trépel5Steve Parrott6Chris Griffiths7Sarah Snuggs8Katie Myers Smith9Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research UnitHealth and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research UnitHealth and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research UnitPragmatic Clinical Trials Unit, Queen Mary University of London, Barts and The London School of Medicine and DentistryPragmatic Clinical Trials Unit, Queen Mary University of London, Barts and The London School of Medicine and DentistryDepartment of Health Sciences, The University of YorkDepartment of Health Sciences, The University of YorkCentre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and DentistryHealth and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research UnitHealth and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research UnitAbstract Background Obesity is a rising global threat to health and a major contributor to health inequalities. Weight management programmes that are effective, economical and reach underprivileged groups are needed. We examined whether a multi-modal group intervention structured to cater for clients from disadvantaged communities (Weight Action Programme; WAP) has better one-year outcomes than a primary care standard weight management intervention delivered by practice nurses (PNI). Methods In this randomised controlled trial, 330 obese adults were recruited from general practices in London and allocated (2:1) to WAP (N = 221) delivered over eight weekly group sessions or PNI (N = 109) who received four sessions over eight weeks. Both interventions covered diet, physical activity and self-monitoring. The primary outcome was the change in weight from baseline at 12 months. To indicate value to the NHS, a cost effectiveness analysis estimated group differences in cost and Quality-Adjusted Life-Years (QALYs) related to WAP. Results Participants were recruited from September 2012 to January 2014 with follow-up completed in February 2015. Most participants were not in paid employment and 60% were from ethnic minorities. 88% of participants in each study arm provided at least one recorded outcome and were included in the primary analysis. Compared with the PNI, WAP was associated with greater weight loss overall (− 4·2 kg vs. − 2·3 kg; difference = − 1·9 kg, 95% CI: -3·7 to − 0·1; P = 0·04) and was more likely to generate a weight loss of at least 5% at 12 months (41% vs. 27%, OR = 14·61 95% CI: 2·32 to 91·96, P = 0·004). With an incremental cost-effectiveness ratio (ICER) of £7742/QALY, WAP would be considered highly cost effective compared to PNI. Conclusions The task-based programme evaluated in this study can provide a template for an effective and economical approach to weight management that can reach clients from disadvantaged communities. Trial registration ISRCTN ISRCTN45820471. Registered 12/10/2012 (retrospectively registered).http://link.springer.com/article/10.1186/s12889-019-6679-3Weight managementObesityWeight lossCost-effectiveness |
| spellingShingle | Hayden McRobbie Peter Hajek Sarrah Peerbux Brennan C. Kahan Sandra Eldridge Dominic Trépel Steve Parrott Chris Griffiths Sarah Snuggs Katie Myers Smith Randomised controlled trial and economic evaluation of a task-based weight management group programme BMC Public Health Weight management Obesity Weight loss Cost-effectiveness |
| title | Randomised controlled trial and economic evaluation of a task-based weight management group programme |
| title_full | Randomised controlled trial and economic evaluation of a task-based weight management group programme |
| title_fullStr | Randomised controlled trial and economic evaluation of a task-based weight management group programme |
| title_full_unstemmed | Randomised controlled trial and economic evaluation of a task-based weight management group programme |
| title_short | Randomised controlled trial and economic evaluation of a task-based weight management group programme |
| title_sort | randomised controlled trial and economic evaluation of a task based weight management group programme |
| topic | Weight management Obesity Weight loss Cost-effectiveness |
| url | http://link.springer.com/article/10.1186/s12889-019-6679-3 |
| work_keys_str_mv | AT haydenmcrobbie randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT peterhajek randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT sarrahpeerbux randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT brennanckahan randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT sandraeldridge randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT dominictrepel randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT steveparrott randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT chrisgriffiths randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT sarahsnuggs randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme AT katiemyerssmith randomisedcontrolledtrialandeconomicevaluationofataskbasedweightmanagementgroupprogramme |