Cost Effectiveness of a Cultural Physical Activity Intervention to Reduce Blood Pressure Among Native Hawaiians with Hypertension.
Journal
PharmacoEconomics - open
ISSN: 2509-4254
Titre abrégé: Pharmacoecon Open
Pays: Switzerland
ID NLM: 101700780
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
accepted:
19
07
2021
pubmed:
15
8
2021
medline:
15
8
2021
entrez:
14
8
2021
Statut:
ppublish
Résumé
The aim of this study was to calculate the costs and assess whether a culturally grounded physical activity intervention offered through community-based organizations is cost effective in reducing blood pressure among Native Hawaiian adults with hypertension. Six community-based organizations in Hawai'i completed a randomized controlled trial between 2015 and 2019. Overall, 263 Native Hawaiian adults with uncontrolled hypertension (≥ 140 mmHg systolic, ≥ 90 mmHg diastolic) were randomized to either a 12-month intervention group of hula (traditional Hawaiian dance) lessons and self-regulation classes, or to an education-only waitlist control group. The primary outcome was change in systolic blood pressure collected at baseline and 3, 6, and 12 months for the intervention compared with the control group. Incremental cost-effectiveness ratios (ICERs) were calculated for primary and secondary outcomes. Non-parametric bootstrapping and sensitivity analyses evaluated uncertainty in parameters and outcomes. The mean intervention cost was US$361/person, and the 6-month ICER was US$103/mmHg reduction in systolic blood pressure and US$95/mmHg in diastolic blood pressure. At 12 months, the intervention group maintained reductions in blood pressure, which exceeded reductions for usual care based on blood pressure outcomes. The change in blood pressure at 12 months resulted in ICERs of US$100/mmHg reduction in systolic blood pressure and US$93/mmHg in diastolic blood pressure. Sensitivity analyses suggested that at the estimated intervention cost, the probability that the program would lower systolic blood pressure by 5 mmHg was 67 and 2.5% at 6 and 12 months, respectively. The 6-month Ola Hou program may be cost effective for low-resource community-based organizations. Maintenance of blood pressure reductions at 6 and 12 months in the intervention group contributed to potential cost effectiveness. Future studies should further evaluate the cost effectiveness of indigenous physical activity programs in similar settings and by modeling lifetime costs and quality-adjusted life-years. NCT02620709.
Identifiants
pubmed: 34389923
doi: 10.1007/s41669-021-00291-6
pii: 10.1007/s41669-021-00291-6
pmc: PMC8807791
doi:
Banques de données
ClinicalTrials.gov
['NCT02620709']
Types de publication
Journal Article
Langues
eng
Pagination
85-94Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL126577
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM138062
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01HL126577
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG059295-01
Pays : United States
Informations de copyright
© 2021. The Author(s).
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