Economic Evaluation of a Worksite Weight Management Program: FUEL Your Life

Introduction:  The Diabetes Prevention Program (DPP) has been demonstrated to be effective as a weight management program that reduces diabetes by reducing the prevalence of obesity. FUEL Your Life (FYL) is an adaptation of DPP from a clinical to a workplace setting. The workplace serves as an ideal setting for the delivery of DPP, as the population is stable, workers interact with each other, and both employers and employees share the burden of illness. Using data from three sites with varying levels of intervention intensity, we present a detailed analysis of the program’s costs in a workplace setting.

 Methods: Data were gathered from three intervention sites that were distinguished by intervention intensity: 1) Self-study intervention (comparison group); 2) Group intervention; and 3) Telephone intervention. In the Self-study modality, participants were given a manual containing the educational and behavior change content of DPP adapted for a worksite setting, while the Group and Telephone modalities received the manual as well as regular contact with a health coach. Analyses were conducted from both the provider perspective and the societal perspective. Programmatic effects and costs were prospectively assessed for N=660 (n=242 Self-study; n=236 Group; n=182 Telephone) participants in the FYL program from January 2013 to April 2015. Personnel and participant time costs were reported through online scheduling software and with time diaries, while all other costs were gathered from the program provider and allocated appropriately across modality. We conducted a sensitivity analysis for all assumptions in the model.

 Results: From the provider/societal perspectives, fewer resources were required for the Self-study intervention ($76/$106 per participant) than for the Group ($162/$336 per participant) and Telephone ($357/$429 per participant) models. Both the Telephone and Group arms demonstrated a marked increase in personnel, overhead, and participant time costs. The personnel time required for the Telephone arm was especially high due to the individual attention and the extra time involved in following-up with participants who were not available at the scheduled call time. The primary health outcome of interest was Body Mass Index (BMI). Preliminary results show reductions in BMI relative to intervention intensity.

 Conclusions: Although costs were higher in the group and phone coaching conditions, the additive effect of the coaching strategies on the outcome suggests that they are cost effective relative to the comparison group. These findings can inform potential program providers with the necessary economic information to implement an obesity prevention intervention in the workplace.