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Costs of implementing a behavioral weight-loss and lifestyle-change program for individuals with serious mental illnesses in community settings

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

Little research has examined costs of adopting a successful lifestyle intervention for people with serious mental illnesses in community clinics. The study aims to calculate the real-world costs of implementing a group-based weight-loss and lifestyle intervention in community settings. We used empirically derived costs to estimate implementation costs and conducted sensitivity analyses to estimate costs: (1) when implementing the intervention in high/low resource-intensive environments and (2) assuming variability in participant enrollment. To implement the STRIDE program for 15 individuals with serious mental illnesses, we estimated costs for the 12-month (30-session) intervention, with materials available in the public domain, at $16,427 or $1095 per participant. The majority of costs, $12,767, were associated with direct labor costs. Replication costs are largely associated with labor. Community health centers offer an untapped resource for implementing behavioral-lifestyle interventions, particularly under the Affordable Care Act, though additional payment reforms or incentives may be needed.

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Acknowledgments

This research was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (Reducing Weight and Diabetes Risk in an Underserved Population) 1R18DK076775. The views expressed herein are those of the authors and do not necessarily reflect those of the National Institutes of Health or other departments of the U.S. government.

Conflict of interest

All authors declare that they have no competing interests.

Adherence to ethical principles

All procedures followed were in accordance with the ethical standards of the Kaiser Permanente Northwest Institutional Review Board for the Protection of Human Subjects and with the Helsinki Declaration of 1975, as revised in 2000. A waiver of informed consent was obtained for all data collected from the electronic medical record.

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Authors and Affiliations

  1. Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR, 97227, USA

    Scott P. Stumbo MA, Bobbi Jo H. Yarborough PsyD, Micah T. Yarborough MA, Shannon L. Janoff MPH, Victor J. Stevens PhD & Carla A. Green PhD, MPH

  2. LifeWorks Northwest, Portland, OR, USA

    Mark Lewinsohn PhD

Authors
  1. Scott P. Stumbo MA
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  2. Bobbi Jo H. Yarborough PsyD
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  3. Micah T. Yarborough MA
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  5. Victor J. Stevens PhD
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  7. Carla A. Green PhD, MPH
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Corresponding author

Correspondence to Scott P. Stumbo MA.

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Implications

Policy: Reimbursement methods and incentives are needed to encourage implementation of lifestyle interventions in community settings, particularly community mental health clinics.

Research: Cost-effectiveness analyses of STRIDE and similar interventions are needed to further inform policy and implementation.

Practice: People with serious mental illness are at high risk for obesity and obesity-related early morbidity and mortality; lifestyle interventions to help lose and maintain weight loss and improve health can be delivered in community settings at relatively low cost.

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Stumbo, S.P., Yarborough, B.J.H., Yarborough, M.T. et al. Costs of implementing a behavioral weight-loss and lifestyle-change program for individuals with serious mental illnesses in community settings. Behav. Med. Pract. Policy Res. 5, 269–276 (2015). https://doi.org/10.1007/s13142-015-0322-3

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