Background
Methods
Design
Participants and procedures
The Chronic Disease Model
Tailored intervention
Study outcomes
Physical activity
Model outcomes
Data analyses
Scenarios applied to the Chronic Disease Model
Baseline differences
Intervention effects on physical activity
Intervention costs
Fixed costs (€) | Variable costs per participant (€) | |
---|---|---|
Printed basic | 3300 | 18 |
Printed environment | 4270 | 21 |
Web-based basic | 3420 | 8 |
Web-based environment | 4880 | 8 |
Control group | – | – |
Calculation of cost-effectiveness
Uncertainty analyses
Results
Baseline characteristics
Control group (n = 411) | Printed basic (n = 439) | Printed environ. (n = 435) | Web-based basic (n = 423) | Web-based environ. (n = 432) |
P
| |
---|---|---|---|---|---|---|
Mean age (years) (±SD) | 64.2 (±9.5) | 63.1 (±8.7) | 64.0 (±9.4) | 61.8 (±7.1) | 60.8 (±7.5) |
.00
|
Gender (% men) | 49.9 | 45.9 | 45.3 | 52.3 | 51.3 | .22 |
Education (% low) | 50.3 | 43.5 | 47.3 | 46.1 | 47.8 | .40 |
Paid job (%) | 42.8 | 40.1 | 43.9 | 36.8 | 40.2 | .27 |
MET-hours PA/week (±SD) | 45.4 (±40.0) | 41.6 (±37.7) | 41.5 (±32.1) | 42.9 (±38.9) | 43.0 (±40.7) | .58 |
Intervention effects on physical activity
Baseline | 12 months(complete cases) | 12 months(imputed) | ∆ MET-hours | |||||
---|---|---|---|---|---|---|---|---|
N
| MET-hours[95% CI] |
N
| MET-hours[95% CI] |
N
| MET-hours[95% CI] | MET-hours[95% CI] |
P-value | |
Printed basic | 429 | 41.60[38.02-45.18] | 273 | 47.97[43.74-52.29] | 427 | 44.87[41.08-48.66] | 3.06[0.38-5.75] |
.025
|
Printed environment | 419 | 41.45[38.37-44.45] | 252 | 50.00[44.91-55.10] | 417 | 44.58[40.87-48.30] | 2.94[0.26-5.62] |
.031
|
Web-based basic | 421 | 42.89[39.16-46.61] | 214 | 48.57[42.96-54.19] | 418 | 43.71[39.77-47.65] | 0.73[-1.94-3.41] | .591 |
Web-based environment | 425 | 42.95[39.07-46.84] | 193 | 43.16[37.45-48.43] | 425 | 42.74[39.07-46.40] | -0.22[-3.19-2.76] | .887 |
Control group | 402 | 45.39[41.47-49.30] | 303 | 43.49[39.54-47.44] | 397 | 42.85[39.14-46.55] | -2.20[-5.10-.71] | .139 |
Long-term health benefits
Printed intervention vs. control | Web-based intervention vs. control | Environmental vs. basic | |||||||
---|---|---|---|---|---|---|---|---|---|
5 year | 10 year | Life time | 5 year | 10 year | Life time | 5 year | 10 year | Life time | |
Diabetes | -3.1% | -2.8% | -2.0% | -1.3% | -1.0% | -0.6% | 1.2% | 1.1% | 0.8% |
Colon cancer | -2.1% | -2.0% | -1.3% | -1.0% | -0.9% | -0.4% | 0.8% | 0.8% | 0.5% |
Breast cancer | -0.6% | -0.6% | -0.3% | -0.3% | -0.2% | -0.1% | -0.3% | -0.3% | -0.2% |
AMI | -2.3% | -2.2% | -1.4% | -1.1% | -1.0% | -0.4% | 1.3% | 1.2% | 0.8% |
Stroke | -1.7% | -1.5% | -0.8% | -0.8% | -0.7% | -0.3% | 0.5% | 0.5% | 0.3% |
Cost-effectiveness
Time horizon | Web-based intervention | Printed intervention |
Basic intervention
|
Environmental intervention
| |
---|---|---|---|---|---|
5 years
|
Incremental effects (versus care-as-usual)
| ||||
QALYs gained | 430 | 1,040 |
−
| -330 | |
Incremental costs (versus care-as-usual)
a
| |||||
Intervention costs | 10 | 30 | 20 | 20 | |
Total costsb
| 10 | 30 |
−
| 0 | |
Incremental intervention costs per QALY gained
c
| |||||
Versus care-as-usual | 20,500 | 29,700 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 36,180 |
−
| -6,500 | |
Incremental total costs per QALY gained
c
| |||||
Versus care-as-usual | 20,760 | 27,520 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 32,290 |
−
| -8,690 | |
10 years
|
Incremental effects (versus care-as-usual)
| ||||
QALYs gained | 1,990 | 5,120 |
−
| -1,700 | |
Incremental costs (versus care-as-usual)
a
| |||||
Intervention costs | 10 | 30 | 20 | 20 | |
Total costsb
| 20 | 40 |
−
| 0 | |
Incremental intervention costs per QALY gained
c
| |||||
Versus care-as-usual | 4,410 | 6,010 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 7,020 |
−
| -1,260 | |
Incremental total costs per QALY gained
c
| |||||
Versus care-as-usual | 8,450 | 7,590 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 7,040 |
−
| -470 | |
Lifetime
|
Incremental effects (versus care-as-usual)
| ||||
QALYs gained | 9,150 | 44,380 |
−
| -16,770 | |
Incremental costs (versus care-as-usual)
a
| |||||
Intervention costs | 10 | 30 | 20 | 20 | |
Total costsb
| 90 | 330 |
−
| -90 | |
Incremental intervention costs per QALY gained
c
| |||||
Versus care-as-usual | 960 | 690 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 620 |
−
| -130 | |
Incremental total costs per QALY gained
c
| |||||
Versus care-as-usual | 10,100 | 7,500 |
−
|
−
| |
Web-based vs. Printed/ Environment vs. Basic |
−
| 6,830 |
−
| 5,290 |
Uncertainty analyses
Analysis | Web-based intervention | Printed intervention | Environmental intervention vs. basic | |
---|---|---|---|---|
Primary
| Incremental costs per QALY gainedc,d
| |||
Versus care-as-usual | 10,100 | 7,500 |
−
| |
Web-based vs. Printed/Environment vs. Basic |
−
| 6,830 | 5,290 | |
Minimal participation
a
| Incremental costs per QALY gainedc,d
| |||
Versus care-as-usual | 20,170 | 7,480 |
−
| |
Web-based vs. Printed/Environment vs. Basic |
−
| 6,510 | 5,180 | |
Maximum participation
b
| Incremental costs per QALY gainedc,d
| |||
Versus care-as-usual | 9,190 | 7,450 |
−
| |
Web-based vs. Printed/Environment vs. Basic |
−
| 7,060 | 4,760 | |
4% discount on costs and effects
| Incremental costs per QALY gainedc,d
| |||
Versus care-as-usual | 15,360 | 12,150 |
−
| |
Web-based vs. Printed/Environment vs. Basic |
−
| 11,340 | 8,890 | |
0% discount on costs and effects
| Incremental costs per QALY gained c,d
| |||
Versus care-as-usual | 16,580 | 13,800 |
−
| |
Web-based vs. Printed/Environment vs. Basic |
−
| 13,310 | 11,100 |