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Drouin O, Sharifi M, Gerber M, Horan C, Orav EJ, Marshall R, Taveras EM. Parents' Willingness to Pay for Pediatric Weight Management Programs. Acad Pediatr 2019; 19:764-772. [PMID: 31128381 PMCID: PMC6731996 DOI: 10.1016/j.acap.2019.05.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/19/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine parents' interest in continuing and willingness to pay (WTP) for 2 pediatric weight management programs following their participation. METHODS Participants were parents of 2- to 12-year-old children with body mass index ≥ 85th percentile who participated in the Connect for Health trial. One group received enhanced primary care (EPC) and the other received EPC plus individualized coaching (EPC+C). At 1 year, we assessed parents' self-reported WTP for a similar program and the maximum amount ($/month) they would pay. We used multivariable regression to examine differences in WTP and WTP amount by intervention arm and by individual and family-level factors. RESULTS Of 638 parents who completed the survey, 85% were interested in continuing and 38% of those parents were willing to pay (31% in the EPC group and 45% in the EPC+C group). The median amount parents were willing to pay was $25/month (interquartile range, $15-$50). In multivariable models, the EPC+C parents were more likely to endorse WTP than the EPC parents (odds ratio, 1.53; 95% confidence interval, 1.05-2.22). Parents of children with Hispanic/Latino versus white ethnicity and those reporting higher satisfaction with the program were also more likely to endorse WTP. CONCLUSIONS Most parents of children in a weight management program were interested in continuing it after it ended, but fewer were willing to pay out of pocket for it. A greater proportion of parents were willing to pay if the program included individualized health coaching.
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Affiliation(s)
- Olivier Drouin
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Harvard-wide Pediatric Health Services Research Fellowship, Boston, MA, USA,Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Monica Gerber
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Christine Horan
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - E. John Orav
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Richard Marshall
- Department of Pediatrics, Harvard Vanguard Medical Associates, Boston, MA, USA
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Harvard-wide Pediatric Health Services Research Fellowship, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health; Boston, MA, USA
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Alva ML, Samuel-Hodge CD, Porterfield D, Thomas T, Leeman J. A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina. Prev Chronic Dis 2017; 14:E51. [PMID: 28662760 PMCID: PMC5494814 DOI: 10.5888/pcd14.160604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Diabetes Prevention Programs (DPPs) have shown that healthy eating and moderate physical activity are effective ways of delaying and preventing type 2 diabetes in people with impaired glucose tolerance. We assessed willingness to pay for DPPs from the perspective of potential recipients and the cost of providing these programs from the perspective of community health centers and local health departments in North Carolina. Methods We used contingent valuation to determine how much potential recipients would be willing to pay to participate in DPPs under 3 different models: delivered by registered professionals (traditional model), by community health workers, or online. By using information on the minimum reimbursement rate at which public health agencies would be prepared to provide the 3 models, we estimated the marginal costs per person of supplying the programs. Matching supply and demand, we estimated the degree of cost sharing between recipients and providers. Results Potential program recipients (n = 99) were willing to pay more for programs led by registered professionals than by community health workers, and they preferred face-to-face contact to an online format. Socioeconomic status (measured by education and employment) and age played the biggest roles in determining willingness to pay. Leaders of public health agencies (n = 27) reported up to a 40% difference in the cost of providing the DPP, depending on the delivery model. Conclusion By using willingness to pay to understand demand for DPPs and computing the provider’s marginal cost of providing these services, we can estimate cost sharing and market coverage of these services and thus compare the viability of alternate approaches to scaling up and sustaining DPPs with available resources.
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Affiliation(s)
- Maria L Alva
- Public Health Economics Program, RTI International, 701 13th St NW No. 750, Washington, DC 20005.
| | - Carmen D Samuel-Hodge
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Deborah Porterfield
- RTI International, Washington, DC.,University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina
| | - Tainayah Thomas
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Jennifer Leeman
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina
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Castelnuovo G, Pietrabissa G, Manzoni GM, Corti S, Ceccarini M, Borrello M, Giusti EM, Novelli M, Cattivelli R, Middleton NA, Simpson SG, Molinari E. Chronic care management of globesity: promoting healthier lifestyles in traditional and mHealth based settings. Front Psychol 2015; 6:1557. [PMID: 26528215 PMCID: PMC4606044 DOI: 10.3389/fpsyg.2015.01557] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 09/25/2015] [Indexed: 11/29/2022] Open
Abstract
Obesity and being overweight could be real chronic conditions above all if there are other complications such as type 2 diabetes, cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. Due to the multifactorial etiology of obesity, evidence-based interventions to improve weight loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. There are significant limitations in this multidisciplinary chronic care management of obesity, most notably those regarding costs and long-term adherence and efficacy. Programs including eHealth platforms and new technologies could overcome limitations connected to the traditional in-patient chronic care management of obesity, thus providing promising opportunities in enhancing weight reduction and reducing complications in terms of long-term efficacy and effectiveness across clinical, organizational, and economic perspectives.
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Affiliation(s)
- Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Department of Psychology, Catholic University of Milan , Milan, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Department of Psychology, Catholic University of Milan , Milan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Faculty of Psychology, eCampus University , Milan, Italy
| | - Stefania Corti
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Department of Psychology, University of Bergamo , Bergamo, Italy
| | - Martina Ceccarini
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Department of Psychology, University of Bergamo , Bergamo, Italy
| | - Maria Borrello
- Department of Psychology, University of Bergamo , Bergamo, Italy
| | - Emanuele M Giusti
- Department of Psychology, Catholic University of Milan , Milan, Italy
| | - Margherita Novelli
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy
| | - Nicole A Middleton
- School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide, SA, Australia
| | - Susan G Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide, SA, Australia
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituti di Ricovero e Cura a Carattere Scientifico , Ospedale San Giuseppe, Verbania, Italy ; Department of Psychology, Catholic University of Milan , Milan, Italy
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