Cost-effectiveness of alternative approaches for motivating activity in sedentary adults: results of Project STRIDE

Abstract

Objective: To evaluate the cost-effectiveness of non-face-to-face interventions for increasing physical activity in sedentary adults. The study took place in Providence, Rhode Island between the years 2000 and 2004.

Methods: Two hundred and thirty-nine participants were randomized to Phone, Print or a contact control. Phone and Print groups were mailed regular surveys regarding their level of physical activity, motivational readiness and self-efficacy. Surveys were scanned by a computer expert system to generate feedback reports. Phone group participants received feedback by telephone. Print group participants received feedback by mail. The contact control group received mailings unrelated to physical activity. Intervention costs were assessed prospectively, from a payer perspective. Physical activity was measured using the 7-day Physical Activity Recall. Ambulatory health service use was assessed via monthly surveys.

Results: The Print intervention was more economically efficient than the Phone intervention in engaging participants in a more active lifestyle.

Conclusion: The Print intervention provides an efficient approach to increasing physical activity. Research is needed to determine the cost-effectiveness of the intervention in a more diverse population, within the context of the health service delivery system and over a longer period of time.

Figure 1. Minutes devoted to physical activity from Physical Activity Recall (PAR) at baseline, 6 and 12 months of participants randomized to Project STRIDE, in Providence, Rhode Island, United States

Note: Common means was assumed at baseline (N=239) LCL = 95% Lower Confidence Limit UCL = 95% Upper Confidence Limit At 6 months, Telephone>Control, p<.01, Print>Control, p<.01 and Telephone = Print. At 12 months, Telephone=Control, Print>Control, p<.001, and Print>Telephone, p<.05.