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

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.

Keywords: Community clinics; Cost of intervention adoption; Implementation costs; Intervention implementation; Lifestyle change; Overweight and obesity; Serious mental illness.