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Cost-Effectiveness Comparison of Delivery Modalities for a Dissonance-Based Eating Disorder Prevention Program over 4-Year Follow-Up

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Abstract

The cost-effectiveness of delivery methods for an eating disorder prevention program is reported. In an effectiveness trial (enrollment 2013–2015) comparing three formats (clinician-led, peer-led, and Internet-delivered) for delivering the Body Project eating disorder prevention program to college women versus an educational video control, the peer-led method was more effective than the three alternatives at preventing onset of eating disorders over 4-year follow-up. Eating disorder incidence was 19.3% for clinician-led groups, 8.1% for peer-led groups, 15.5% for Internet-based eBody Project participants, and 17.6% for educational video controls. Delivery costs per person are reported for the Body Project, including participant time, and the cost-effectiveness is calculated for peer-led groups versus the video control. Data analyses were conducted in 2019–2021. Delivery costs per person for the Body Project, including participant time, were approximately $96 for clinician-led groups, $80 for peer-led groups, and $22 for the eBody Project, compared with $9 for the educational video control. For each additional case of eating disorder onset that was prevented by the peer-led groups, compared with the video control, the cost was about $740. There were no differences in health care utilization across condition. Eating disorder prevention costs via the Body Project compare very favorably with the costs for treating an eating disorder, which previously have been estimated to range from approximately $20,300 for cognitive-behavioral therapy for bulimia nervosa to approximately $119,200 for adequate care treatment of anorexia nervosa. These analyses demonstrate the economic value of the Body Project for preventing eating disorders among college-age women when delivered in peer-facilitated groups. ClinicalTrials.gov Identifier: NCT01949649

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Acknowledgements

The authors would like to thank Julie Pope for her efforts in coordinating study data collection and for the information she provided to help with the cost inventories.

Funding

This study was supported by grant # MH097720 from the National Institute of Mental Health, which played no role in the identification, design, conduct, and reporting of the analysis.

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Authors and Affiliations

  1. Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA

    Laura Akers & Paul Rohde

  2. Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA

    Heather Shaw & Eric Stice

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  1. Laura Akers
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Contributions

Tasks completed by the authors are as follows: LA conducted the cost analysis, interpreted the findings, and lead the writing of the manuscript. PR, HS, and ES conceived and designed the study for which the cost analysis was conducted, supervised the data acquisition, and revised the manuscript for important intellectual content. All authors read and approved the final version of the submitted manuscript.

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Correspondence to Laura Akers.

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All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed written consent was obtained from all participants included in this study.

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The authors declare no competing interests.

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Akers, L., Rohde, P., Shaw, H. et al. Cost-Effectiveness Comparison of Delivery Modalities for a Dissonance-Based Eating Disorder Prevention Program over 4-Year Follow-Up. Prev Sci 22, 1086–1095 (2021). https://doi.org/10.1007/s11121-021-01264-1

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