The cost-effectiveness of alternative methods of nutrition education for hypercholesterolemic children

Objectives. This study compared the cost-effectiveness, from the family's perspective, of a parent-child auto-tutorial nutrition education program with that of counseling by a dietitian after identification of hypercholesterolemic children in pediatric offices. Methods. Personnel, parent time, equipment, and laboratory costs associated with the interventions were analyzed. Reductions in dietary fat as a percentage of total calories were analyzed by means of 24-hour dietary recalls and in plasma low-density lipoprotein cholesterol at 3 and 12 months postintervention. Results. Average costs totaled $208.08 for the parent- child auto-tutorial program and $213.28 for counseling. While the parent- child program was somewhat less cost-effective in terms of dietary change, it was more cost-effective in terms of lipid reduction at 3 months, although this advantage disappeared by 12 months. Conclusions. Modest reductions in fat in the diet and in plasma lipid levels were achieved at costs that also appear modest in comparison with treatment of elevated cholesterol in adulthood. Follow-up interventions may be needed to sustain effects, while longitudinal studies are needed to assess the long-term cost benefit.