Appendix Table 2.

Summary Evidence Table of Included Studies Providing Cost of Combined Diet and Physical Activity Promotion Programs to Reduce Type 2 Diabetes Among Persons at Increased Risk

Study, Year (Reference); Location	Population Size, n	Population Characteristics	Intervention Setting/Intervention Format	Duration	Intervention Intensity (Number of Sessions)	Method	Type of Personnel	Cost Valuation for Identifying Clients (Recruitment; Screening)	Cost Valuation for Implementing the Intervention	Total Program Costs per Person	Cost per Person per Session
DPP/DPPOS
DPP Research Group, 2012 (19); United States	3,243	Participants with IGT and fasting hyperglycemia, aged ≥25y, BMI ≥24 kg/m2, 68% women, 45% minority	Clinical trial Intensive lifestyle modification	10 y	Year 1–3: Same as DPP Year 4–10: 4 quarterly group visits, with the option of 2 additional sessions each year	Individual	Health professionals: Case managers Medical staff	–	Staff time: Questionnaire Training materials: Questionnaire Other components: Questionnaire	Year 1: $2,469 Year 2: $1,090 Year 3: $1,127 Year 4: $214 Year 5: $150 Year 6: $134 Year 7: $167 Year 8: $171 Year 9: $157 Year 10: $201 Total: $5,881	$102
Translational DPP
Kramer et al, 2009 (20); United States	42	Adults with prediabetes and/or metabolic syndrome	Community setting Modified DPP (group lifestyle balance program)	1 y	Core: 12 group sessions Maintenance: 9 group sessions Total: 21 sessions	Group	Health professionals: Trained prevention professionals	–	Staff time: Staff report Training materials: NR Other components: NR	$335	$16
Kramer et al, 2011 (21); United States	81	Adults with prediabetes and/or metabolic syndrome	Community setting Modified DPP (group lifestyle balance program)	1 y	Core: 12 group sessions Maintenance: 9 group sessions Total: 21 sessions	Group	Trained laypeople: Diabetes educators	–	Staff time: NR Training materials: NR Other components: NR	$357	$17
Krukowski et al, 2013 (22); United States	116	Older adults (aged ≥60 y) who were obese (BMI ≥30 kg/m2) and who had no significant memory problems	12-session translational DPP per reference 20	1 y	Core: 12 weekly group sessions Total: 12 sessions	Group	Trained laypeople: Trained lay health educator	Recruitment: Staff compilation Screening: -	Staff time: Staff compilation Training materials: Staff compilation Other components: Staff compilation	$191	$16
Vadheim et al, 2010(23); United States	84	Adults at high risk for both diabetes and CVD	Community setting Adapted DPP	10 mo	Core: 1 6 weekly group sessions Maintenance: 6 monthly group sessions Total: 22 sessions	Group	Mixed health professional and trained laypeople: Diabetes educator, nurse	–	Staff time: NR Training materials: NR Other components: NR	$652	$30
Smith et al, 2010 (24); United States	NR	BMI ≥25 kg/m2 and metabolic syndrome	2 urban and 2 rural medical practices in Pennsylvania Modified DPP To help patients with metabolic syndrome lose weight and improve at least 1 metabolic syndrome component	3 mo	12 group sessions Total: 12 sessions	Group	Mixed health professional and trained laypeople: Trained health professional and lay health workers	Recruitment: - Screening: NR	Staff time: NR Training materials: NR Other components: NR	$407	$34
Irvine et al, 2011 (25); United Kingdom	3,887	At-risk individuals with diabetes (aged 45–70 y)	Community setting Delivered by Diabetes Prevention Facilitators Promote a 7% weight loss within 6 mo using both diet and exercise	7 mo	Core: 4 group educational sessions in 3 mo Maintenance: 4 monthly group sessions Total: 8 sessions	Group	Mixed health professional and trained laypeople: Diabetes prevention facilitators Physicotherapist Volunteers with diabetes	Recruitment: - Screening: NR	Staff time: Questionnaire Training materials: Questionnaire Other components: Questionnaire	$443	$55
Ockene et al, 2012 (26); United States	312	Participants who were at high risk for type 2 diabetes	Community setting LLDPP between 2004 and 2007 Healthy food choices, walking 4000 steps per day	1 y	3 individual and 13 group sessions Total: 16 sessions	Mixed group and individual	Trained laypeople: Trained community health workers	–	Staff time: NR Training materials: NR Other components: NR	$839	$53
Lawlor et al, 2013 (27); United States	301	Overweight or obese participants (BMI 25–39 kg/m2) with elevated fasting blood glucose indicating prediabetes	Community setting HELP PD trial A DPP-based lifestyle weight-loss group	2 y	Core: 26 weekly group sessions and 3 individual sessions in 6 mo Maintenance: 18 monthly group sessions Total: 47 sessions	Mixed group and individual	Mixed health professional and trained laypeople: Trained community health workers and dietician	Recruitment: - Screening: NR	Staff time: Questionnaire Training materials: Questionnaire Other components: Questionnaire	Year 1:$613 Year 2: $305 Total: $918	$20
Translational non-DPP
Feldman et al, 2013 (28); Sweden	142	KMSP in primary care, diagnosed with metabolic syndrome	Primary care Promote healthy lifestyles, in particular changes in dietary and physical activity habits	1 y	Core: 26 group lifestyle counseling and support sessions twice a week for 3 mo Maintenance: 18 biweekly group counseling and support sessions for 9 mo Total: 44 sessions	Group	Health professional: Practice nurses Health coordinator	Recruitment: Program documentation Screening: -	Staff time: Program documentation Training materials: Program documentation Other components: Program documentation	$427*	$10*
Sagarra et al, 2014 (29); Spain	552	Aged 45–75 y at risk for diabetes with IGT and/or IFG	Primary care setting DE-PLAN project 6-h structured lifestyle intervention (diet and physical activity) similar to Finnish DPS using specific teaching techniques Individual or group format	4.2 y	Year 1: 4 sessions (6 h) Years 2–4: Continuous intervention through telephone calls, text message, letters, and interviews, scheduled for every 6–8 wk	Group or individual (2 groups)	Health professional: Physicians, nurses, and dieticians	Recruitment: Forms Screening: Forms	Staff time: Forms Training materials: Forms Other components: Forms	$1,133 for the whole intensive intervention group $1,077 for the group format $1,242 for the individual format	$4 for the group format* $43 for individual format*
Jacobs-van der Bruggen, 2007 (30); Netherlands	NR	Adults with moderate risks for diabetes, obese adults aged 30–70 y	Community setting Nutrition and exercise for adults with moderate risks for diabetes	3 y	Year 1: 4 individual and 1 group session; 1 individual advice by a researcher; 52 weekly fitness programs Years 2–3: 3 individual and 1 group session; 52 biweekly fitness programs Total: 114 sessions Nutrition: 9 sessions Fitness: 105 sessions	Mixed group and individual	Health professionals: Dietitian, not clear who delivered the fitness program	–	Staff time: Questionnaire Training materials: Questionnaire Other components: Questionnaire	$1,416	Regular session: $64 Fitness: $8

BMI = body mass index; CVD = cardiovascular disease; DE-PLAN = Diabetes in Europe: Prevention Using Lifestyle, Physical Activity, and Nutritional Intervention; DPP = Diabetes Prevention Program; DPPOS = Diabetes Prevention Program Outcomes Study; DPS = Diabetes Prevention Study; HELP PD = Healthy Living Partnerships to Prevent Diabetes; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; KMSP = Kalmar Metabolic Syndrome Program; LLDPP = Lawrence Latino Diabetes Prevention Project; NR = not reported.

^*Only included cost to deliver lifestyle intervention.