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College of Health and Human Development, Pennsylvania State University, University Park 16802, USA.
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.
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