Skip to main content
Top
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Study protocol

Effectiveness and cost-effectiveness of 'BeweegKuur', a combined lifestyle intervention in the Netherlands: Rationale, design and methods of a randomized controlled trial

Authors: Brenda AJ Berendsen, Marike RC Hendriks, Evert ALM Verhagen, Nicolaas C Schaper, Stef PJ Kremers, Hans HCM Savelberg

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Improving the lifestyle of overweight and obese adults is of increasing interest in view of its role in several chronic diseases. Interventions aiming at overweight or weight-related chronic diseases suffer from high drop-out rates. It has been suggested that Motivational Interviewing and more frequent and more patient-specific coaching could decrease the drop-out rate. 'BeweegKuur' is a multidisciplinary lifestyle intervention which offers three programmes for overweight persons. The effectiveness and the cost-effectiveness of intensively guided programmes, such as the 'supervised exercise programme' of 'BeweegKuur', for patients with high weight-related health risk, remain to be assessed. Our randomized controlled trial compares the expenses and effects of the 'supervised exercise programme' with those of the less intensively supervised 'start-up exercise programme'.

Methods/Design

The one-year intervention period involves coaching by a lifestyle advisor, a physiotherapist and a dietician, coordinated by general practitioners (GPs). The participating GP practices have been allocated to the interventions, which differ only in terms of the amount of coaching offered by the physiotherapist. Whereas the 'start-up exercise programme' includes several consultations with physiotherapists to identify barriers hampering independent exercising, the 'supervised exercise programme' includes more sessions with a physiotherapist, involving exercise under supervision. The main goal is transfer to local exercise facilities. The main outcome of the study will be the participants' physical activity at the end of the one-year intervention period and after one year of follow-up. Secondary outcomes are dietary habits, health risk, physical fitness and functional capacity. The economic evaluation will consist of a cost-effectiveness analysis and a cost-utility analysis. The primary outcome measures for the economic evaluation will be the physical activity and the number of quality-adjusted life years. Costs will be assessed from a societal perspective with a time horizon of two years. Additionally, a process evaluation will be used to evaluate the performance of the intervention and the participants' evaluation of the intervention.

Discussion

This study is expected to provide information regarding the additional costs and effects of the 'supervised exercise programme' in adults with very high weight-related health risk.

Trial registration number

Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894: i-xii. 1-253 World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894: i-xii. 1-253
2.
go back to reference Blissmer B, Riebe D, Dye G, Ruggiero L, Greene G, Caldwell M: Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects. Health Qual Life Outcomes. 2006, 4: 43-10.1186/1477-7525-4-43.CrossRefPubMedPubMedCentral Blissmer B, Riebe D, Dye G, Ruggiero L, Greene G, Caldwell M: Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects. Health Qual Life Outcomes. 2006, 4: 43-10.1186/1477-7525-4-43.CrossRefPubMedPubMedCentral
4.
go back to reference Polder JJ, Takken J, Meerding WJ, Kommer GJ, Stokx LJ: Kosten van ziekten in Nederland: De zorgeuro ontrafeld [Costs of diseases in the Netherlands]. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). 2000 Polder JJ, Takken J, Meerding WJ, Kommer GJ, Stokx LJ: Kosten van ziekten in Nederland: De zorgeuro ontrafeld [Costs of diseases in the Netherlands]. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). 2000
5.
go back to reference Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D: Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. 2010, 376: 1775-1784. 10.1016/S0140-6736(10)61514-0.CrossRefPubMed Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D: Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. 2010, 376: 1775-1784. 10.1016/S0140-6736(10)61514-0.CrossRefPubMed
6.
go back to reference Jakicic JM: The effect of physical activity on body weight. Obesity (Silver Spring). 2009, 17 (Suppl 3): S34-38.CrossRef Jakicic JM: The effect of physical activity on body weight. Obesity (Silver Spring). 2009, 17 (Suppl 3): S34-38.CrossRef
7.
go back to reference Sullivan PW, Morrato EH, Ghushchyan V, Wyatt HR, Hill JO: Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000-2002. Diabetes Care. 2005, 28: 1599-1603. 10.2337/diacare.28.7.1599.CrossRefPubMed Sullivan PW, Morrato EH, Ghushchyan V, Wyatt HR, Hill JO: Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000-2002. Diabetes Care. 2005, 28: 1599-1603. 10.2337/diacare.28.7.1599.CrossRefPubMed
8.
go back to reference Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346: 393-403.CrossRefPubMed Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346: 393-403.CrossRefPubMed
9.
go back to reference Hardcastle S, Taylor A, Bailey M, Castle R: A randomised controlled trial on the effectiveness of a primary health care based counselling intervention on physical activity, diet and CHD risk factors. Patient Educ Couns. 2008, 70: 31-39. 10.1016/j.pec.2007.09.014.CrossRefPubMed Hardcastle S, Taylor A, Bailey M, Castle R: A randomised controlled trial on the effectiveness of a primary health care based counselling intervention on physical activity, diet and CHD risk factors. Patient Educ Couns. 2008, 70: 31-39. 10.1016/j.pec.2007.09.014.CrossRefPubMed
10.
go back to reference Mensink M, Blaak EE, Corpeleijn E, Saris WH, de Bruin TW, Feskens EJ: Lifestyle intervention according to general recommendations improves glucose tolerance. Obes Res. 2003, 11: 1588-1596. 10.1038/oby.2003.211.CrossRefPubMed Mensink M, Blaak EE, Corpeleijn E, Saris WH, de Bruin TW, Feskens EJ: Lifestyle intervention according to general recommendations improves glucose tolerance. Obes Res. 2003, 11: 1588-1596. 10.1038/oby.2003.211.CrossRefPubMed
11.
go back to reference Mensink M, Feskens EJ, Saris WH, De Bruin TW, Blaak EE: Study on Lifestyle Intervention and Impaired Glucose Tolerance Maastricht (SLIM): preliminary results after one year. Int J Obes Relat Metab Disord. 2003, 27: 377-384. 10.1038/sj.ijo.0802249.CrossRefPubMed Mensink M, Feskens EJ, Saris WH, De Bruin TW, Blaak EE: Study on Lifestyle Intervention and Impaired Glucose Tolerance Maastricht (SLIM): preliminary results after one year. Int J Obes Relat Metab Disord. 2003, 27: 377-384. 10.1038/sj.ijo.0802249.CrossRefPubMed
12.
go back to reference Goodpaster BH, Delany JP, Otto AD, Kuller L, Vockley J, South-Paul JE, Thomas SB, Brown J, McTigue K, Hames KC, Lang W, Jakicic JM: Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. 2010, 304: 1795-1802. 10.1001/jama.2010.1505.CrossRefPubMedPubMedCentral Goodpaster BH, Delany JP, Otto AD, Kuller L, Vockley J, South-Paul JE, Thomas SB, Brown J, McTigue K, Hames KC, Lang W, Jakicic JM: Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. 2010, 304: 1795-1802. 10.1001/jama.2010.1505.CrossRefPubMedPubMedCentral
13.
go back to reference Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344: 1343-1350. 10.1056/NEJM200105033441801.CrossRefPubMed Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344: 1343-1350. 10.1056/NEJM200105033441801.CrossRefPubMed
14.
go back to reference Praet SF, van Rooij ES, Wijtvliet A, Boonman-de Winter LJ, Enneking T, Kuipers H, Stehouwer CD, van Loon LJ: Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008, 51: 736-746. 10.1007/s00125-008-0950-y.CrossRefPubMedPubMedCentral Praet SF, van Rooij ES, Wijtvliet A, Boonman-de Winter LJ, Enneking T, Kuipers H, Stehouwer CD, van Loon LJ: Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008, 51: 736-746. 10.1007/s00125-008-0950-y.CrossRefPubMedPubMedCentral
15.
go back to reference Wing RR: Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010, 170: 1566-1575.PubMed Wing RR: Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010, 170: 1566-1575.PubMed
16.
go back to reference Van Sluijs EM, Van Poppel MN, Twisk JW, Brug J, Van Mechelen W: The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention. Health Educ Res. 2005, 20: 345-356. 10.1093/her/cyg129.CrossRefPubMed Van Sluijs EM, Van Poppel MN, Twisk JW, Brug J, Van Mechelen W: The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention. Health Educ Res. 2005, 20: 345-356. 10.1093/her/cyg129.CrossRefPubMed
17.
go back to reference Bemelmans WJE, Wendel-Vos W, Bogers RP, Milder IE, de Hollander EL, Barte JCM, Tariq L, Jacobs-van der Bruggen MAM: (Kosten)effectiviteit beweeg- en dieetadvisering bij mensen met (hoog risico op) diabetes mellitus type 2: Literatuuronderzoek en modelsimulaties rondom de Beweegkuur [(Cost effectiveness of exercise and healthy diet counseling among people with increased risk of type II diabetes mellitus: Literature research and model simulations concerning 'de Beweegkuur']. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). 2008 Bemelmans WJE, Wendel-Vos W, Bogers RP, Milder IE, de Hollander EL, Barte JCM, Tariq L, Jacobs-van der Bruggen MAM: (Kosten)effectiviteit beweeg- en dieetadvisering bij mensen met (hoog risico op) diabetes mellitus type 2: Literatuuronderzoek en modelsimulaties rondom de Beweegkuur [(Cost effectiveness of exercise and healthy diet counseling among people with increased risk of type II diabetes mellitus: Literature research and model simulations concerning 'de Beweegkuur']. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). 2008
18.
go back to reference De Weerdt I, Broeders I, Schaars D: Prototype De BeweegKuur. Het beste recept voor uw gezondheid. Een interventie voor de (eerstelijns) zorg om mensen met (een hoog risico op) diabetes mellitus type 2 te begeleiden naar een actievere leefstijl. NISB. 2008 De Weerdt I, Broeders I, Schaars D: Prototype De BeweegKuur. Het beste recept voor uw gezondheid. Een interventie voor de (eerstelijns) zorg om mensen met (een hoog risico op) diabetes mellitus type 2 te begeleiden naar een actievere leefstijl. NISB. 2008
19.
go back to reference Helmink JH, Meis JJ, de Weerdt I, Visser FN, de Vries NK, Kremers SP: Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme. Int J Behav Nutr Phys Act. 2010, 7: 49-10.1186/1479-5868-7-49.CrossRefPubMedPubMedCentral Helmink JH, Meis JJ, de Weerdt I, Visser FN, de Vries NK, Kremers SP: Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme. Int J Behav Nutr Phys Act. 2010, 7: 49-10.1186/1479-5868-7-49.CrossRefPubMedPubMedCentral
21.
go back to reference Miller WR, Rollnick S: Motivational Interviewing: Preparing people to change addictive behaviour. 1991, New York: Guilford Press Miller WR, Rollnick S: Motivational Interviewing: Preparing people to change addictive behaviour. 1991, New York: Guilford Press
22.
go back to reference Visser F, Hiddink G, Koelen M, van Binsbergen J, Tobi H, van Woerkum C: Longitudinal changes in GPs' task perceptions, self-efficacy, barriers and practices of nutrition education and treatment of overweight. Fam Pract. 2008, 25 (Suppl 1): i105-111.CrossRefPubMed Visser F, Hiddink G, Koelen M, van Binsbergen J, Tobi H, van Woerkum C: Longitudinal changes in GPs' task perceptions, self-efficacy, barriers and practices of nutrition education and treatment of overweight. Fam Pract. 2008, 25 (Suppl 1): i105-111.CrossRefPubMed
23.
go back to reference Helmink JH, Kremers SP, van Boekel LC, van Brussel-Visser FN, de Vries NK: Factors determining the motivation of primary health care professionals to implement and continue the 'Beweegkuur' lifestyle intervention programme. J Eval Clin Pract. 2011 Helmink JH, Kremers SP, van Boekel LC, van Brussel-Visser FN, de Vries NK: Factors determining the motivation of primary health care professionals to implement and continue the 'Beweegkuur' lifestyle intervention programme. J Eval Clin Pract. 2011
24.
go back to reference Helmink JHM, Kremers SPJ, Van Boekel LC, Van Brussel-Visser FN, Preller L, De Vries NK: The BeweegKuur programme: a qualitative study of promoting and impeding factors for successful implementation of a primary health care lifestyle intervention for overweight and obese people. Family Practice. Helmink JHM, Kremers SPJ, Van Boekel LC, Van Brussel-Visser FN, Preller L, De Vries NK: The BeweegKuur programme: a qualitative study of promoting and impeding factors for successful implementation of a primary health care lifestyle intervention for overweight and obese people. Family Practice.
25.
go back to reference Health Council of the Netherlands: Guidelines for a healthy diet 2006. The Hague: Health Council of the Netherlands. 2006 Health Council of the Netherlands: Guidelines for a healthy diet 2006. The Hague: Health Council of the Netherlands. 2006
26.
go back to reference Nederlandse Diabetes Federatie: NDF Voedingsrichtlijn voor diabetes [NDF Food guidelines for diabetes]. 2006 Nederlandse Diabetes Federatie: NDF Voedingsrichtlijn voor diabetes [NDF Food guidelines for diabetes]. 2006
27.
go back to reference Kwaliteitsinstituut voor de Gezondheidszorg CBO: Richtlijn: Diagnostiek en behandeling van obesitas bij volwassenen en kinderen [Guidelines: Diagnosis and treatment of obesity in adults and children]. 2008 Kwaliteitsinstituut voor de Gezondheidszorg CBO: Richtlijn: Diagnostiek en behandeling van obesitas bij volwassenen en kinderen [Guidelines: Diagnosis and treatment of obesity in adults and children]. 2008
28.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed
29.
go back to reference Annegarn J: Objective physical activity assessment in patients with chronic organ failure: a validation study of a new single-unit activity monitor. Archives of Physical Medicine and Rehabilitation. 2011 Annegarn J: Objective physical activity assessment in patients with chronic organ failure: a validation study of a new single-unit activity monitor. Archives of Physical Medicine and Rehabilitation. 2011
30.
go back to reference van Assema P, Brug J, Ronda G, Steenhuis I: The relative validity of a short Dutch questionnaire as a means to categorize adults and adolescents to total and saturated fat intake. J Hum Nutr Diet. 2001, 14: 377-390. 10.1046/j.1365-277X.2001.00310.x.CrossRefPubMed van Assema P, Brug J, Ronda G, Steenhuis I: The relative validity of a short Dutch questionnaire as a means to categorize adults and adolescents to total and saturated fat intake. J Hum Nutr Diet. 2001, 14: 377-390. 10.1046/j.1365-277X.2001.00310.x.CrossRefPubMed
31.
go back to reference van Sloten TT, Savelberg HH, Duimel-Peeters IG, Meijer K, Henry RM, Stehouwer CD, Schaper NC: Peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations. Diabetes Res Clin Pract. 2011, 91: 32-39. 10.1016/j.diabres.2010.09.030.CrossRefPubMed van Sloten TT, Savelberg HH, Duimel-Peeters IG, Meijer K, Henry RM, Stehouwer CD, Schaper NC: Peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations. Diabetes Res Clin Pract. 2011, 91: 32-39. 10.1016/j.diabres.2010.09.030.CrossRefPubMed
32.
go back to reference Valk GD, Nauta JJ, Strijers RL, Bertelsmann FW: Clinical examination versus neurophysiological examination in the diagnosis of diabetic polyneuropathy. Diabet Med. 1992, 9: 716-721. 10.1111/j.1464-5491.1992.tb01879.x.CrossRefPubMed Valk GD, Nauta JJ, Strijers RL, Bertelsmann FW: Clinical examination versus neurophysiological examination in the diagnosis of diabetic polyneuropathy. Diabet Med. 1992, 9: 716-721. 10.1111/j.1464-5491.1992.tb01879.x.CrossRefPubMed
33.
go back to reference Gale CR, Martyn CN, Cooper C, Sayer AA: Grip strength, body composition, and mortality. Int J Epidemiol. 2007, 36: 228-235.CrossRefPubMed Gale CR, Martyn CN, Cooper C, Sayer AA: Grip strength, body composition, and mortality. Int J Epidemiol. 2007, 36: 228-235.CrossRefPubMed
34.
go back to reference Sayer AA, Syddall HE, Dennison EM, Martin HJ, Phillips DI, Cooper C, Byrne CD: Grip strength and the metabolic syndrome: findings from the Hertfordshire Cohort Study. QJM. 2007, 100: 707-713. 10.1093/qjmed/hcm095.CrossRefPubMedPubMedCentral Sayer AA, Syddall HE, Dennison EM, Martin HJ, Phillips DI, Cooper C, Byrne CD: Grip strength and the metabolic syndrome: findings from the Hertfordshire Cohort Study. QJM. 2007, 100: 707-713. 10.1093/qjmed/hcm095.CrossRefPubMedPubMedCentral
35.
go back to reference Podsiadlo D, Richardson S: The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39: 142-148.CrossRefPubMed Podsiadlo D, Richardson S: The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991, 39: 142-148.CrossRefPubMed
36.
go back to reference Astrand PO, Ryhming I: A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol. 1954, 7: 218-221.PubMed Astrand PO, Ryhming I: A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol. 1954, 7: 218-221.PubMed
37.
go back to reference Cink RE, Thomas TR: Validity of the Astrand-Ryhming nomogram for predicting maximal oxygen intake. Br J Sports Med. 1981, 15: 182-185. 10.1136/bjsm.15.3.182.CrossRefPubMedPubMedCentral Cink RE, Thomas TR: Validity of the Astrand-Ryhming nomogram for predicting maximal oxygen intake. Br J Sports Med. 1981, 15: 182-185. 10.1136/bjsm.15.3.182.CrossRefPubMedPubMedCentral
38.
go back to reference Astrand I: Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl. 1960, 49: 1-92.PubMed Astrand I: Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl. 1960, 49: 1-92.PubMed
39.
go back to reference Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982, 14: 377-381.PubMed Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982, 14: 377-381.PubMed
40.
go back to reference Brooks R: EuroQol: the current state of play. Health Policy. 1996, 37: 53-72. 10.1016/0168-8510(96)00822-6.CrossRefPubMed Brooks R: EuroQol: the current state of play. Health Policy. 1996, 37: 53-72. 10.1016/0168-8510(96)00822-6.CrossRefPubMed
41.
go back to reference Dolan P: Modeling valuations for EuroQol health states. Med Care. 1997, 35: 1095-1108. 10.1097/00005650-199711000-00002.CrossRefPubMed Dolan P: Modeling valuations for EuroQol health states. Med Care. 1997, 35: 1095-1108. 10.1097/00005650-199711000-00002.CrossRefPubMed
42.
go back to reference Lamers LM, Stalmeier PFM, McDonnell J, Krabbe PFM, van Busschbach JJ: Kwaliteit van leven meten in economische evaluaties: het Nederlands EQ-5D-tarief. Ned Tijdschr Geneeskd. 2005, 149: 1574-1578.PubMed Lamers LM, Stalmeier PFM, McDonnell J, Krabbe PFM, van Busschbach JJ: Kwaliteit van leven meten in economische evaluaties: het Nederlands EQ-5D-tarief. Ned Tijdschr Geneeskd. 2005, 149: 1574-1578.PubMed
43.
go back to reference Oostenbrink JB, Koopmanschap MA, Rutten FF: Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics. 2002, 20: 443-454. 10.2165/00019053-200220070-00002.CrossRefPubMed Oostenbrink JB, Koopmanschap MA, Rutten FF: Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics. 2002, 20: 443-454. 10.2165/00019053-200220070-00002.CrossRefPubMed
44.
go back to reference Hakkaart-van Roijen L, Tan SS, Bouwmans CAM: Handleiding voor kostenonderzoek, methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. College voor zorgverzekeringen. 2010, Geactualiseerde versie Hakkaart-van Roijen L, Tan SS, Bouwmans CAM: Handleiding voor kostenonderzoek, methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. College voor zorgverzekeringen. 2010, Geactualiseerde versie
45.
go back to reference Saunders RP, Evans MH, Joshi P: Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. Health Promot Pract. 2005, 6: 134-147. 10.1177/1524839904273387.CrossRefPubMed Saunders RP, Evans MH, Joshi P: Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide. Health Promot Pract. 2005, 6: 134-147. 10.1177/1524839904273387.CrossRefPubMed
46.
go back to reference Sallis JF, Bowles HR, Bauman A, Ainsworth BE, Bull FC, Craig CL, Sjöström M, De Bourdeaudhuij I, Lefevre J, Matsudo V, Matsudo S, Macfarlane DJ, Gomez LF, Inoue S, Murase N, Volbekiene V, McLean G, Carr H, Heggebo LK, Tomten H, Bergman P: Neighborhood Environments and Physical Activity Among Adults in 11 Countries. American Journal of Preventive Medicine. 2009, 36: 484-490. 10.1016/j.amepre.2009.01.031.CrossRefPubMed Sallis JF, Bowles HR, Bauman A, Ainsworth BE, Bull FC, Craig CL, Sjöström M, De Bourdeaudhuij I, Lefevre J, Matsudo V, Matsudo S, Macfarlane DJ, Gomez LF, Inoue S, Murase N, Volbekiene V, McLean G, Carr H, Heggebo LK, Tomten H, Bergman P: Neighborhood Environments and Physical Activity Among Adults in 11 Countries. American Journal of Preventive Medicine. 2009, 36: 484-490. 10.1016/j.amepre.2009.01.031.CrossRefPubMed
47.
go back to reference Ekelund U, Franks PW, Sharp S, Brage S, Wareham NJ: Increase in physical activity energy expenditure is associated with reduced metabolic risk independent of change in fatness and fitness. Diabetes Care. 2007, 30: 2101-2106. 10.2337/dc07-0719.CrossRefPubMed Ekelund U, Franks PW, Sharp S, Brage S, Wareham NJ: Increase in physical activity energy expenditure is associated with reduced metabolic risk independent of change in fatness and fitness. Diabetes Care. 2007, 30: 2101-2106. 10.2337/dc07-0719.CrossRefPubMed
Metadata
Title
Effectiveness and cost-effectiveness of 'BeweegKuur', a combined lifestyle intervention in the Netherlands: Rationale, design and methods of a randomized controlled trial
Authors
Brenda AJ Berendsen
Marike RC Hendriks
Evert ALM Verhagen
Nicolaas C Schaper
Stef PJ Kremers
Hans HCM Savelberg
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-815

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue