A factorial-design cluster randomised controlled trial investigating the cost-effectiveness of a nutrition supplement and an exercise programme on pneumonia incidence, walking capacity and body mass index in older people living in Santiago, Chile: the CENEX study protocol

Dangour, Albala Cecilia, Aedo Cristian, Elbourne Diana, Grundy Emily, Walker Damian, Uauy, Uauy Ricardo

Description

Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a nutritional supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the supplementation programme. Aim The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing nutrition supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile. Methods The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of nutrition for older people based on sound science-base and evidence for cost-effectiveness. Trial registration ISRCTN48153354

Informations

• Publié par: biomed
• Publié le: 01 janvier 2007
• Nombre de lectures: 5
• Langue: English

Extrait

Nutrition Journal

BioMedCentral

Open Access Research A factorial-design cluster randomised controlled trial investigating the cost-effectiveness of a nutrition supplement and an exercise programme on pneumonia incidence, walking capacity and body mass index in older people living in Santiago, Chile: the CENEX study protocol 1 2 34 Alan D Dangour*, Cecilia Albala, Cristian Aedo, Diana Elbourne, 5 61 Emily Grundy, Damian Walkerand Ricardo Uauy

1 Address: Nutritionand Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of 2 3 Hygiene & Tropical Medicine, London, UK,Instituto de Nutrición y Tecnología de los Alimentos, University of Chile, Santiago, Chile,INACAP, 4 Santiago, Chile,Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, 5 London, UK,Centre for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene & Tropical 6 Medicine, London, UK andDepartment of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA Email: Alan D Dangour*  [e-mail]; Cecilia Albala  [e-mail]; Cristian Aedo  [e-mail]; Diana Elbourne  [e-mail]; Emily Grundy  [e-mail]; Damian Walker  [e-mail]; Ricardo Uauy  [e-mail] * Corresponding author

Published: 5 July 2007Received: 9 March 2007 Accepted: 5 July 2007 Nutrition Journal2007,6:14 doi:10.1186/1475-2891-6-14 This article is available from: http://www.nutritionj.com/content/6/1/14 © 2007 Dangour et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background:Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into theProgramme of Complementary Feeding for the Older Population(PACAM) which has been providing a nutritional supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the supplementation programme. Aim:The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing nutrition supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio- economic status living in Santiago, Chile. Methods:The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24- month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of nutrition for older people based on sound science-base and evidence for cost-effectiveness. Trial registration:ISRCTN48153354

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