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Attrition in Pediatric Weight Management

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abstract
Pediatric obesity continues to be one of the most important health issues facing children and families today, and there remains a need for effective treatment options. Recent expert recommendations outlined directions for treatment, with multidisciplinary teams and tertiary-care clinics providing intensive resources for obese children and their families. However, it appears from the few reports in the literature that weight management programs have high rates of attrition, ranging from 27 to 73%. Given the paucity of literature in this area, there is little evidence upon which build a response to this problem. The goal of this study was to better understand family attrition from a single, tertiary-care pediatric obesity treatment program (Brenner FIT at Brenner Children’s Hospital) in an effort to identify contributors to and patterns of attrition. This study was a mixed methods study utilizing a clinical database, retrospective chart review, and survey of program dropouts. A third of patients and their families dropped out in the initial four month treatment phase. This severely obese patient population with many weight-related co-morbidities had many psycho-social issues pertinent to family-based behavioral treatment, but few characteristics were significantly associated with dropout. Older children and those with below average performance in school appeared to drop out of treatment to a greater degree. The Inactive group had a lower BMI than the active group. Attrition did not appear to occur at a particular time during treatment, but was steady across the eight visits. Parent/caregiver report of reasons for dropout focused on lack of weight change in the child, program not meeting expectations, their child not being ready to make changes, and the child desired to leave the program. We conclude that there are few health or socio-demographic contributors to attrition, and no clear pattern to when families dropped out. Families note child-related issues as contributing to drop out. Further study of family and program-related factors is needed to improve retention, and possibly, success in weight management.
subject
attrition
obesity
pediatric
weight management
contributor
Skelton, Joseph (author)
Vitolins, Mara (committee chair)
Goff, David (committee member)
O'Shea, T. Michael (committee member)
Ip, Edward (committee member)
Beech, Bettina (committee member)
date
2010-05-05T16:13:22Z (accessioned)
2010-06-18T18:57:08Z (accessioned)
2010-05-05T16:13:22Z (available)
2010-06-18T18:57:08Z (available)
2010-05-05T16:13:22Z (issued)
degree
Clinical Epidemiology & Health Services (discipline)
identifier
http://hdl.handle.net/10339/14668 (uri)
language
en_US (iso)
publisher
Wake Forest University
rights
Release the entire work for access only to the Wake Forest University system for one year from the date below. After one year, release the entire work for access worldwide. (accessRights)
title
Attrition in Pediatric Weight Management
type
Thesis

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