Adherence and barriers in e‐health self‐control training for enhancing childhood multidisciplinary obesity treatment

Abstract

Training self-control as the assumed underlying mechanism for weight loss is a promising pathway for improving long-term outcomes of childhood multidisciplinary obesity treatment (MOT). The present study is the first to analyse adherence to ehealth self-control training in paediatric obesity. We hypothesized that low adherence would relate to child characteristics and to contextual treatment barriers. Participants were recruited as a part of a larger randomized controlled trial, evaluating an e-health self-control training during inpatient MOT (intensive phase) and its outpatient aftercare (booster phase). A number of 68 youngsters with severe obesity between 11 to 19 years old were included in the present study. Excellent adherence was observed in the intensive phase during inpatient MOT, but rates decreased in the booster phase. As predicted, the low adherence group had a significantly higher weight status throughout the entire study period. Differences in contextual treatment barriers did not appear. Further in-depth analysis showed that the low adherence group frequently experienced practical obstacles. The end of inpatient MOT and high weight status can be considered important risk factors for low adherence in an additional self-control training aimed at facilitating weight loss.

Attrition rate and predictors of a monitoring mHealth application in adolescents with obesity

“…By contrast, lower adjusted BMI may result in less perceived need for app usage during treatment. Notably, these findings contradict Naets et al 33 research. However, when adding deficits in executive functions to the model, the effect of adjusted BMI disappeared and only deficits in initiating were a significant negative predictor of attrition.…”

“…31 Existing research has investigated potential predictors of attrition in lifestyle interventions for adults, adolescents and children with obesity. 32,33 Demographic variables and variables linked to self-controlled behaviour have been identified as predictors. For instance, older age has been found to predict attrition in lifestyle interventions for children and adolescents, although evidence regarding the effects of sex and baseline weight status is inconclusive.…”

“…34 Another study investigating an eHealth self-control intervention found that higher weight status was associated with attrition, while age and sex did not have significant effects. 33 Self-controlled behaviour is governed by executive functions (EFs), which regulate goal-directed behaviour, internal states and physiological processes. 35,36 Impaired EFs have been identified as threats to treatment continuation in adolescents with obesity.…”

Improving Treatment Outcome in Children With Obesity by an Online Self-Control Training: A Randomized Controlled Trial

“…This previous study used a gamified self-control training, where most participants reported trying to score well on the tasks. In our study, a non-gamified training resulted in major challenges motivating our patients to complete the training sessions, with >25% of the children reporting the training was too demanding ( 33 ). As individual engagement is known to impact the efficacy, this might have contributed to the absence of a general effect ( 34 ).…”

The Role of Perceived Energy and Self-Beliefs for Physical Activity and Sports Activity of Patients With Multiple Sclerosis and Chronic Stroke

“…First, in accordance with Dalgas et al (2019)'s term of "sport as medicine, " physical activity and sport lessons should be prescribed by physicians. Second, self-control can be enhanced by training (Friese et al, 2017;Naetes et al, 2020) and self-efficacy for PA can be strengthened by behavior change techniques (Ashford et al, 2010;Olander et al, 2013). As true for healthy people, changing perceived energy and self-beliefs is undoubtfully a good start, but probably still not enough.…”