Determinants of dropout and compliance of children participating in a multidisciplinary intervention programme for overweight and obesity in socially deprived areas

Abstract

Background Children with overweight and obesity in socially deprived areas (SDAs) are less likely to complete and be compliant to a weight-loss programme. Objectives To identify factors associated with dropout and compliance of a multidisciplinary weight-loss programme in SDA. Methods This prospective longitudinal cohort study included children (6–12 years) with overweight and obesity in a 12-week multidisciplinary intervention living in SDA in Rotterdam, the Netherlands. Potential predictive variables for dropout and compliance included were age, sex, the weight of the child and parents, quality of life, and referral status (self-registration or referral). A Cox proportional hazards model was performed to study the association between dropout and its potential predictive variables, whereas logistic regression analyses were used for the potential predictors for compliance. Results A total of 121 children started the intervention programme. Forty-one (33.9%) children dropped out and 68 (56.2%) were compliant with the intervention. The risk of dropping out of the intervention was significantly lower for a child with overweight parents than for those with parents with normal weight (adjusted hazard ratio [HR] 0.22 [95% confidence interval, CI 0.063–0.75]), and for those with parents with obesity (adjusted HR 0.18 [95% CI 0.060–0.52]). No other potential predictive variables were associated with dropout or compliance. Conclusion Children from SDA participating in a weight-loss programme have a relatively high dropout and a low compliance rate. Parental weight seems to be an important predictor for dropout of children from SDA, where children with normal weight or obese parents have the highest risk of dropout compared with children of overweight parents.

Treating Children and Adolescents with Obesity: Predictors of Early Dropout in Pediatric Weight-Management Programs

“…In a prospective longitudinal cohort study of children with overweight and obesity in socially deprived areas of Rotterdam, Hassan et al [14] demonstrated a dropout rate of 33.9%. Children with overweight parents had a significantly lower probability of dropout than those with parents with obesity or normal weight.…”

“…It is possible to speculate that normal-weight parents worry less about weight, so they may not evaluate the urgency of losing weight. Instead, the higher risk of dropout found in the group of children with parents with obesity could be correlated with the notion that necessary lifestyle changes might be more complicated for them [14,39]. Park et al [15] identified lower family functioning, lower initial attendance rates, and non-self-directed pathways as factors associated with dropout.…”

“…Therefore, a prospective strategy to enhance the effectiveness of pediatric weight-management programs involves tackling dropout issues and promoting better compliance. Reducing dropout rates in lifestyle modifications in pediatric weight-control interventions is, therefore, critical for long-term behavioral changes [14][15][16].…”