Risk Factors for Poor Attendance in a Family-Based Pediatric Obesity Intervention Program for Young Children

Abstract

Objective This study examined the role of demographic characteristics, psychological factors, and family functioning on attendance in a randomized controlled trial of a family-based pediatric obesity program. Method Participants included 155 children between the ages of 4 and 7 years (M age = 5.77, 57.4% female, 73.6% African-American, M BMI = 25.5) and their primary caregivers who were randomized to the treatment group. Three groups of participants were created based on their patterns of attendance during the program: 1) noncompleters, 2) partial completers, and 3) completers. Results Results indicated no differences among the attendance groups in child gender, child BMI, or child psychological functioning. Significant group differences were found with respect to race/ethnicity, parent marital status, and family income, such that noncompleters were more likely to be racial/ethnic minorities, to living in single parent households, and to have lower incomes than partial completers and completers. After controlling for the effects these socio-demographic risk factors, noncompleters and partial completers reported more family dysfunction characterized by high levels of disengagement than completers. Conclusion Adapting existing weight management programs to include a focus on family engagement in the early stages of treatment may help to improve participation in family-based obesity interventions targeting high risk, socio-economically disadvantaged youth.

Participant characteristics and intervention processes associated with reductions in television viewing in the High Five for Kids study

“…Consistent with other studies that have found racial/ethnic minority status to be associated with poor attendance and attrition in family-based pediatric interventions targeting weight loss, (Williams et al, 2010) we found Latino parents had lower odds of completing >=2 intervention visits. High Five employed various retention strategies including a child-friendly mascot, project branding, and small incentives such as water bottles, an art contest, birthday cards and a seasonal newsletter.…”

Acceptability and non-compliance in a family-led weight-management programme for obese Pacific children

“…Fewer community-based weight-management interventions report on participant experiences leading to non-completion. Other possible non-completion factors in community-based lifestyle modification programmes include fear of weight stigmatisation, cultural incongruence between participants and providers, and imprecise programme intensity and duration (24,31,32) . The present study aimed to uncover the factors influencing both participant retention and conversely non-completion in a family-led weight-management programme for obese Pacific children in New Zealand.…”

Embedding weight-related messages within a general parenting programme: development and feasibility evaluation of Parents and Tots Together

“…One multi-centre trial of a family-based obesity treatment intervention reported a drop-out rate of greater than 90% (Pinelli et al, 1999). Studies examining predictors of programme attendance have consistently found that attendance is poorer among lowincome and racial minority families (Williams et al, 2010;Zeller et al, 2004). In general, attendance rates at general parenting programmes have been found to be higher than those reported for obesity treatment interventions (Gross et al, 2009;Webster-Stratton et al, 2001).…”

“…Attendance rates were relatively high; nearly 70% of the parents attended six or more of the nine PTT sessions. Poor attendance has been identified as a key challenge in family-based obesity treatment interventions (Williams et al, 2010). One multi-centre trial of a family-based obesity treatment intervention reported a drop-out rate of greater than 90% (Pinelli et al, 1999).…”