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Title Attrition in Pediatric Weight Management
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Publication Date
Date Accessioned
University/Publisher Wake Forest University
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.
Subjects/Keywords attrition
Language en
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.
Country of Publication us
Record ID handle:10339/14668
Repository wfu
Date Retrieved
Date Indexed 2019-01-18
Issued Date 2010-05-05 16:13:22

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ATTRITION IN PEDIATRIC WEIGHT MANAGEMENT BY JOSEPH A. SKELTON A Thesis submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCE in…

…Obesity 3 Attrition From Clinical Obesity Treatment Programs 4 Are Controlled Trials Any Better 11 Attrition In Adult Weight Management Studies 14 Adherence: A Model For The Study Of Attrition 17 Summary And Future Directions 19 Goals Of This…

…Study 22 CHAPTER 2: ATTRITION IN A PEDIATRIC WEIGHT MANAGEMENT PROGRAM Abstract 24 Introduction 25 Methods 26 Results 31 Discussion 43 CHAPTER 3: DISCUSSION Project Summary 48 Additional Analyses 49 Future Directions 56 REFERENCE LIST…

…59 CURRICULUM VITAE 63 iii LIST OF ILLUSTRATIONS CHAPTER 1: TABLES Table 1: Attrition rates in outpatient pediatric weight management programs 5 Table 2: Attrition in pediatric obesity treatment studies 12 Table 3: Variables associated with…

attrition from adult behavioral weight 16 management treatment FIGURES Figure 1: Model of adherence to pediatric medical regimens 18 CHAPTER 2: TABLES Table 1: Characteristics of Children and Families included in study 33 Table 2: Family socio…

…demographic characteristics, by attrition status at 36 4 months of treatment Table 3: Physical and mental health characteristics of families, by attrition 37 status at 4 months of treatment Table 4: Odds Ratio Estimates of Active Program Status at four…

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…

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