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Child Obes. 2011 Jun 20;7(3):185-193.

Attrition in a Multidisciplinary Pediatric Weight Management Clinic.

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1
Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC.

Abstract

BACKGROUND:

Pediatric weight management clinics experience significant dropout, and few studies have investigated this problem. The objective of this study was to identify family and clinic characteristics associated with attrition from a tertiary care pediatric weight management clinic.

METHODS:

This was a prospective and retrospective clinical database study of a multidisciplinary clinic for obese children 2-18 years with a weight-related co-morbidity. All patients seen between November, 2007, and July, 2009, were included. Characteristics of Active and Inactive families were compared using chi-squared and t-tests, and logistic regression was used to identify independent correlates of program status. A one-page survey was mailed to all Inactive families.

RESULTS:

A total of 133 patients were seen during the study period. Their mean age was 12 years old, mean BMI was 38 kg/m(2), 53% were female, 52% represented racial/ethnic minorities, and 50% were Medicaid recipients. In all, 32% dropped out of treatment. Inactive children had significantly lower BMI z-scores, were older, and were more likely to have poor school performance than active children. Similar results were found on regression analysis: Children with higher BMI z-scores, commercial insurance, average school performance, and a major weight-related co-morbidity were less likely to be inactive. The most common parent-reported reasons for dropping out were: Child not wanting to make changes, weight not improving, child desired to leave program, and program not meeting parent or child's expectations.

CONCLUSIONS:

Attrition from pediatric weight management treatment is high, with age, weight, school performance, and health associated with dropout. Parents mostly reported child-related issues, including lack of weight loss, as reasons for dropout.

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