Zeller Meg, Kirk Shelley, Claytor Randal, Khoury Philip, Grieme Jennifer, Santangelo Megan, Daniels Stephen
Division of Psychology NL D-3015, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
J Pediatr. 2004 Apr;144(4):466-70. doi: 10.1016/j.jpeds.2003.12.031.
The current study examined characteristics of families who initiated weight management treatment for their obese child/adolescent and withdrew prematurely.
Participants (body mass index > or =95(th) percentile) were enrolled in a pediatric interdisciplinary weight management clinic. Retrospective chart review revealed noncompleters (n=116) completed > or =1 visit(s) but withdrew before completion of the initial 4-month treatment phase. Completers (n=96) completed the initial treatment phase. Completers and noncompleters were compared on baseline demographic, psychological, clinical, and laboratory measures. Regression analyses assessed the degree to which these factors predicted attrition.
Fifty-five percent of patients withdrew prematurely from treatment. Noncompleters were more likely to be Medicaid recipients, black, older, and self-report greater depressive symptomatology and lower self-concept.
These data have implications for the design of pediatric weight management intervention models that improve the rate of completion for economically disadvantaged and minority youth. Screening for depressive symptomatology may identify patients at risk for treatment dropout who could be targeted for increased support and retention strategies.
本研究调查了那些为其肥胖儿童/青少年启动体重管理治疗但过早退出的家庭的特征。
参与者（体重指数大于或等于第95百分位数）被纳入一家儿科跨学科体重管理诊所。回顾性病历审查显示，未完成治疗者（n = 116）完成了≥1次就诊，但在初始4个月治疗阶段结束前退出。完成治疗者（n = 96）完成了初始治疗阶段。对完成治疗者和未完成治疗者在基线人口统计学、心理学、临床和实验室指标方面进行了比较。回归分析评估了这些因素预测退出治疗的程度。
55%的患者过早退出治疗。未完成治疗者更有可能是医疗补助受助者、黑人、年龄较大，且自我报告有更严重的抑郁症状和更低的自我概念。
这些数据对儿科体重管理干预模型的设计具有启示意义，该模型可提高经济弱势和少数族裔青少年的治疗完成率。筛查抑郁症状可能会识别出有治疗退出风险的患者，这些患者可作为增加支持和保留策略的目标对象。
