1 Pediatric Comprehensive Weight Management Center, Department of Pediatrics, Division of Child Behavioral Health, University of Michigan C.S. Mott Children's and Von Voigtlander Women's Hospital , Ann Arbor, MI.
Child Obes. 2013 Oct;9(5):409-17. doi: 10.1089/chi.2013.0069. Epub 2013 Sep 12.
One of the most frequently cited challenges faced by pediatric weight management programs/clinics is attrition, with many studies reporting rates greater than 50%. Few studies have evaluated parental perspectives on recommendations for weight-management treatment enhancement. The aim of this study was to elicit perspectives on areas for improvement, discussions with staff about discontinuation, and potentially modifiable aspects of attrition from parents who prematurely discontinued stage 3 pediatric weight management treatment.
This study was performed as a semistructured interview as part of a telephone survey assessing reasons for attrition.
Interviews were performed with 147 parents of children who attended programs/clinics at 13 children's hospitals participating in the National Association of Children's Hospitals and Related Institutions (now Children's Hospital Association) FOCUS on a Fitter Future II collaborative. The majority of parents (65%) denied talking to staff about their decisions to stop coming. When describing what could have been done to retain families, parents most frequently discussed changing logistics (e.g., hours and locations). Parents described changes in logistics and components (i.e., nutrition education, exercise, and behavior education/support) when asked what would work best for their family for pediatric weight management.
Parental responses appeared to express frustration about flexibility with appointment times and treatment locations. The most frequently desired components were those traditionally offered by stage 3 pediatric weight management programs/clinics, and this may suggest a need for treatment delivery of these components to be more individualized. Additional discussion with families about their desire to discontinue treatment may provide a timely opportunity to address this need.
儿科体重管理项目/诊所面临的最常被提及的挑战之一是患者流失，许多研究报告的流失率超过 50%。很少有研究评估家长对体重管理治疗增强的建议的看法。本研究旨在从提前停止儿科体重管理治疗第 3 阶段的家长那里了解改进领域、与工作人员讨论停药以及可能的可改变的流失因素的观点。
本研究作为电话调查的一部分进行了半结构化访谈，以评估流失的原因。
对参加全国儿童医院协会和相关机构（现更名为儿童医院协会）FOCUS on a Fitter Future II 合作项目的 13 家儿童医院的 13 个项目/诊所的 147 名儿童的家长进行了访谈。大多数家长（65%）否认与工作人员讨论过他们停止就诊的决定。在描述可以采取哪些措施来留住家庭时，家长们最常提到改变后勤（例如，时间和地点）。当被问及什么对他们的儿科体重管理家庭最有效时，家长们描述了后勤和组件的变化（即营养教育、运动和行为教育/支持）。
家长的反应似乎表达了对预约时间和治疗地点灵活性的不满。家长最常希望得到的是传统上由第 3 阶段儿科体重管理项目/诊所提供的组件，这可能表明需要更个性化地提供这些组件的治疗。与家庭进一步讨论他们停止治疗的愿望可能是解决这一需求的及时机会。
