Spring Bonnie, Sohn Min-Woong, Locatelli Sara M, Hadi Sattar, Kahwati Leila, Weaver Frances M
Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA.
BMC Public Health. 2014 Apr 15;14:363. doi: 10.1186/1471-2458-14-363.
High attrition is a common problem for weight loss programs and directly affects program effectiveness. Since 2006, the Veterans Health Administration (VHA) has offered obesity treatment to its beneficiaries through the MOVE! Weight Management Program for Veterans (MOVE!). An early evaluation of this program showed that attrition rate was high. The present study examines how individual, facility, and program factors relate to retention for participants in the on-site MOVE! group program.
Data for all visits to MOVE! group treatment sessions were extracted from the VHA outpatient database. Participants were classified into three groups by their frequency of visits to the group program during a six month period after enrollment: early dropouts (1 - 3 visits), late dropouts (4 - 5 visits), and completers (6 or more visits). A generalized ordered logit model was used to examine individual, facility, and program factors associated with retention.
More than 60% of participants were early dropouts and 11% were late dropouts. Factors associated with retention were older age, presence of one or more comorbidities, higher body mass index at baseline, lack of co-payment requirement, geographic proximity to VA facility, addition of individual consultation to group treatment, greater program staffing, and regular, on-site physical activity programming. A non-completion rate of 74% for on-site group obesity treatment poses a major challenge to reducing the population prevalence of obesity within the VHA.
Greater attention to individualized consultation, accessibility to the program, and facility factors including staffing and physical activity resources may improve retention.
高流失率是减肥项目中常见的问题，直接影响项目效果。自2006年以来，退伍军人健康管理局（VHA）通过“行动起来！退伍军人体重管理项目”（MOVE!）为其受益人提供肥胖症治疗。对该项目的早期评估显示流失率很高。本研究探讨个体、机构和项目因素与参加现场MOVE! 小组项目的参与者留存率之间的关系。
从VHA门诊数据库中提取所有参加MOVE! 小组治疗课程的访问数据。根据参与者在入组后六个月内参加小组项目的频率，将其分为三组：早期退出者（1 - 3次访问）、晚期退出者（4 - 5次访问）和完成者（6次或更多次访问）。使用广义有序logit模型来研究与留存相关的个体、机构和项目因素。
超过60%的参与者是早期退出者，11%是晚期退出者。与留存相关的因素包括年龄较大、存在一种或多种合并症、基线时体重指数较高、无需自付费用、距离VA机构较近、在小组治疗中增加个体咨询、项目人员配备更多以及有规律的现场体育活动安排。现场小组肥胖症治疗的未完成率为74%，这对降低VHA内肥胖症的人群患病率构成了重大挑战。
更多地关注个性化咨询、项目的可及性以及包括人员配备和体育活动资源在内的机构因素可能会提高留存率。
