Nobles James, Griffiths Claire, Pringle Andy, Gately Paul
Institute of Sport, Physical Activity and Leisure, Centre of Active Lifestyles, Carnegie Faculty, Leeds Beckett University, Headingley Campus, Leeds, UK.
MoreLife (UK) Ltd., Churchwood Hall, Leeds Beckett University, Headingley Campus, Leeds, UK.
Int J Behav Nutr Phys Act. 2016 Jul 19;13:76. doi: 10.1186/s12966-016-0399-1.
Approximately 50% of paediatric weight management (WM) programme attendees do not complete their respective programmes. High attrition rates compromise both programme effectiveness and cost-efficiency. Past research has examined pre-intervention participant characteristics associated with programme (non-)completion, however study samples are often small and not representative of multiple demographics. Moreover, the association between programme characteristics and participant engagement is not well known. This study examined participant and programme characteristics associated with engagement in a large, government funded, paediatric WM programme. Engagement was defined as the family's level of participation in the WM programme.
Secondary data analysis of 2948 participants (Age: 10.44 ± 2.80 years, BMI: 25.99 ± 5.79 kg/m(2), Standardised BMI [BMI SDS]: 2.48 ± 0.87 units, White Ethnicity: 70.52%) was undertaken. Participants attended a MoreLife programme (nationwide WM provider) between 2009 and 2014. Participants were classified into one of five engagement groups: Initiators, Late Dropouts, Low- or High- Sporadic Attenders, or Completers. Five binary multivariable logistic regression models were performed to identify participant (n = 11) and programmatic (n = 6) characteristics associated with an engagement group. Programme completion was classified as ≥70% attendance.
Programme characteristics were stronger predictors of programme engagement than participant characteristics; particularly small group size, winter/autumn delivery periods and earlier programme years (proxy for scalability). Conversely, participant characteristics were weak predictors of programme engagement. Predictors varied between engagement groups (e.g. Completers, Initiators, Sporadic Attenders). 47.1% of participants completed the MoreLife programme (mean attendance: 59.4 ± 26.7%, mean BMI SDS change: -0.15 ± 0.22 units), and 21% of those who signed onto the programme did not attend a session.
As WM services scale up, the efficacy and fidelity of programmes may be reduced due to increased demand and lower financial resource. Further, limiting WM programme groups to no more than 20 participants could result in greater engagement. Baseline participant characteristics are poor and inconsistent predictors of programme engagement. Thus, future research should evaluate participant motives, expectations, and barriers to attending a WM programme to enhance our understanding of participant WM engagement. Finally, we suggest that session-by-session attendance is recorded as a minimum requirement to improve reporting transparency and enhance external validity of study findings.
约50%参加儿科体重管理（WM）项目的儿童未完成各自的项目。高流失率损害了项目效果和成本效益。过去的研究考察了与项目（未）完成相关的干预前参与者特征，然而研究样本往往较小，且不能代表多个人口统计学特征。此外，项目特征与参与者参与度之间的关联尚不清楚。本研究考察了与参与一个大型的、政府资助的儿科WM项目相关的参与者和项目特征。参与度被定义为家庭参与WM项目的程度。
对2948名参与者（年龄：10.44±2.80岁，体重指数：25.99±5.79kg/m²，标准化体重指数[BMI SDS]：2.48±0.87单位，白人种族：70.52%）进行二次数据分析。参与者在2009年至2014年期间参加了一个“更多生活”项目（全国性的WM服务提供商）。参与者被分为五个参与度组之一：发起者、后期退出者、低或高零星参与者或完成者。进行了五个二元多变量逻辑回归模型，以确定与参与度组相关的参与者（n = 11）和项目（n = 6）特征。项目完成被定义为出勤率≥70%。
项目特征比参与者特征更能预测项目参与度；特别是小组规模小、秋冬交付期和项目年份较早（可扩展性的代理指标）。相反，参与者特征对项目参与度的预测作用较弱。预测因素在不同参与度组之间有所不同（例如完成者、发起者、零星参与者）。47.1%的参与者完成了“更多生活”项目（平均出勤率：59.4±26.7%，平均BMI SDS变化：-0.15±0.22单位），并且报名参加该项目的人中有21%未参加过一次课程。
随着WM服务的扩大，由于需求增加和财政资源减少，项目的有效性和保真度可能会降低。此外，将WM项目组限制在不超过20名参与者可能会导致更高的参与度。基线参与者特征对项目参与度的预测较差且不一致。因此，未来的研究应评估参与者参加WM项目的动机、期望和障碍，以增进我们对参与者WM参与度的理解。最后，我们建议将逐次出勤情况记录作为最低要求，以提高报告透明度并增强研究结果的外部有效性。
