Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Child Obes. 2020 Jun;16(4):238-243. doi: 10.1089/chi.2020.0032.
Little is known about factors that affect a family's ability to engage in pediatric weight management clinics (PWMCs). We aimed at comparing child and family characteristics of patients referred to a PWMC by participants' attendance at orientation, attendance at intake, or completing the program. We performed a retrospective study of patients ages 2-18 years referred to a PWMC between 2014 and 2017. We extracted data from electronic medical records and clinic databases, including age, sex, race/ethnicity, language, referral year, address, and insurance. We performed -tests and chi-square tests to examine the association of engagement outcomes with covariates. We used separate multivariate logistic regression models to assess the predictors of engagement outcomes, including significant covariates from bivariate analyses. Participants ( = 2020 referred) had a mean age of 11.5 ± 3.5 years; 72% had Medicaid, and 34% lived in city limits. Participants were 39% white, 30% black, and 27% Hispanic. Of those referred, 41% attended orientation, 14% attended intake, and 9% completed. Significant predictors of attending orientation were age [odds ratio (OR): 0.93, 95% confidence interval (CI): 0.91-0.96], male sex (OR: 0.74, 95% CI: 0.60-0.91), Hispanic ethnicity (OR: 1.69, 95% CI: 1.26-2.26), living in city limits (OR: 1.39, 95% CI: 1.11-1.75), and Medicaid (OR: 0.77, 95% CI: 0.60-0.98). Significant predictors of attending intake were age (OR: 0.93, 95% CI: 0.90-0.96), Medicaid (OR: 0.61, 95% CI: 0.46-0.81), and 2017 referral year (OR: 0.21, 95% CI: 0.12-0.35). Hispanic ethnicity was associated with twice the odds of completion (OR: 2.07, 95% CI: 1.10-3.91). Child and family characteristics more strongly predicted initial engagement with a PWMC than completion. Future research should examine how targeting these predictors (, referring at younger age) can improve PWMC engagement.
关于影响家庭参与儿科体重管理诊所（PWMC）能力的因素知之甚少。我们旨在比较参与者参加定向、就诊或完成方案后，转介到 PWMC 的患者的儿童和家庭特征。我们对 2014 年至 2017 年间转介到 PWMC 的 2-18 岁患者进行了回顾性研究。我们从电子病历和诊所数据库中提取了数据，包括年龄、性别、种族/族裔、语言、转介年份、地址和保险。我们进行了 -检验和卡方检验，以检查参与结果与协变量的关联。我们使用单独的多变量逻辑回归模型来评估参与结果的预测因素，包括来自双变量分析的显著协变量。参与者（ = 2020 人）的平均年龄为 11.5±3.5 岁；72%有医疗补助，34%居住在城市范围内。参与者中，39%为白人，30%为黑人，27%为西班牙裔。在被转介的人中，41%参加了定向，14%参加了就诊，9%完成了。参加定向的显著预测因素是年龄[优势比（OR）：0.93，95%置信区间（CI）：0.91-0.96]、男性（OR：0.74，95%CI：0.60-0.91）、西班牙裔（OR：1.69，95%CI：1.26-2.26）、居住在城市范围内（OR：1.39，95%CI：1.11-1.75）和医疗补助（OR：0.77，95%CI：0.60-0.98）。参加就诊的显著预测因素是年龄（OR：0.93，95%CI：0.90-0.96）、医疗补助（OR：0.61，95%CI：0.46-0.81）和 2017 年转介年份（OR：0.21，95%CI：0.12-0.35）。西班牙裔与完成的可能性增加了两倍（OR：2.07，95%CI：1.10-3.91）。儿童和家庭特征与 PWMC 的初始参与度比完成度更密切相关。未来的研究应该探讨如何针对这些预测因素（例如，在更年轻的时候转介）来提高 PWMC 的参与度。
