Research Center of CHU Sainte Justine, Université de Montréal 3175 chemin de la Côte-Sainte-Catherine, Montréal, Quebec H3T 1C5, Canada; Department of Mathematics and Statistics, Concordia University 1455 boulevard de Maisonneuve Ouest, Montréal, Quebec H3G 1M8, Canada.
Research Center of CHU Sainte Justine, Université de Montréal 3175 chemin de la Côte-Sainte-Catherine, Montréal, Quebec H3T 1C5, Canada.
Obes Res Clin Pract. 2021 Mar-Apr;15(2):157-162. doi: 10.1016/j.orcp.2021.01.007. Epub 2021 Feb 16.
Attrition in pediatric weight management programs is notoriously high. Greater understanding of its determinants is needed to inform retention strategies. We identified determinants of attrition in CIRCUIT, a healthy lifestyle intervention program for youth at risk of cardiovascular disease.
A one-arm intervention study of children aged 4-18 years who initiated the CIRCUIT program in the first five years of its existence (N = 403). We defined attrition as attending the baseline visit but ceasing attendance prior to the 1-year follow-up. Potential determinants of dropout included the child's age, sex, ethnicity, body mass index (BMI) z-score, family socio-demographic characteristics, and estimated driving time to the program, all measured at baseline. Associations were estimated bivariately, using chi-squared- and t-tests, and simultaneously in a multivariable logistic regression model.
Of the 403 participants who started the program, 198 (49%) dropped out within 12 months of enrollment. Youth who dropped out were older (mean age 12.8y vs. 11.3y; p < 0.01), were less likely to live with both parents (62% vs. 71%; p = 0.05), and to have mothers who had completed high school (79% vs. 88%; p = 0.01). No group differences were observed for sex, ethnicity, baseline BMI z-score, fathers' education, or driving time to the program. In multivariate models, only older age at initiation of the intervention (OR: 1.2; CI: 1.1,1.3) and lower maternal education (OR: 2.0; CI: 1.0,3.8) were associated with dropout.
Improved tailoring of interventions to older pediatric participants and to families of lower maternal education may help reduce attrition in CIRCUIT and similar lifestyle intervention programs.
儿科体重管理项目的流失率非常高。为了制定保留策略，我们需要更深入地了解其决定因素。我们确定了 CIRCUIT 项目中的流失决定因素，CIRCUIT 是一个针对心血管疾病风险青少年的健康生活方式干预项目。
这是一项针对在 CIRCUIT 项目开展的前五年内开始该项目的 4-18 岁儿童的单臂干预研究（N=403）。我们将流失定义为参加基线访视但在 1 年随访前停止参加。辍学的潜在决定因素包括儿童的年龄、性别、种族、体重指数（BMI）z 分数、家庭社会人口统计学特征以及到达项目的估计驾驶时间，所有这些都在基线时进行测量。使用卡方检验和 t 检验进行单变量关联分析，并在多变量逻辑回归模型中同时进行分析。
在 403 名开始该项目的参与者中，有 198 名（49%）在注册后 12 个月内流失。流失的青少年年龄较大（平均年龄 12.8 岁 vs. 11.3 岁；p<0.01），与父母同住的可能性较小（62% vs. 71%；p=0.05），母亲完成高中学业的可能性也较小（79% vs. 88%；p=0.01）。在性别、种族、基线 BMI z 分数、父亲的教育程度或到达项目的驾驶时间方面，没有观察到组间差异。在多变量模型中，只有干预开始时的年龄较大（OR：1.2；CI：1.1，1.3）和母亲教育程度较低（OR：2.0；CI：1.0，3.8）与辍学相关。
更好地针对较年长的儿科参与者和母亲教育程度较低的家庭定制干预措施，可能有助于减少 CIRCUIT 和类似生活方式干预项目的流失率。
