• Poster
  • March 1, 2014

The Use of a Novel Tool for Decreasing Patient Attrition in Pediatric Weight Management Programs

Presented at the Society for Pediatric Psychology, March 2014

Melissa Santos, PhD, Connecticut Children's Medical Center
Bethany J. (Sallinen) Gaffka, PhD, University of Michigan
Kimberly Guion, PhD, Oregon Health & Science University
Erinn T. Rhodes, MD, MPH, Boston Children's Hospital
Laura Shaffer, PhD, University of Louisville School of Medicine

Elizabeth Getzoff Testa, PhD, Mt Washington Pediatric Hospital
Sarah Hampl, MD, Children's Mercy Hospitals & Clinics

Objective:
Research has identified factors such as insurance, scheduling, engagement, and psychosocial concerns as leading to drop-out from obesity programs. While these may not be easily modified, one other cited variable, mismatched expectations, may be. This poster focuses on families' expectations regarding psychosocial variables upon entry into weight management treatment.

Methods:
An interprofessional workgroup in Children's Hospital Association's FOCUS on a Fitter Future obesity collaborative, developed a clinical tool based on results of a previous multisite study. Completed by caregivers and adolescents, this tool identifies expectations upon entering a pediatric weight management program. The tool encompasses numerous areas, including eating behaviors, indicators of treatment success, and psychosocial variables. Interest in help with topics is rated using a 5-point Likert scale (1 = Not at All to 5 = Very Much).

Results:
Surveys were obtained from 405 caregivers and 160 adolescents from12 Children's Hospitals. Caregivers/adolescents endorsed "very much" interest in learning about the following topics: handling teasing/bullying = 22.7% caregivers; 15.6% adolescents; making friends more easily = 22.2% caregivers; 16.3% adolescents; feeling better about him/herself= 45.9% caregivers; 28.1% adolescents; how to be motivated to eat healthy =54.1% caregivers; 44.4% adolescents; how to be motivated to be physically activity = 56.1% caregivers; 45.6% adolescents.

Conclusions:
This tool is a first step in addressing families' expectations for treatment including a focus on their psychosocial concerns. Further work will be done to determine how well families felt their expectations were addressed during treatment and the association with attrition. 

Relevance to Conference Theme:
This poster fits the theme of "Coming Full Circle to Clinical Care: Translational Science" as it highlights a tool based on research used clinically to address treatment expectations. While many of the barriers identified in research as factors in drop-out may be difficult for clinical programs to modify, this tool draws on a potentially modifiable factor: mismatched expectations.