Family-reported barriers and predictors of short-term attendance in a multidisciplinary intervention for managing childhood obesity: A psycho-family-system based randomised controlled trial (ENTREN-F)

Marta Rojo, Tatiana Lacruz, Santos Solano, Ana Gutiérrez, Lucía Beltrán-Garrayo, Oscar L Veiga, Montserrat Graell, Ana Rosa Sepúlveda, Marta Rojo, Tatiana Lacruz, Santos Solano, Ana Gutiérrez, Lucía Beltrán-Garrayo, Oscar L Veiga, Montserrat Graell, Ana Rosa Sepúlveda

Abstract

Objective: This study was aimed to examine patient enrolment in the pre-intervention stage, family-reported barriers, attendance rates and underlying predictors of short-term attendance in a family-system-based randomised controlled trial for managing childhood obesity in children aged 8-12-years-old (ENTREN-F).

Method: Psychosocial and anthropometric measures were collected through primary health referral. The data were used for descriptive analyses of sample characteristics and linear regression analyses.

Results: Low enrolment rates and several family-reported barriers were observed in the pre-intervention stage. Logistical barriers were the most frequent family-reported reason for attrition in the different stages of the study. Having a first face-to-face orientation session with the families and the use of motivational interviewing helped to improve adherence in the initial phases of the study. After 6 months of intervention, family based treatments (FBTs) under consideration achieve greater adherence compared with the standard intervention. Moreover, family involvement was a predictor of success for better treatment adherence rates. By contrast, participants who attended a brief standard intervention, mothers with primary education, greater body mass index, higher levels of depressive symptomatology and more critical comments towards their children, children with higher weight status and lower levels of self-reported depressive symptoms at baseline attended interventions less frequently.

Conclusions: In future programmes a comprehensive screening of modifiable factors related to family and their setting characteristics is paramount prior to intervention, identifying key barriers related to drop-out, especially in the case of less-advantaged families.

Trial registration: ClinicalTrials.gov NCT04465799.

Keywords: adherence; attendance; family-based interventions; paediatric obesity; treatment programmes.

Conflict of interest statement

The authors have no competing interests to declare relevant to this article's content.

© 2022 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Description of the three interventions. † Sessions that involve the parents, with or without the child
FIGURE 2
FIGURE 2
CONSORT diagram of the study

References

    1. Ball, G. D. , Sebastianski, M. , Wijesundera, J. , Keto‐Lambert, D. , Ho, J. , Zenlea, I. , & Skelton, J. A. (2021). Strategies to reduce attrition in managing pediatric obesity: A systematic review. Pediatric Obesity, 16(4), e12733. 10.1111/ijpo.12733
    1. Beck, A. T. , Steer, R. A. , & Brown, G. K. (1996). Manual for the Beck depression inventory‐II. Psychological Corporation.
    1. Berge, J. M. , & Everts, J. C. (2011). Family‐based interventions targeting childhood obesity: A meta‐analysis. Childhood Obesity, 7(2), 110–121.
    1. Blasco‐Fontecilla, H. , Delgado‐Gomez, D. , Legido‐Gil, T. , De Leon, J. , Pérez‐Rodríguez, M. M. , & Baca‐García, E. (2012). Can the Holmes‐Rahe Social Readjustment Rating Scale (SRRS) be used as a suicide risk scale? An exploratory study. Archives of Suicide Research, 16(1), 13–28. 10.1080/13811118.2012.640616
    1. Borrello, M. , Pietrabissa, G. , Ceccarini, M. , Manzoni, G. M. , & Castelnuovo, G. (2015). Motivational interviewing in childhood obesity treatment. Frontiers in Psychology, 6, 1732. 10.3389/fpsyg.2015.01732
    1. Brown, C. L. , Dovico, J. , Garner‐Edwards, D. , Moses, M. , & Skelton, J. A. (2020). Predictors of engagement in a pediatric weight management clinic after referral. Childhood Obesity, 16(4), 238–243.
    1. Brownell, K. D. (2004). The LEARN program for weight management. American Health Publishing Company.
    1. Byrd‐Bredbenner, C. , Delaney, C. , Martin‐Biggers, J. , Koenings, M. , & Quick, V. (2017). The marketing plan and outcome indicators for recruiting and retaining parents in the HomeStyles randomized controlled trial. Trials, 18(1), 1–18.
    1. Chai, L. K. , Collins, C. , May, C. , Brain, K. , See, D. W. , & Burrows, T. (2019). Effectiveness of family‐based weight management interventions for children with overweight and obesity: An umbrella review. JBI Evidence Synthesis, 17(7), 1341–1427.
    1. Davanzo, P. , Kerwin, L. , Nikore, V. , Esparza, C. , Forness, S. , & Murelle, L. (2004). Spanish translation and reliability testing of the child depression inventory. Child Psychiatry and Human Development, 35, 75–92. 10.1023/B:
    1. De la Peña, F. R. , Villavicencio, L. R. , Palacio, J. D. , Félix, F. J. , Larraguibel, M. , Viola, L. , Ortiz, S. , Rosetti, M. , Abadi, A. , Montiel, C , Mayer, P. A. , Fernández, S. , Jaimes, A. , Feria, M. , Sosa, L. , Rodríguez, A. , Zavaleta, P. , Uribe, D. , Galicia, F. , … Ulloa, R. E. (2018). Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM‐5 (K‐SADS‐PL‐5) Spanish version. BMC Psychiatry, 18(1), 1–7. 10.1186/s12888-018-1773-0
    1. Dhaliwal, J. , Nosworthy, N. M. , Holt, N. L. , Zwaigenbaum, L. , Avis, J. L. , Rasquinha, A. , & Ball, G. D. (2014). Attrition and the management of pediatric obesity: An integrative review. Childhood Obesity, 10(6), 461–473. 10.1089/chi.2014.0060
    1. Farnesi, B. C. , Ball, G. D. C. , & Newton, A. S. (2012). Family–health professional relations in pediatric weight management: An integrative review. Pediatric Obesity, 7(3), 175–186. 10.1111/j.2047-6310.2012.00029.x
    1. Faul, F. , Erdfelder, E. , Buchner, A. , & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. 10.3758/BRM.41.4.1149
    1. Hollingshead, A. (1975). Four factor index of social status. Yale University Department of Psychology.
    1. Jensen, C. D. , Aylward, B. S. , & Steele, R. G. (2012). Predictors of attendance in a practical clinical trial of two pediatric weight management interventions. Obesity, 20(11), 2250–2256. 10.1038/oby.2012.96
    1. Kovacs, M. (1992). Children’s depression inventory (CDI). Multi‐health Systems, Inc.
    1. Leung, A. W. , Chan, R. S. , Sea, M. M. , & Woo, J. (2017). An overview of factors associated with adherence to lifestyle modification programs for weight management in adults. International Journal of Environmental Research and Public Health, 14(8), 922. 10.3390/ijerph14080922
    1. Lundahl, A. , Kidwell, K. M. , & Nelson, T. D. (2014). Parental underestimates of child weight: A meta‐analysis. Pediatrics, 133(3), 689–703.
    1. Luque, V. , Feliu, A. , Escribano, J. , Ferré, N. , Flores, G. , Monné, R. , & Closa‐Monasterolo, R. (2019). The Obemat 2.0 study: A clinical trial of a motivational intervention for childhood obesity treatment. Nutrients, 11(2), 419.
    1. Martínez Rubio, A. , & Gil Barcenilla, B. (2013). Entrevista motivacional: Una herramienta en el manejo de la obesidad infantil. Pediatría Atención Primaria, 15, 133–141. 10.4321/S1139-76322013000300016
    1. McGeown, L. , Ball, G. D. , & Mushquash, A. R. (2021). Is there a role for self‐referral in pediatric weight management? Childhood Obesity, 17(8), 559–562.
    1. Miller, W. R. , & Rollnick, S. (2004). Talking oneself into change: Motivational interviewing, stages of change, and therapeutic process. Journal of Cognitive Psychotherapy, 18(4), 299–308.
    1. Morgan, P. J., Jones, R. A. , Collins, C. E. , Hesketh, K. D. , Young, M. D. , Burrows, T. L. , & Campbell, K. J. (2016). Practicalities and research considerations for conducting childhood obesity prevention interventions with families. Children, 3(4), 24.
    1. Newson, L. , Povey, R. , Casson, A. , & Grogan, S. (2013). The experiences and understandings of obesity: Families’ decisions to attend a childhood obesity intervention. Psychology and Health, 28(11), 1287–1305. 10.1080/08870446.2013.803106
    1. Parkinson, K. N. , Reilly, J. J. , Basterfield, L. , Reilly, J. K. , Janssen, X. , Jones, A. R. , & Adamson, A. J. (2017). Mothers' perceptions of child weight status and the subsequent weight gain of their children: A population‐based longitudinal study. International Journal of Obesity, 41(5), 801–806. 10.1038/ijo.2017.20
    1. Rahelić, V. , Głąbska, D. , Guzek, D. , Pavić, E. , Rumora Samarin, I. , Bogdanić, A. , & Krnić, N. (2020). Role of parents in body mass reduction in children with obesity—adherence, and success of 1‐year participation in an intervention program. Medicine, 56(4), 168. 10.3390/medicina56040168
    1. Rhee, K. E. , De Lago, C. W. , Arscott‐Mills, T. , & Mehta, S. D. (2005). Factors associated with parental readiness to make changes for overweight children. Pediatrics, 116(1), e94–e101. 10.1542/peds.2004-2479
    1. Rhodes, E. T. , Boles, R. E. , Chin, K. , Christison, A. , Testa, E. G. , Guion, K. , & Hampl, S. E. (2017). Expectations for treatment in pediatric weight management and relationship to attrition. Childhood Obesity, 13(2), 120–127.
    1. Royston, P. , Altman, D. G. , & Sauerbrei, W. (2006). Dichotomizing continuous predictors in multiple regression: A bad idea. Statistics in Medicine, 25(1), 127–141. 10.1002/sim.2331
    1. Sacher, P. M. , Kolotourou, M. , Chadwick, P. M. , Cole, T. J. , Lawson, M. S. , Lucas, A. , & Singhal, A. (2010). Randomized controlled trial of the MEND program: A family‐based community intervention for childhood obesity. Obesity, 18(S1), S62–S68.
    1. Salas, A. M. , Gattas, Z. V. , Ceballos, S. X. , & Burrows, A. R. (2010). Effects of psychological support as an adjunct to a weight‐reducing program among obese children. Revista Medica de Chile, 138(10), 1217–1225. 10.4067/S0034-98872010001100002
    1. Sallinen Gaffka, B. J. , Frank, M. , Hampl, S. , Santos, M. , & Rhodes, E. T. (2013). Parents and pediatric weight management attrition: Experiences and recommendations. Childhood Obesity, 9(5), 409–417. 10.1089/chi.2013.0069
    1. Sanz, J. , Perdigón, A. L. , & Vázquez, C. (2003). Adaptación española del inventario para la depresión de Beck‐II (BDI‐II): 2. Propiedades psicométricas en población general. Clínica y Salud, 14(3), 249–280.
    1. Sepúlveda, A. R. , Anastasiadou, D. , Rodríguez, L. , Almendros, C. , Andrés, P. , Vaz, F. , & Graell, M. (2014). Spanish validation of the family questionnaire (FQ) in families of patients with an eating disorder. Psicothema, 26(3), 321–327.
    1. Sepúlveda, A. R. , Solano, S. , Blanco, M. , Lacruz, T. , & Veiga, O. (2020). Feasibility, acceptability, and effectiveness of multidisciplinary intervention in childhood obesity from primary care: Nutrition, physical activity, emotional regulation, and family. European Eating Disorders Review, 28(2), 184–198. 10.1002/erv.270
    1. Silver, M. P. , & Cronin, S. M. (2019). Health care providers’ perspectives on family compliance and behavior change in a childhood obesity program. Health Education & Behavior, 46(4), 582–591. 10.1177/1090198119831053
    1. Skelton, J. A. , & Beech, B. M. (2011). Attrition in pediatric weight management: A review of the literature and new directions. Obesity Reviews, 12(5), e273–e281. 10.1111/j.1467-789X.2010.00803.x
    1. Skelton, J. A. , Goff, D. C., Jr. , Ip, E. , & Beech, B. M. (2011). Attrition in a multidisciplinary pediatric weight management clinic. Childhood Obesity, 7(3), 185–193. 10.1089/chi.2011.0010
    1. Skelton, J. A. , Van Fossen, C. , Harry, O. , & Pratt, K. J. (2020). Family dynamics and pediatric weight management: Putting the family into family‐based treatment. Current Obesity Reports, 9(4), 424–441.
    1. Sobradillo, B. , Aguirre, A. , Aresti, U. , Bilbao, A. , Fernández‐Ramos, C. , Lizarraga, A. , Lorenzo, H , Madariaga, L. , Rica, I. , Ruiz, I. , Sánchez, E. , Santamaría, C. , Serrano, J. M. , Zabala, A. , Zurimendi Y. B., & Hernández, M. (2004). Curvas y tablas de crecimiento. (Estudio longitudinal y transversal). Fundación Faustino Orbegozo.
    1. Spence, N. D. , Newton, A. S. , Keaschuk, R. A. , Ambler, K. A. , Jetha, M. M. , Holt, N. L. , & Ball, G. D. (2017). Predictors of short‐and long‐term attrition from the parents as agents of change randomized controlled trial for managing pediatric obesity. Journal of Pediatric Health Care, 31(3), 293–301. 10.1016/j.pedhc.2016.09.003
    1. Spence, N. D. , Skelton, J. A. , & Ball, G. D. (2020). A proposed standardized approach to studying attrition in pediatric weight management. Obesity Research & Clinical Practice, 14(1), 60–65. 10.1016/j.orcp.2019.11.004
    1. Spence, S. H. , Barrett, P. M. , & Turner, C. M. (2003). Psychometric properties of the spence children’s anxiety scale with young adolescents. Journal of Anxiety Disorders, 17(6), 605–625. 10.1016/S0887-6185(02)00236-0
    1. Staiano, A. E. , Marker, A. M. , Comeaux, J. , Frelier, J. M. , Hsia, D. S. , & Broyles, S. T. (2017). Family‐based behavioral treatment for childhood obesity: Caretaker‐reported barriers and facilitators. The Ochsner Journal, 17(1), 83–92.
    1. Staniford, L. J. , Copeland, R. J. , & Breckon, J. D. (2019). ‘What’s the point when you only lose a pound?’ Reasons for attrition from a multi‐component childhood obesity treatment intervention: A qualitative inquiry. Qualitative Research in Sport, Exercise and Health, 11(3), 382–397. 10.1080/2159676X.2018.1474375
    1. Vittrup, B. , & McClure, D. (2018). Barriers to childhood obesity prevention: Parental knowledge and attitudes. Pediatric Nursing, 44(2), 81–87.
    1. Wiedemann, G. , Rayki, O. , Feinstein, E. , & Hahlweg, K. (2002). The family questionnaire. Development and validation of a new self‐report scale for assessing expressed emotion. Psychiatry Research, 109(3), 265–279. 10.1016/S0165-1781(02)00023-9
    1. Williams, S. L. , Van Lippevelde, W. , Magarey, A. , Moores, C. J. , Croyden, D. , Esdaile, E. , & Daniels, L. (2017). Parent engagement and attendance in PEACH™ QLD–an up‐scaled parent‐led childhood obesity program. BMC Public Health, 17(1), 1–10. 10.1186/s12889-017-4466-6

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