Socio-demographic, anthropometric, and psychosocial predictors of attrition across behavioral weight-loss trials
Rachel W Goode, Lei Ye, Susan M Sereika, Yaguang Zheng, Meghan Mattos, Sushama D Acharya, Linda J Ewing, Cynthia Danford, Lu Hu, Christopher C Imes, Eileen Chasens, Nicole Osier, Juliet Mancino, Lora E Burke, Rachel W Goode, Lei Ye, Susan M Sereika, Yaguang Zheng, Meghan Mattos, Sushama D Acharya, Linda J Ewing, Cynthia Danford, Lu Hu, Christopher C Imes, Eileen Chasens, Nicole Osier, Juliet Mancino, Lora E Burke
Abstract
Preventing attrition is a major concern in behavioral weight loss intervention studies. The purpose of this analysis was to identify baseline and six-month predictors associated with participant attrition across three independent clinical trials of behavioral weight loss interventions (PREFER, SELF, and SMART) that were conducted over 10 years. Baseline measures included body mass index, Barriers to Healthy Eating, Beck Depression Inventory-II (BDI), Hunger Satiety Scale (HSS), Binge Eating Scale (BES), Medical Outcome Study Short Form (MOS SF-36 v2) and Weight Efficacy Lifestyle Questionnaire (WEL). We also examined early weight loss and attendance at group sessions during the first 6 months. Attrition was recorded at the end of the trials. Participants included 504 overweight and obese adults seeking weight loss treatment. The sample was 84.92% female and 73.61% white, with a mean (± SD) age of 47.35 ± 9.75 years. After controlling for the specific trial, for every one unit increase in BMI, the odds of attrition increased by 11%. For every year increase in education, the odds of attrition decreased by 10%. Additional predictors of attrition included previous attempts to lose 50-79 lbs, age, not possessing health insurance, and BES, BDI, and HSS scores. At 6 months, the odds of attrition increased by 10% with reduced group session attendance. There was also an interaction between percent weight change and trial (p<.001). Multivariate analysis of the three trials showed education, age, BMI, and BES scores were independently associated with attrition (ps ≤ .01). These findings may inform the development of more robust strategies for reducing attrition.
Trial registration: ClinicalTrials.gov NCT00277771 NCT00330629 NCT00896194.
Keywords: Attrition; Binge eating; Weight loss.
Copyright © 2015 Elsevier Ltd. All rights reserved.
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Source: PubMed