Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study
De Miguel-Etayo P (1,2,3), Muro C (2), Santabárbara J (4,5), López-Antón R (6), Morandé G (7), Martín-Matillas M (8,9), Azcona-San J M (10,11), Martí A (11,12,13), Campoy C (14,15), Marcos A (16), Moreno LA (1,2), Garagorri JM (1,3).
(1) GENUD (Growth, Exercise, NUtrition and Development) Research Group. Universidad de Zaragoza, Zaragoza, Spain.
(2) Department of Physiatry and Nursing, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2) C/ Domingo Miral s/n, Universidad de Zaragoza, Zaragoza, Spain.
(3) Department of Pediatrics, Faculty of Medicine, C/ Domingo Miral s/n, Universidad de Zaragoza, Zaragoza, Spain.
(4) Department of Microbiology, Preventive Medicine and Public Health, Faculty of Sports and Health Sciences, Universidad de Zaragoza, Huesca, Spain.
(5) Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.
(6) Department of Psychology and Sociology, Faculty of Social and Human Sciences, Universidad de Zaragoza, Campus Ciudad Escolar, Teruel, Spain.
(7) Unit of Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
(8) Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
(9) PROFITH (PROmoting FITness and Health through physical activity) Research Group, University of Granada, Granada, Spain.
(10) Pediatric Endocrinology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain.
(11) Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
(12) Department of Food Sciences, Nutrition and Physiology, Universidad of Navarra, Pamplona, Navarra, Spain.
(13) CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
(14) Department of Pediatrics, Faculty of Medicine, University of Granada, Granada, Spain.
(15) EURISTIKOS Centre for Excellence in Pediatric Research, Biomedical Research Centre, Health Sciences Technology Park, University of Granada, Granada, Spain.
(16) Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain.
The aims of this study were to identify the cognitive and behavioral predictors of dropping-out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents.
Overweight/obese adolescents (n=156, aged: 13 to 16 years; 71 males, 85females) were included in a multi-component (diet, physical activity and psychological support) family-based group treatment program.
At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%).
The risk of dropping-out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (OR=1.20, 95%CI=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping-out (OR= 0.87, 95%CI=0.77-0.99, P=0.040).
Adolescents' social insecurity was the main predictor of drop-out in a multi-component family-group based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, while the family's awareness of eating-related behavior needs adjustment.
CITA DEL ARTÍCULO Int J Obes (Lond). 2015 Sep 18. doi: 10.1038/ijo.2015.183