Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study
P De Miguel-Etayo 1 2 3 , C Muro 2 , J Santabárbara 4 5 , R López-Antón 6 , G Morandé 7 , M Martín-Matillas 8 9 , M C Azcona-San Julián 10 11 , A Martí 11 12 13 , C Campoy 14 15 , A Marcos 16 , L A Moreno 1 2 , J M Garagorri 1 3 , EVASYON Study Group
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.