Adherence to behavioral targets and treatment attendance during a pediatric weight control trial

Abstract

Better weight loss outcomes are achieved in adults and youth who adhere to obesity treatment regimens (i.e., session attendance and prescribed changes in weight control behaviors). However, more research is needed regarding children’s adherence to a range of behaviors relevant for weight maintenance over long-term follow-up. Overweight children (N=101, aged 7-12 years), along with an overweight parent, participated in a 20-week family-based behavioral weight loss treatment (FBT) and were then assigned to either a behaviorally-focused or socially-focused 16-week weight maintenance treatment (MT). Treatment attendance and child and parent adherence (i.e., reported use of skills targeted within treatment) were examined in relation to child percent overweight change from baseline to post-FBT, post-MT, and 2-year follow-up. Higher attendance predicted better child weight outcomes at post-MT, but not at 2-year follow-up. Adherence to self-regulatory skills/goal-setting skills predicted child weight outcomes at 2-year follow-up among the behaviorally-focused MT group. Future research is needed to examine mediators of change within family-based weight control interventions, including behavioral and socially-based targets. Incorporating self-regulatory weight maintenance skills into a comprehensive MT may maximize children’s sustained weight control.

Adherence to a lifestyle program for youth with type 2 diabetes and its association with treatment outcome in the TODAY clinical trial

“…The current analysis indicates that attendance rates in each of the 3 phases of the TODAY intervention averaged about 60% of the planned sessions; further, more than half of the sample attended 75% or more of the intervention sessions. These rates of attendance are similar to those obtained in other pediatric obesity clinical trials that have focused on youth without diabetes 3‐5 . For example, Kalarchian et al observed an attendance rate of 63% at sessions over a 6‐month period, with ≥75% attendance by 50% of the youth, and attendance was significantly associated with weight loss.…”

“…Session attendance has been used in several pediatric obesity trials as a proxy for program adherence 3‐5 . The current analysis indicates that attendance rates in each of the 3 phases of the TODAY intervention averaged about 60% of the planned sessions; further, more than half of the sample attended 75% or more of the intervention sessions.…”

“…Findings in the pediatric obesity literature have documented a relationship between proxies for lifestyle program adherence, such as session attendance and compliance with self‐monitoring of food intake and physical activity, and program outcomes. Higher levels of session attendance have been shown to be related to greater decreases in child percent overweight 3‐5 . Self‐monitoring also has been shown to be associated with successful weight management in adolescents with obesity and minority youth with severe obesity .…”

“…Higher levels of session attendance have been shown to be related to greater decreases in child percent overweight. [3][4][5] Self-monitoring also has been shown to be associated with successful weight management in adolescents with obesity 6 and minority youth with severe obesity. 7 Further, there is some evidence that parent self-monitoring is related to short-term weight losses among adolescents.…”

Determinants of Implementation Effectiveness in a Physical Activity Program for Church-Going Latinas

“…Previous literature suggests that mean participation rates in family-based prevention and control programs typically range from 59% to 85% and are an important predictor of subsequent changes in program outcomes such as physical activity and BMI. 36-39 Consistent with this literature, a cut-point of approximately 65% was set for differentiating between churches with high vs. low average participation rates. Finally, qualitative data were compared to quantitative assessments of implementation effectiveness to identify church-specific factors most salient to implementation of Faith in Action (see Tables 3 and 4).…”