Individual, facility, and program factors affecting retention in a national weight management program

Abstract

BackgroundHigh attrition is a common problem for weight loss programs and directly affects program effectiveness. Since 2006, the Veterans Health Administration (VHA) has offered obesity treatment to its beneficiaries through the MOVE! Weight Management Program for Veterans (MOVE!). An early evaluation of this program showed that attrition rate was high. The present study examines how individual, facility, and program factors relate to retention for participants in the on-site MOVE! group program.MethodsData for all visits to MOVE! group treatment sessions were extracted from the VHA outpatient database. Participants were classified into three groups by their frequency of visits to the group program during a six month period after enrollment: early dropouts (1 – 3 visits), late dropouts (4 – 5 visits), and completers (6 or more visits). A generalized ordered logit model was used to examine individual, facility, and program factors associated with retention.ResultsMore than 60% of participants were early dropouts and 11% were late dropouts. Factors associated with retention were older age, presence of one or more comorbidities, higher body mass index at baseline, lack of co-payment requirement, geographic proximity to VA facility, addition of individual consultation to group treatment, greater program staffing, and regular, on-site physical activity programming. A non-completion rate of 74% for on-site group obesity treatment poses a major challenge to reducing the population prevalence of obesity within the VHA.ConclusionsGreater attention to individualized consultation, accessibility to the program, and facility factors including staffing and physical activity resources may improve retention.

Predictors of Retention Among African Americans in a Randomized Controlled Trial to Test the Healthy Eating and Active Living in the Spirit (HEALS) Intervention

“…11 Factors that have been identified as influencing retention in weightloss trials include age, sex, race, distance to intervention site, cognitive impairment, occupational status, education, socioeconomic status, smoking, physical activity level and depression. 9,[16][17][18][19] A review of 50 studies of AAs in clinical trials identified barriers to retention including lack of a study partner, lower educational level, and lack of compensation. 20 An earlier study conducted by our team found that a decentralized CBPR approach led to intervention…”

Derivation and Evaluation of a Risk-Scoring Tool to Predict Participant Attrition in a Lifestyle Intervention Project

“…A range of factors has been associated with risk of participant attrition in longitudinal studies (Blanton et al 2006; Brown et al 2006; Clark et al 1996; Dalle Grave et al 2005; Fabricatore et al 2009; Fitzpatrick et al 2014; Honas et al 2003; Kong et al 2010; Manson et al 2011; McGuigan et al 2003; O–Brien et al 2012; WarrenFindlow et al 2003; Williams et al 2008). With respect to lifestyle interventions to promote weight loss, multiple studies have attempted to identify baseline factors that predict the risk of participant attrition (Fabricatore et al 2009; Fitzpatrick et al 2014; Honas et al 2003; Rothberg et al 2015; Spring et al 2014). Most lifestyle intervention projects that investigated this issue had relatively small sample size with younger age being the most consistent predictor for attrition in those studies.…”

Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial

“…Finally, these findings highlight that phone-based coaching is a viable treatment modality for increasing access. Moving forward, combining evidence from this and other evaluations to date, [46][47][48][49][50] the VA can continue their leadership in developing effective and cutting-edge population-based initial treatment and long-term continuous-care weight management programs for US veterans.…”