Parent Binge Eating and Depressive Symptoms as Predictors of Attrition in a Family-Based Treatment for Pediatric Obesity

Braden, Abby; Madowitz, Jennifer; Matheson, Brittany E.; Bergmann, Kristie; Crow, Scott J.; Boutelle, Kerri N.

doi:10.1089/chi.2014.0109

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…These behavioral interventions are associated with short-term weight reduction for participating children (Jull & Chen, 2013; Oude Luttikhuis et al, 2009). Family-based approaches to behavioral intervention incorporate families into treatment approaches and acknowledge the role of parents in guiding behavior (Braden et al, 2015; Epstein, Paluch, Roemmich, & Beecher, 2007). These approaches to intervention have demonstrated the greatest benefit for sustained, long-term health outcomes compared to other behavioral approaches (Boutelle, Cafri, & Crow, 2012; Braden et al, 2015; Heinberg et al, 2010; Skelton, Buehler, Irby, & Grzywacz, 2012;).…”

mentioning

confidence: 99%

“…Family-based approaches to behavioral intervention incorporate families into treatment approaches and acknowledge the role of parents in guiding behavior (Braden et al, 2015; Epstein, Paluch, Roemmich, & Beecher, 2007). These approaches to intervention have demonstrated the greatest benefit for sustained, long-term health outcomes compared to other behavioral approaches (Boutelle, Cafri, & Crow, 2012; Braden et al, 2015; Heinberg et al, 2010; Skelton, Buehler, Irby, & Grzywacz, 2012;). However, evidence suggests that sustained weight loss success is often not achieved by participants in childhood obesity intervention programs due to low adherence and other factors, such as high attrition, that threaten meaningful participation (Oude Luttikhuis et al, 2009; Twiddy, Wilson, Bryant, & Rudolf, 2012).…”

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confidence: 99%

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Health Care Providers’ Perspectives on Family Compliance and Behavior Change in a Childhood Obesity Program

Silver

Cronin

2019

Health Educ Behav

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Background. Evidence suggests that children and adolescents growing up in low-income families and those with underrepresented ethnocultural backgrounds tend to have high prevalence rates of obesity and more difficulty adhering to childhood obesity interventions. However, less is known about how intergenerational, family-based approaches to lifestyle interventions for childhood obesity support sustained behavior change. Aims. The aim of this study was to explore the perspectives of health care providers regarding family adherence and behavior change in a childhood obesity program that served ethnoculturally diverse and low-income families. Method. Semistructured in-person interviews were conducted with 18 providers at one of three hospitals participating in a Canadian family-based childhood obesity program. Data were thematically analyzed using a constant comparative approach. Results. The following key themes emerged as challenges from the provider’s perspective for family adherence and behavior modification in the childhood obesity program: divergent views about obesity, complicated lives and logistical priorities, parental role modeling, and intergenerational tensions. Discussion and Conclusion. This examination of providers’ perspectives on family adherence and behavior modification relevant to the management of childhood obesity highlight the importance of tailoring childhood obesity programs to the complex and diverse needs of families from diverse backgrounds. Recommendations include methods of service delivery that address logistical challenges and are better suited to extended families, particularly grandparents.

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confidence: 99%

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confidence: 99%

Health Care Providers’ Perspectives on Family Compliance and Behavior Change in a Childhood Obesity Program

Silver

Cronin

2019

Health Educ Behav

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“…Furthermore, associations among parental binge eating, restrictive parental feeding practices and child weight, suggest that interventions focusing on parental feeding practices might improve pediatric obesity. In addition to the potential modeling or transmission of eating‐disorder behaviors to youth, parental binge eating and obesity have treatment implications for youth, as they are associated with attrition from pediatric obesity treatment . This, taken together with parents' misguided attempts to improve weight and control over eating through weight‐criticism and focus on weight, suggests the merits of co‐occurring parent and child treatment, or family treatment, to improve outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the potential modeling or transmission of eating-disorder behaviors to youth, parental binge eating and obesity have treatment implications for youth, as they are associated with attrition from pediatric obesity treatment. 47,48 This, taken together with parents' misguided attempts to improve weight and control over eating through weight-criticism and focus on weight [9][10][11][12][13] , suggests the merits of co-occurring parent and child treatment, or family treatment, to improve outcomes.…”

Section: Discussionmentioning

confidence: 99%

Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight

Lydecker

Grilo

2016

Intl J Eating Disorders

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Objective A limited literature suggests an association between parental eating disorders and child eating-disorder behaviors although this research has focused primarily on restrictive-type eating disorders and very little is known about families with binge-eating disorder. Methods The current study focused on parents (N=331; 103 fathers and 226 mothers), comparing parents with core features of binge-eating disorder (BED; n=63) to parents with obesity and no eating disorder (OB; n=85) and parents with healthy-weight and no eating disorder (HW; n=183). Results Parents with BED were significantly more likely than OB and HW parents to report child binge eating, and more likely than HW parents to report child overeating. Parents with BED felt greater responsibility for child feeding than OB parents, and felt more concern about their child's weight than OB and HW parents. Dietary restriction of the child by the parents was related to child binge eating, overeating, and child overweight, and parental group was related to child binge eating (parental BED), overeating (parental BED) and child weight (parental OB). Conclusion Parents with BED report greater disturbance in their children's eating than OB and HW parents, and OB parents report higher child weight than HW parents. This suggests that it is important to consider both eating-disorder psychopathology and obesity in clinical interventions and research. Our cross-sectional findings, which require experimental and prospective confirmations, provide preliminary evidence suggesting potential factors in families with parental BED and obesity to address in treatment and prevention efforts for pediatric eating disorders and obesity.

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“…race/ethnicity, insurance status and patient and parental body mass index [BMI]) , programme logistics and content (e.g. inconvenient appointment times and unclear expectations) and behavioural and mental health problems in both caregivers and patients . Methods to address attrition have shown variable impact .…”

Section: Introductionmentioning

confidence: 99%

Outcomes from an orientation model to reduce attrition in paediatric weight management

et al. 2016

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We aimed to reduce attrition of newly referred patients in a pediatric weight management program by implementing an Orientation to address families’ expectations and screen for and support behavioral and mental health problems and psychosocial stressors at program outset. Orientation impact was monitored with run charts with percentages of scheduled encounters completed. Long-term impact was assessed by comparing patients in the initial 6 months of the Orientation to a baseline group of referred patients during the same 6-month time interval in the prior year (Pre-Orientation Group). The outcome measure was program attrition within 15 months. Groups were compared using Kaplan-Meier survival analysis and Cox proportional hazards regression modeling. Patients in the Orientation group had a 23% increased odds of attrition compared to patients in the Pre-Orientation group (aHR 1.23; 95% CI 1.01, 1.51) and shorter median duration of follow-up (2.0 vs. 2.9 months, p=0.004). An increase in BMI z-score of 1 unit resulted in a nearly 5-fold increased odds of attrition (aHR 5.24; 95% CI 2.95, 9.3). An orientation for new patients did not reduce attrition within 15 months. We suggest that ongoing retention strategies should be embedded into the treatment phase of the program.

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Parent Binge Eating and Depressive Symptoms as Predictors of Attrition in a Family-Based Treatment for Pediatric Obesity

Cited by 5 publications

References 35 publications

Health Care Providers’ Perspectives on Family Compliance and Behavior Change in a Childhood Obesity Program

Health Care Providers’ Perspectives on Family Compliance and Behavior Change in a Childhood Obesity Program

Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight

Outcomes from an orientation model to reduce attrition in paediatric weight management

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