Analysis of Patient Stages of Change and Health Outcomes in 215GO!

Objectives: To examine the relationship between the subjects’ stages of change at their initial visits and their return to the clinic for subsequent visits. To examine the relationship between changes in the subjects’ stages of change and changes in their health outcome measures. To examine the relationship between the subjects’ demographics and their stages of change.Methods: A retrospective cohort study using information from the 215GO! childhood obesitydatabase was conducted. Relevant patient information was retrieved from the 215GO! database at each health center and compiled into one complete dataset. Descriptive and inferential analyses were conducted using SAS 9.1.3.Results: There were 843 participants in this study. Of these participants, 88% were overweight or obese, 7% were hypertensive, and 6% were hyperlipidemic. Approximately 46% did not return to the clinic after their initial visit. Hispanic participants were more likely to return for three or more subsequent 215GO! visits than other race/ethnicities. At baseline, 31% of youthswere in the preparation stage, 12% were in the action stage, 9% were in the pre-contemplation and contemplation stages, and 48% of participants were missing data on initial stage of change. Initial stage of change was not associated with number of return visits in bivariate or multivariateanalysis: adjusted odds ratio = 1.04 (95% confidence interval = 0.73, 1.49). Models were adjusted for age, sex, race/ethnicity, insurance type, and health center attended.Conclusion: Stage of change was not associated with patients returning to 215GO! for subsequent visits. It was found that most patients are in the preparation stage at their initial clinic visit, indicating they intend to undergo behavioral changes toward a healthier lifestyle within the next month. Despite an apparent readiness to change their behaviors, nearly half ofthe children appeared to face some barrier to returning to the 215GO! clinic. Thus, the staff were unable to engage the children in the program’s standard services. A restructuring of 215GO! toprovide intensive services on the first visit and to increase health and nutrition services during all health center visits should be considered.M.P.H., Public Health -- Drexel University, 201