Parent and child factors influencing attendance in a community-based obesity intervention

Increasing evidence suggests that community-based, family-centered childhood obesity treatment programs are effective in improving weight status and reducing rates of childhood overweight or obesity. Research has positively linked program attendance and completion with success in BMI reduction; however, with attrition rates averaging around 41%, it is imperative that programs are designed to facilitate successful adherence to the program. The Texas Childhood Obesity Research Demonstration (TX CORD) project is a study to prevent obesity among low-income children aged 2-12. Obesity prevention in TX CORD was operationalized through primary (community-wide) and secondary (targeted) prevention programs. The secondary prevention included a one-year intervention, with an initial 3 months of intensive intervention (MEND/CATCH) followed by 9 months of a transition program. The objective of this study was to utilize data from the 3-month intensive phase of the secondary prevention component of the TX CORD project to understand which factors influence parent and child attendance. Attendance was analyzed both as a continuous variable (the number of sessions attended) as well as a categorical variable (attendance at \u3c 40% of sessions versus ≥ 40% of sessions). Preliminary bivariate analyses examined the association between attendance and various independent variables, including parent and child demographic and health behavior data. Variables significantly associated with attendance were entered into multiple linear and logistic regression models to identify independent predictors of attendance. Parental obesity was the most significant contributor to poorer attendance (β= -0.23, -0.31, -0.30; OR=10.20, 12.66, 13.98 for Class I, Class II, and Class III obesity, respectfully), followed by foreign-born parents (β= 0.25), relatively higher annual household income (β= 0.24, OR=0.68), younger child age (β= -0.17), and increased number of children in the household (OR= 1.45). Childhood obesity intervention design must consider the factors that both positively and negatively influence attendance to effectively improve programs to better engage participants and reduce barriers to attendance