Determinants of dropout and compliance of children participating in a multidisciplinary intervention programme for overweight and obesity in socially deprived areas.
Hevy Hassan, Selinde Snoeck Henkemans, Jolande van Teeffelen, Kees Kornelisse, Patrick J E Bindels, Bart W Koes, Marienke van Middelkoop
Author Information
Hevy Hassan: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. ORCID
Selinde Snoeck Henkemans: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Jolande van Teeffelen: Dietician Practice in Primary Care, diëtistenpraktijk HRC, Rotterdam, The Netherlands.
Kees Kornelisse: Fysiotherapie Heemraadssingel, Rotterdam, The Netherlands.
Patrick J E Bindels: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Bart W Koes: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. ORCID
Marienke van Middelkoop: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
BACKGROUND: Children with overweight and obesity in socially deprived areas (SDAs) are less likely to complete and be compliant to a weight-loss programme. OBJECTIVES: To identify factors associated with dropout and compliance of a multidisciplinary weight-loss programme in SDA. METHODS: This prospective longitudinal cohort study included children (6-12 years) with overweight and obesity in a 12-week multidisciplinary intervention living in SDA in Rotterdam, the Netherlands. Potential predictive variables for dropout and compliance included were age, sex, the weight of the child and parents, quality of life, and referral status (self-registration or referral). A Cox proportional hazards model was performed to study the association between dropout and its potential predictive variables, whereas logistic regression analyses were used for the potential predictors for compliance. RESULTS: A total of 121 children started the intervention programme. Forty-one (33.9%) children dropped out and 68 (56.2%) were compliant with the intervention. The risk of dropping out of the intervention was significantly lower for a child with overweight parents than for those with parents with normal weight (adjusted hazard ratio [HR] 0.22 [95% confidence interval, CI 0.063-0.75]), and for those with parents with obesity (adjusted HR 0.18 [95% CI 0.060-0.52]). No other potential predictive variables were associated with dropout or compliance. CONCLUSION: Children from SDA participating in a weight-loss programme have a relatively high dropout and a low compliance rate. Parental weight seems to be an important predictor for dropout of children from SDA, where children with normal weight or obese parents have the highest risk of dropout compared with children of overweight parents.
