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Ethnicity, insurance type, and follow-up in a pediatric weight management program
Andrew M Tershakovec1, Kerri Kuppler
1The Children's Hospital of Philadelphia, Division of Gastroenterology and Nutrition Philadelphia, Pennsylvania 19104, USA. tersh@mail.med.upenn.edu
Objective:
To assess the characteristics of children and adolescents who drop out of a clinical weight management program.
Research Methods And Procedures:
A retrospective survey of children and adolescents attending a pediatric weight management program [n = 518; mean +/- SEM: age 10.4 +/- 0.2 years, BMI z-score 4.9 +/- 0.1, 62% female, 41% African American and 57% white] was undertaken. Characteristics of children (age, relative weight, gender, and ethnicity) who dropped out of the program were compared with characteristics of those who continued beyond the initial assessment as a function of type of insurance.
Results:
The children who dropped out of the program after the initial assessment differed by ethnicity from those who continued in the program: 63% of white children returned for more than one visit, whereas only 35% of the African-American children continued in the program. Indemnity insurance coverage was associated with more clinic visits, as compared with managed care insurance. The association between insurance type and clinic visit number was of borderline significance (p = 0.06), when ethnic group was added to this analysis.
Discussion:
Ethnicity is associated with attendance in a Pediatric Weight Management Program. Given the epidemic of obesity in children and adolescents, issues related to program compliance must be assessed to improve overall outcome. This is especially important given the high rate of obesity among African Americans and the low rate of ongoing attendance observed among African Americans in the Weight Management Program.