Patient engagement and attrition in pediatric obesity clinics and programs: results and recommendations

Area of Science:

• Pediatric Endocrinology
• Obesity Medicine
• Healthcare Management

Background:

• Pediatric tertiary care centers offer intensive, multidisciplinary stage 3 treatment for pediatric obesity.
• High patient attrition rates present a significant challenge to the effective delivery of these interventions.
• Limited knowledge exists regarding specific practices employed by pediatric weight management clinics to minimize attrition.

Purpose of the Study:

• To survey pediatric weight management clinics and group-based programs on their methods for engaging and retaining obese children.
• To benchmark patient nonattendance rates at initial and follow-up visits among participating hospitals.
• To identify barriers to retention and contrast clinic-based versus group-based program results.

Main Methods:

• Survey of hospital members and non-members of FOCUS on a Fitter Future regarding patient engagement and retention techniques.
• Benchmarking activity focused on patient nonattendance rates at clinic visits.
• Comparative analysis of results from clinic-based and group-based programs.

Main Results:

• Group-based programs reported that most patients did not complete 50% of follow-up visits.
• Multiple patient/family-level barriers to retention were identified.
• Multiple clinic/program-level barriers to retention were identified.

Conclusions:

• Significant challenges exist in retaining pediatric patients in intensive weight management programs.
• Both patient/family factors and program-specific elements contribute to attrition.
• Successful retention techniques should inform the planning and improvement of pediatric obesity interventions.