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Individual, facility, and program factors affecting retention in a national weight management program.

Bonnie Spring, Min-Woong Sohn1, Sara M Locatelli

  • 1Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA. msohn@northwestern.edu.

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Summary

High attrition in weight loss programs is a challenge. Improving retention in the Veterans Health Administration

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Area of Science:

  • Obesity treatment effectiveness
  • Health services research
  • Behavioral health interventions

Background:

  • High attrition rates negatively impact weight loss program effectiveness.
  • The Veterans Health Administration's MOVE! Weight Management Program for Veterans (MOVE!) faces significant participant dropout.
  • Understanding factors influencing retention is crucial for program success.

Purpose of the Study:

  • To examine individual, facility, and program factors associated with participant retention in the on-site MOVE! group program.
  • To identify key determinants of dropout versus completion in a large-scale veteran weight management program.

Main Methods:

  • Utilized VHA outpatient database for visit data from the MOVE! group program.
  • Classified participants into early dropouts (1-3 visits), late dropouts (4-5 visits), and completers (6+ visits) within six months.
  • Employed a generalized ordered logit model to analyze retention factors.

Main Results:

  • Over 74% of participants did not complete the program (60% early, 11% late dropouts).
  • Factors associated with higher retention included older age, comorbidities, higher baseline BMI, no co-payment, proximity to VA facilities, individual consultation, increased staffing, and on-site physical activity.
  • High non-completion rates present a substantial barrier to reducing obesity prevalence within the VHA.

Conclusions:

  • Improving retention may involve enhancing individualized consultation accessibility.
  • Facility-level factors like staffing and physical activity resources are important for program completion.
  • Addressing accessibility and facility resources can mitigate high attrition rates in veteran obesity treatment.