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Patient Retention in Pediatric Weight Management Programs in the United States: Analyses of Data from the Pediatrics

Asheley Cockrell Skinner1,2, Haolin Xu2, Amy Christison3

  • 1Department of Population Health Sciences, Duke University, Durham, NC, USA.

Childhood Obesity (Print)
|August 20, 2021
PubMed

Insights

Patient retention in pediatric weight management (PWM) programs is challenging. While program characteristics showed little association with retention, non-Hispanic Black children had lower follow-up rates, and Hispanic children had higher rates.

Area of Science:

  • Pediatric Obesity and Weight Management
  • Public Health
  • Healthcare Disparities

Background:

  • Low patient retention in pediatric weight management (PWM) programs hinders achieving recommended provider contact hours.
  • Understanding factors influencing patient retention is crucial for program success and effective treatment delivery.

Purpose of the Study:

  • To investigate associations between individual patient characteristics, program attributes, and patient retention in multicomponent PWM programs.
  • To identify key determinants of sustained engagement in pediatric obesity interventions.

Main Methods:

  • Prospective longitudinal study of 6502 children (≤18 years) across 32 PWM programs.
  • Multivariable models with site-clustering random effects were used to analyze retention (any follow-up visit).
  • Examined associations between retention and patient demographics, insurance, and program characteristics.

Main Results:

  • Overall retention was 67% with at least one follow-up visit; 12% had four or more.
  • Non-Hispanic Black children showed lower retention (aOR=0.79) compared to non-Hispanic White children.
  • Hispanic children (any race) demonstrated higher retention (aOR=1.22); retention was similar across insurance types and unaffected by age, gender, weight status, or comorbidities.

Conclusions:

  • Few program characteristics were clearly linked to retention, suggesting diverse program formats can support engagement.
  • Patient-specific, unmeasured factors likely play a significant role in retention.
  • Improved strategies to identify and address individual patient barriers are necessary to enhance retention in PWM programs.

Keywords:
obesity treatmentpediatric obesityretention

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