Clinical Research Program Coordinator Nationwide Childrens Hosptial Columbus, OH 43206-1727, Ohio, United States
Background: Attrition in pediatric weight management (PWM) clinics is often high, meaning patients tend not to return after their first or second visit. There is limited data on caregiver-level factors that may affect attrition in PWM visits for school-aged children (aged 6-11 years old). Objective: This study aims to determine possible caregiver factors such as age, income, education, and baseline scale scores on caregiver-provider communication that may lead to higher attrition in PWM clinics. Design/Methods: We conducted an exploratory analysis of a longitudinal study examining the caregiver-level predictors of attrition in PWM visits. Caregivers of children 6-11 years were recruited from a PWM clinic at Nationwide Children’s Hospital. Retention was measured by the number of visits attended within 12 months. Quantitative surveys were given to caregivers following their child’s PWM visit to determine predictors of attrition. Validated measures included: the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE; range 5-35), Working Alliance Inventory (WAI-SR; range 12-60). Participants were categorized into 3 groups based on the total number of visits completed: 1–2, 3–4, and 5–6 visits. Baseline demographic characteristics and scale scores were summarized for each group. Continuous variables were described using medians and interquartile ranges (IQRs), while categorical variables were summarized as frequencies and percentages. Differences across visit groups were evaluated using the Kruskal–Wallis test for continuous variables and Pearson’s chi-square test for categorical variables. A two-sided p-value < 0.05 was considered statistically significant. Results: Of the 56 enrolled caregivers, the median age was 38 (IQR: 32-42) years; most caregivers self-reported as white (n=34, 61.8%); and most caregivers (n=29, 51.7%) reported an income below $50,000. Almost all participants (n = 54, 96.4%) had completed at least a high school education. Most caregivers reported that their healthcare provider had high levels of empathy (median [IQR] score of 35 [31-35]) and a strong therapeutic alliance (median [IQR] score of 56 [49, 60]). There were no statistically significant differences in demographic variables or scale scores (p > 0.05) for all comparisons.
Conclusion(s): Participants who attended more sessions did not differ from those with fewer visits in terms of age, income, education, or baseline scale scores. Qualitative interviews may be needed to determine the reasoning behind high attrition rates in PWM clinics.
