Open AccessPredictors of Engagement in a Pediatric Weight Management Clinic after Referral
Author(s) -
Callie L. Brown,
Jaclyn Dovico,
Dara Garner-Edwards,
M. J. Moses,
Joseph A. Skelton
Publication year - 2020
Publication title -
childhood obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 38
eISSN - 2153-2176
pISSN - 2153-2168
DOI - 10.1089/chi.2020.0032
Subject(s) - medicine , medicaid , confidence interval , referral , odds ratio , logistic regression , ethnic group , demography , attendance , medical record , multivariate analysis , affect (linguistics) , family medicine , pediatrics , health care , psychology , communication , sociology , anthropology , economics , economic growth
Background: Little is known about factors that affect a family's ability to engage in pediatric weight management clinics (PWMCs). We aimed at comparing child and family characteristics of patients referred to a PWMC by participants' attendance at orientation, attendance at intake, or completing the program. Methods: We performed a retrospective study of patients ages 2-18 years referred to a PWMC between 2014 and 2017. We extracted data from electronic medical records and clinic databases, including age, sex, race/ethnicity, language, referral year, address, and insurance. We performed t -tests and chi-square tests to examine the association of engagement outcomes with covariates. We used separate multivariate logistic regression models to assess the predictors of engagement outcomes, including significant covariates from bivariate analyses. Results: Participants ( N = 2020 referred) had a mean age of 11.5 ± 3.5 years; 72% had Medicaid, and 34% lived in city limits. Participants were 39% white, 30% black, and 27% Hispanic. Of those referred, 41% attended orientation, 14% attended intake, and 9% completed. Significant predictors of attending orientation were age [odds ratio (OR): 0.93, 95% confidence interval (CI): 0.91-0.96], male sex (OR: 0.74, 95% CI: 0.60-0.91), Hispanic ethnicity (OR: 1.69, 95% CI: 1.26-2.26), living in city limits (OR: 1.39, 95% CI: 1.11-1.75), and Medicaid (OR: 0.77, 95% CI: 0.60-0.98). Significant predictors of attending intake were age (OR: 0.93, 95% CI: 0.90-0.96), Medicaid (OR: 0.61, 95% CI: 0.46-0.81), and 2017 referral year (OR: 0.21, 95% CI: 0.12-0.35). Hispanic ethnicity was associated with twice the odds of completion (OR: 2.07, 95% CI: 1.10-3.91). Conclusions: Child and family characteristics more strongly predicted initial engagement with a PWMC than completion. Future research should examine how targeting these predictors ( e.g. , referring at younger age) can improve PWMC engagement.