Table 2.
Attrition in paediatric obesity treatment studies
| Study | n | Study description | Attrition | Comments |
|---|---|---|---|---|
| Ebbeling et al. 2003 (45) | 16 | Randomized controlled trial comparing low-glycemic index diet vs. energy restricted, low-fat diet, aged 13–21 years, 6 month individual session intervention and 6-month follow-up | 12.5% | Small but well designed RCT with process evaluation and thorough study of outcomes No difference between control or intervention group, including attendance, with groups attending 9.4 ± 0.6 of the 12 planned sessions |
| Levine et al. 2001 (36) | 24 | Feasibility study of family-based intervention Families with children aged 8–12 years, 10–12 session, group behavioural intervention, three cohorts |
33% | Small study of family-based intervention following psychosocial factors, with no mention of study power No control group Dropout occurred early (mean of 2.3 ± 1.3 visits) No differences found between completers and dropouts aside from race (significantly more African–American, 67%, vs. Caucasian families, 22% dropped out, P = 0.05) Attrition highest in first cohort (55%), decreased in second and third cohorts (17%, 22%) |
| Resnicow et al. 2000 (35) | 57 | Feasibility study using group sessions, weekly to twice weekly for 6 months, intervention focused on healthy behaviours using social cognitive theory, community-based, aged 11–17 years | 45% attrition rate 43% attendance at sessions 54% of participants classified as ‘low attenders’ |
Developmental study, no control group No differences between low attenders and high attenders aside from high-density lipoprotein cholesterol and diastolic blood pressure |
| Savoye et al. 2007 (37) | 209 | Parallel, randomized, controlled trial of group weight management programme vs. control (less intense intervention, every 6 months visit to outpatient clinic), twice weekly to every other week for 1 year, aged 8–16 years | Intervention: 18% at 6 months, 29% at 12 months Control: 26% at 6 months, 33% at 12 months |
Large, well-designed RCT with control group Adequately powered to assess weight outcomes Original randomization modified after 83% dropped out of structured meal planning at 6 months. No statistical differences in attrition rates among racial/ethnic groups |
| Schwartz et al. 2007 (38) | 91 | Feasibility study of motivational interviewing (MI) in primary care paediatric office with overweight children (body mass index 85th–95th percentile) 3–7 years of age Individual visits in 3-tier intervention: control (routine care), minimal (MD only with MI), intensive (MD, RD with MI) |
33% overall 10% in control 32% in minimal intervention 50% in intensive intervention |
True feasibility study with control group No differences between dropouts and completers in age, gender, body mass index percentiles |
RCT, Randomized Controlled Trial; MI, Motivational Interviewing; RD, Registered Dietitian.