title: Reasons for non-return to a pediatric weight management program.
abstract: OBJECTIVE
  Obesity in childhood has become a major public health concern because of increasing rates of overweight and obesity. To address this epidemic, effective dietetic interventions must be developed. We examined parent/caregiver and/or patient reasons for not returning for follow-up clinical care in the Alberta Health Services, Edmonton Area's Nutrition Services Pediatric Weight Management Program (NS PWMP) in Edmonton, Alberta.
  
  
  METHODS
  A qualitative telephone survey was developed to identify reasons for non-return to the NS PWMP. Face validity was evaluated by five pediatric registered dietitians (RDs).
  
  
  RESULTS
  The survey was administered to parents/caregivers of children or adolescents aged 2.5 to 14.2 years (n=21) who attended fewer than two appointments in the NS PWMP. The major reasons for non-return included physical barriers (scheduling, parking, location), organizational barriers (clinic environment), and program educational content (type of educational tools, the focus of lifestyle education on the individual rather than the family, physical activity interventions, and appropriateness of information for the parent or child).
  
  
  CONCLUSIONS
  Development and delivery of effective dietetic interventions for children and adolescents at risk of overweight and obesity may be achieved by emphasizing skill building within the child and the family. Analysis of child and family feedback on clinical RD services is critical to optimization of care in a pediatric weight management program.
authors.affiliation: Nutrition Services, Regional Nutrition and Food Services, Alberta Health Services, Edmonton Area, AB, Canada.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Kitscha
authors.forename: Kim
authors.initials: K
authors.lastname: Brunet
authors.forename: Anna
authors.initials: A
authors.lastname: Farmer
authors.forename: Diana R
authors.initials: DR
authors.lastname: Mager
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000193:education / Q000523:psychology*; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D050177:Overweight / Q000517:prevention & control; D010290:Parents / Q000193:education / Q000523:psychology*; D010349:Patient Compliance; D011634:Public Health; D020377:Self Efficacy; D016896:Treatment Outcome; D015431:Weight Loss