title: Reasons for (non)participating in a telephone-based intervention program for families with overweight children.
abstract: OBJECTIVE
  Willingness to participate in obesity prevention programs is low; underlying reasons are poorly understood. We evaluated reasons for (non)participating in a novel telephone-based obesity prevention program for overweight children and their families.
  
  
  METHODS
  Overweight children and adolescents (BMI>90(th) percentile) aged 3.5-17.4 years were screened via the CrescNet database, a representative cohort of German children, and program participation (repetitive computer aided telephone counseling) was offered by their local pediatrician. Identical questionnaires to collect baseline data on anthropometrics, lifestyle, eating habits, sociodemographic and psychosocial parameters were analyzed from 433 families (241 participants, 192 nonparticipants). Univariate analyses and binary logistic regression were used to identify factors associated with nonparticipation.
  
  
  RESULTS
  The number of overweight children (BMI>90(th) percentile) was higher in nonparticipants than participants (62% vs. 41.1%,p<0.001), whereas the number of obese children (BMI>97(th) percentile) was higher in participants (58.9% vs.38%,p<0.001). Participating girls were younger than boys (8.8 vs.10.4 years, p<0.001). 87.3% and 40% of participants, but only 72.2% and 24.7% of nonparticipants, respectively, reported to have regular breakfasts (p = 0.008) and 5 regular daily meals (p = 0.003). Nonparticipants had a lower household-net-income (p<0.001), but higher subjective physical wellbeing than participants (p = 0.018) and believed that changes in lifestyle can be made easily (p = 0.05).
  
  
  CONCLUSIONS
  An important reason for nonparticipation was non-awareness of their child's weight status by parents. Nonparticipants, who were often low-income families, believed that they already perform a healthy lifestyle and had a higher subjective wellbeing. We hypothesize that even a low-threshold intervention program does not reach the families who really need it.
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Alff
authors.forename: Jana
authors.initials: J
authors.lastname: Markert
authors.forename: Silke
authors.initials: S
authors.lastname: Zschaler
authors.forename: Ruth
authors.initials: R
authors.lastname: Gausche
authors.forename: Wieland
authors.initials: W
authors.lastname: Kiess
authors.forename: Susann
authors.initials: S
authors.lastname: Blüher
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005190:Family; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control*; D011788:Quality of Life; D045808:Refusal to Participate / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013689:Telephone