title: Parent perspectives on attrition from tertiary care pediatric weight management programs.
abstract: OBJECTIVE
  To describe parent/caregiver reasons for attrition from tertiary care weight management clinics/programs.
  
  
  METHODS
  A telephone survey was administered to 147 parents from weight management clinics/programs in the National Association of Children's Hospitals and Related Institutions' (now Children's Hospital Association's) FOCUS on a Fitter Future II collaborative.
  
  
  RESULTS
  Scheduling, barriers to recommendation implementation, and transportation issues were endorsed by more than half of parents as having a moderate to high influence on their decision not to return. Family motivation and mismatched expectations between families and clinic/program staff were mentioned as influential by more than one-third. Only mismatched expectations correlated with patient demographics and program characteristics. [corrected].
  
  
  CONCLUSIONS
  Although limited by small sample size, the study found that parents who left geographically diverse weight management clinics/programs reported similar reasons for attrition. Future efforts should include offering alternative visit times, more treatment options, and financial and transportation assistance and exploring family expectations.
authors.affiliation: Children's Mercy Hospitals and Clinics and Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO 64108, USA. shampl@cmh.edu
authors.forename: Sarah
authors.initials: S
authors.lastname: Hampl
authors.forename: Michelle
authors.initials: M
authors.lastname: Demeule
authors.forename: Ihuoma
authors.initials: I
authors.lastname: Eneli
authors.forename: Maura
authors.initials: M
authors.lastname: Frank
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Hawkins
authors.forename: Shelley
authors.initials: S
authors.lastname: Kirk
authors.forename: Patricia
authors.initials: P
authors.lastname: Morris
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Sallinen
authors.forename: Melissa
authors.initials: M
authors.lastname: Santos
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Ward
authors.forename: Erinn
authors.initials: E
authors.lastname: Rhodes
mesh_terms: D000293:Adolescent; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019458:Insurance Coverage; D008297:Male; D009042:Motivation; D009765:Obesity / Q000208:ethnology / Q000517:prevention & control*; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance; D012017:Referral and Consultation; D012201:Reward; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care; D014195:Travel
keywords: implementation barriers; mismatched expectations; reasons; scheduling; survey; transportation