title: Distance as a predictor of treatment attendance in a family based pediatric weight management program in rural areas.
abstract: OBJECTIVE
  The primary aim of this study was to determine whether demographic variables and distance to treatment were significant predictors of treatment attendance in a family based healthy lifestyle intervention program held in rural counties.
  
  
  METHODS
  Two hundred forty-nine children aged 8-12 who were overweight or obese and their parents participated in a 21-session healthy lifestyle intervention. Measures were obtained at baseline, and attendance included the number of the first core 12 sessions attended. Hierarchical linear regression analyses were conducted to identify variables that significantly predicted treatment attendance, and exploratory moderation analyses were conducted to examine if demographic variables moderated effects of distance to treatment site predicting group attendance.
  
  
  RESULTS
  Results support significant inverse relationships between distance to treatment and treatment attendance. Additionally, parents' marriage status significantly moderated the relationship between distance to treatment and treatment attendance.
  
  
  CONCLUSIONS
  These results expand the literature to a rural sample and indicate the importance of marital status for treatment attendance. Knowledge of these barriers to treatment provides information to tailor interventions to improve attendance in the future. Possible strategies include addressing cultural norms, providing resources to overcome time and travel barriers, and implementing e-health interventions.
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
authors.forename: Page
authors.initials: P
authors.lastname: Klitzman
authors.forename: Bridget
authors.initials: B
authors.lastname: Armstrong
authors.forename: David M
authors.initials: DM
authors.lastname: Janicke
mesh_terms: D000293:Adolescent; D000068959:Body Weight Maintenance; D002648:Child; D003376:Counseling / Q000379:methods; D005190:Family / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D040242:Risk Reduction Behavior; D012424:Rural Population
keywords: family medicine; health promotion; psychology; rural