title: Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study.
abstract: The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment.
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.|Department of Physiatry and Nursing, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Zaragoza, Spain.|Department of Pediatrics, Faculty of Medicine, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: P
authors.initials: P
authors.lastname: De Miguel-Etayo
authors.affiliation: Department of Physiatry and Nursing, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Muro
authors.affiliation: Department of Microbiology, Preventive Medicine and Public Health, Faculty of Sports and Health Sciences, Universidad de Zaragoza, Huesca, Spain.|Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Santabárbara
authors.affiliation: Department of Psychology and Sociology, Faculty of Social and Human Sciences, Universidad de Zaragoza, Teruel, Spain.
authors.forename: R
authors.initials: R
authors.lastname: López-Antón
authors.affiliation: Unit of Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Morandé
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.|PROFITH (PROmoting FITness and Health through physical activity) Research Group, University of Granada, Granada, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martín-Matillas
authors.affiliation: Pediatric Endocrinology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain.|Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
authors.forename: M C
authors.initials: MC
authors.lastname: Azcona-San Julián
authors.affiliation: Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.|Department of Food Sciences, Nutrition and Physiology, Universidad of Navarra, Pamplona, Spain.|CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martí
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Granada, Granada, Spain.|EURISTIKOS Centre for Excellence in Pediatric Research, Biomedical Research Centre, Health Sciences Technology Park, University of Granada, Granada, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Campoy
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Marcos
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.|Department of Physiatry and Nursing, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.|Department of Pediatrics, Faculty of Medicine, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Garagorri
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001521:Behavior Therapy; D005240:Feasibility Studies; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010290:Parents; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012649:Self Concept; D012944:Social Support; D013030:Spain / Q000453:epidemiology; D015431:Weight Loss; D061217:Weight Reduction Programs