title: Socio-demographic, anthropometric, and psychosocial predictors of attrition across behavioral weight-loss trials.
abstract: Preventing attrition is a major concern in behavioral weight loss intervention studies. The purpose of this analysis was to identify baseline and six-month predictors associated with participant attrition across three independent clinical trials of behavioral weight loss interventions (PREFER, SELF, and SMART) that were conducted over 10 years. Baseline measures included body mass index, Barriers to Healthy Eating, Beck Depression Inventory-II (BDI), Hunger Satiety Scale (HSS), Binge Eating Scale (BES), Medical Outcome Study Short Form (MOS SF-36 v2) and Weight Efficacy Lifestyle Questionnaire (WEL). We also examined early weight loss and attendance at group sessions during the first 6 months. Attrition was recorded at the end of the trials. Participants included 504 overweight and obese adults seeking weight loss treatment. The sample was 84.92% female and 73.61% white, with a mean (± SD) age of 47.35 ± 9.75 years. After controlling for the specific trial, for every one unit increase in BMI, the odds of attrition increased by 11%. For every year increase in education, the odds of attrition decreased by 10%. Additional predictors of attrition included previous attempts to lose 50-79 lbs, age, not possessing health insurance, and BES, BDI, and HSS scores. At 6 months, the odds of attrition increased by 10% with reduced group session attendance. There was also an interaction between percent weight change and trial (p<.001). Multivariate analysis of the three trials showed education, age, BMI, and BES scores were independently associated with attrition (ps ≤ .01). These findings may inform the development of more robust strategies for reducing attrition.
authors.affiliation: University of Pittsburgh School of Social Work, Pittsburgh, PA, USA; University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
authors.forename: Rachel W
authors.initials: RW
authors.lastname: Goode
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA; University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA; University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.affiliation: Boston College School of Nursing, Chestnut Hill, MA, USA.
authors.forename: Yaguang
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Mattos
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Sushama D
authors.initials: SD
authors.lastname: Acharya
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Ewing
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Danford
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Hu
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Imes
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Chasens
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Osier
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Juliet
authors.initials: J
authors.lastname: Mancino
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA; University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: lbu100@pitt.edu.
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
mesh_terms: D000328:Adult; D000367:Age Factors; D001521:Behavior Therapy; D056912:Binge-Eating Disorder / Q000175:diagnosis; D015992:Body Mass Index; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: Attrition; Binge eating; Weight loss