Slow and Steady: Readiness, Pretreatment Weekly Strengthening Activity, and Pediatric Weight Management Program Completion

Background: Pediatric weight management programs have substantial attrition rates, which have led to recommendations to assess readiness prior to enrollment. Both pretreatment readiness scales and behaviors, such as exercise, have been theorized to predict subsequent program completion. The purpose of this study was to explore the role of self-reported pretreatment exercise in adolescents on completion of a pediatric weight management program and to explore the predictive ability of standard readiness scales. Methods: A total of 146 obese (BMI >= 95th percentile) pediatric (ages 11-18) participants joined a 6-month multidisciplinary weight management program between March, 2007, and July, 2010. Completers were compared retrospectively to noncompleters on demographic, readiness, and pretreatment exercise practices from clinic-developed intake questionnaires using univariate analyses. Regression analyses specified the degree to which these variables predicted program completion. Results: The 6-month completion rate was 53%. There was no relationship between self-reported readiness and program completion. Self-reported pretreatment weekly strengthening activity (SA) was significantly associated with program completion, compared to those who performed SA either never [univariate odds ratio (OR) 3.18, 95% confidence interval (CI) 1.51-6.68, p = 0.002; multivariate OR 2.43, 95% CI 1.06-5.58, p = 0.036] or daily (univariate OR 4.90, 95% CI 1.74-13.77, p = 0.002; multivariate OR 4.69, 95% CI 1.45-15.14, p = 0.010). No relationship was found between other forms of exercise and program completion. Conclusions: Self-reported pretreatment weekly SA, but not standard readiness scales, predicted pediatric weight management program completion.