Abstract PS1-13: High Five for Kids: Predictors of Participation in a Clinically-Based Obesity Prevention Intervention

Abstract

Aim: To examine predictors of participation in an obesity prevention trial among preschool-age children.

Method: High Five for Kids is a cluster-randomized controlled trial of a planned 500 children in 10 primary care pediatric offices. Eligible children are 2–6.9 years old with BMI >95^th percentile (obese), or 85^th-95^th percentile (overweight) if at least one parent is overweight. The initial intervention period is 12 months, with a 1-year follow-up period, and the primary outcome is BMI. Through screening of electronic medical records, we have identified and contacted 766 age-eligible and BMI-eligible children to date. We recruit parents via telephone following an introductory letter. We interviewed 220 of 306 (72%) parents who refused participation (refusers).

Results: Parents who refused participation (n=220) did not differ from those who participated (n=470) by education (62.8% vs 55.3% with college degree, P=0.07) or by the number of children at home (2.2 vs 2.3, P=0.21). Children of parents who refused participation did not differ from those who participated by age (4.5 yrs vs 4.6 yrs, P=0.65) or sex (48.1% vs 44.5% female, P=0.36). The two groups did differ by proportion of children in BMI category (63.6% vs 52.9% overweight and 36.4% vs 47.0% obese, P=0.009). After adjusting for parent education level, number of children at home, and child age and sex, we found that parents were 53% more likely (OR=1.53; 95% CI, 1.10–2.14) to participate if their children were obese vs. overweight. Among the 80 refusers with obese children, 27.5% cited as a reason for refusal that their children did not have a problem with weight versus 37.9% among the 140 refusers with overweight children.

Conclusions: Overweight parents of preschool-age children with a BMI 85^th-95^th percentile are less likely to have their children participate in an obesity prevention trial than parents of children with BMI >95^th percentile. One reason appears to be that they less frequently consider their children to have a weight problem.