Predictors of dropout in a lifestyle intervention : Substudy of the PREVIEW trial

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Title: Predictors of dropout in a lifestyle intervention : Substudy of the PREVIEW trial
Author: Orpana, Sini
Contributor: University of Helsinki, Faculty of Agriculture and Forestry, Department of Food and Environmental Sciences
Publisher: Helsingin yliopisto
Date: 2018
Language: eng
Thesis level: master's thesis
Discipline: Ravitsemustiede
Abstract: Dropout is a serious problem in lifestyle interventions. Dropout is inadequately analyzed and inconsistently reported in weight loss and lifestyle intervention literature even though it is considered to be one of the most important aspects in assessing trial success. Attrition decreases the statistical power of the study, weakens the reliability and validity of the results, decreases generalizability of the outcomes, and deteriorates the accuracy of given recommendations. In addition, withdrawal leads to poor intervention outcomes and wasted resources. Dropout rates in weight loss intervention range from 7 to 90 percent. The analysis of this study comprised of the first two years of a three-year intervention called PREVIEW. The participants analyzed in this thesis (N = 2088) were overweight or obese prediabetic adults with an age of 52 ± 11.5 years at the start of the trial. Participants came from six European and two Australasian countries. Two thirds of the participants were women and the majority were Caucasian. The final prediction model was computed with multivariate logistic regression. Forty-four percent of the participants dropped out by year two. Dropouts were younger, had a higher baseline BMI, and lost less weight in the weight loss phase than the completers. Compared to Australia, the odds for dropping out were higher in the other countries analyzed. The odds for dropout in an ascending order were: Australia, Finland, New Zealand, the Netherlands, Bulgaria, the United Kingdom, Spain and Denmark. Compared to university education, the odds for dropping out were higher for participants with secondary vocational education, secondary school education, or education indicated as ‘other’. The findings of this thesis may be used in the development of similar trials and in public healthcare. In lifestyle intervention programs, special attention could be directed to individuals who are likely to drop out. In addition, as dropout is dependent of the explanatory variables, the results may also benefit future analysis of data from PREVIEW.
Subject: Dropout (DO)
lifestyle intervention
weight loss
weight maintenance (WM)
low-energy diet (LED)
early WM DO
late WM DO
body mass index (BMI)
diabetes risk score (DRS)

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