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Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Participant recruitment and retention in a pilot program to prevent weight gain in low-income overweight and obese mothers

Authors: Mei-Wei Chang, Roger Brown, Susan Nitzke

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

Recruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income populations. This paper describes strategies for recruitment and retention and presents predictors of early (two-month post intervention) and late (eight-month post intervention) dropout (non retention) and overall retention among young, low-income overweight and obese mothers participating in a community-based randomized pilot trial called Mothers In Motion.

Methods

Low-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in southern Michigan. Participants (n = 129) were randomly assigned to an intervention (n = 64) or control (n = 65) group according to a stratification procedure to equalize representation in two racial groups (African American and white) and three body mass index categories (25.0-29.9 kg/m2, 30.0-34.9 kg/m2, and 35.0-39.9 kg/m2). The 10-week theory-based culturally sensitive intervention focused on healthy eating, physical activity, and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences. Forward stepwise multiple logistic regression was performed to examine whether dietary fat, fruit and vegetable intake behaviors, physical activity, perceived stress, positive and negative affect, depression, and race predicted dropout as data were collected two-month and eight-month after the active intervention phase.

Results

Trained personnel were successful in recruiting subjects. Increased level of depression was a predictor of early dropout (odds ratio = 1.04; 95% CI = 1.00, 1.08; p = 0.03). Greater stress predicted late dropout (odds ratio = 0.20; 95% CI = 0.00, 0.37; p = 0.01). Dietary fat, fruit, and vegetable intake behaviors, physical activity, positive and negative affect, and race were not associated with either early or late dropout. Less negative affect was a marginal predictor of participant retention (odds ratio = 0.57; 95% CI = 0.31, 1.03; p = 0.06).

Conclusion

Dropout rates in this study were higher for participants who reported higher levels of depression and stress.

Trial registration

Current Controlled Trials NCT00944060
Appendix
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Literature
1.
go back to reference Blumenthal DS, Sung J, Coates R, Williams J, Liff J: Recruitment and retention of subjects for a longitudinal cancer prevention study in an inner-city black community. Health Serv Res. 1995, 30 (1 Pt 2): 197-205.PubMedPubMedCentral Blumenthal DS, Sung J, Coates R, Williams J, Liff J: Recruitment and retention of subjects for a longitudinal cancer prevention study in an inner-city black community. Health Serv Res. 1995, 30 (1 Pt 2): 197-205.PubMedPubMedCentral
2.
go back to reference Havas S, Anliker J, Greenberg D, Block G, Block T, Blik C, Langenberg P, DiClemente C: Final results of the Maryland WIC Food for Life program. Prev Med. 2003, 37 (5): 406-416. 10.1016/S0091-7435(03)00160-9.CrossRefPubMed Havas S, Anliker J, Greenberg D, Block G, Block T, Blik C, Langenberg P, DiClemente C: Final results of the Maryland WIC Food for Life program. Prev Med. 2003, 37 (5): 406-416. 10.1016/S0091-7435(03)00160-9.CrossRefPubMed
3.
go back to reference McManus K, Antinoro L, Sacks F: A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord. 2001, 25 (10): 1503-1511. 10.1038/sj.ijo.0801796.CrossRefPubMed McManus K, Antinoro L, Sacks F: A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord. 2001, 25 (10): 1503-1511. 10.1038/sj.ijo.0801796.CrossRefPubMed
4.
go back to reference Tate DF, Wing RR, Winett RA: Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001, 285 (9): 1172-1177. 10.1001/jama.285.9.1172.CrossRefPubMed Tate DF, Wing RR, Winett RA: Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001, 285 (9): 1172-1177. 10.1001/jama.285.9.1172.CrossRefPubMed
5.
go back to reference Davis Martin P, Rhode PC, Dutton GR, Redmann SM, Ryan DH, Brantley PJ: A primary care weight management intervention for low-income African-American women. Obesity (Silver Spring). 2006, 14 (8): 1412-1420. 10.1038/oby.2006.160.CrossRef Davis Martin P, Rhode PC, Dutton GR, Redmann SM, Ryan DH, Brantley PJ: A primary care weight management intervention for low-income African-American women. Obesity (Silver Spring). 2006, 14 (8): 1412-1420. 10.1038/oby.2006.160.CrossRef
6.
go back to reference Graffagnino CL, Falko JM, La Londe M, Schaumburg J, Hyek MF, Shaffer LE, Snow R, Caulin-Glaser T: Effect of a community-based weight management program on weight loss and cardiovascular disease risk factors. Obes Res. 2006, 14 (2): 280-288. 10.1038/oby.2006.36.CrossRef Graffagnino CL, Falko JM, La Londe M, Schaumburg J, Hyek MF, Shaffer LE, Snow R, Caulin-Glaser T: Effect of a community-based weight management program on weight loss and cardiovascular disease risk factors. Obes Res. 2006, 14 (2): 280-288. 10.1038/oby.2006.36.CrossRef
7.
go back to reference Katzer L, Bradshaw AJ, Horwath CC, Gray AR, Obrien S, Joyce J: Evaluation of a "nondieting" stress reduction program for overweight women: A randomized trial. Am J Health Promot. 2008, 22 (4): 264-274. 10.4278/060728113R1.1.CrossRefPubMed Katzer L, Bradshaw AJ, Horwath CC, Gray AR, Obrien S, Joyce J: Evaluation of a "nondieting" stress reduction program for overweight women: A randomized trial. Am J Health Promot. 2008, 22 (4): 264-274. 10.4278/060728113R1.1.CrossRefPubMed
8.
go back to reference Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ: Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: A randomized trial. JAMA. 2005, 293 (1): 43-53. 10.1001/jama.293.1.43.CrossRefPubMed Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ: Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: A randomized trial. JAMA. 2005, 293 (1): 43-53. 10.1001/jama.293.1.43.CrossRefPubMed
9.
go back to reference Martin PD, Dutton GR, Rhode PC, Horswell RL, Ryan DH, Brantley PJ: Weight Loss Maintenance Following a Primary Care Intervention for Low-income Minority Women. Obesity (Silver Spring). 2008, 16 (11): 2462-2467. 10.1038/oby.2008.399.CrossRef Martin PD, Dutton GR, Rhode PC, Horswell RL, Ryan DH, Brantley PJ: Weight Loss Maintenance Following a Primary Care Intervention for Low-income Minority Women. Obesity (Silver Spring). 2008, 16 (11): 2462-2467. 10.1038/oby.2008.399.CrossRef
10.
go back to reference Dalle Grave R, Calugi S, Molinari E, Petroni ML, Bondi M, Compare A, Marchesini G: Weight loss expectations in obese patients and treatment attrition: An observational multicenter study. Obes Res. 2005, 13 (11): 1961-1969. 10.1038/oby.2005.241.CrossRefPubMed Dalle Grave R, Calugi S, Molinari E, Petroni ML, Bondi M, Compare A, Marchesini G: Weight loss expectations in obese patients and treatment attrition: An observational multicenter study. Obes Res. 2005, 13 (11): 1961-1969. 10.1038/oby.2005.241.CrossRefPubMed
11.
go back to reference Jeffery RW, Sherwood NE, Brelje K, Pronk NP, Boyle R, Boucher JL, Hase K: Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes. Int J Obes Relat Metab Disord. 2003, 27 (12): 1584-1592. 10.1038/sj.ijo.0802473.CrossRefPubMed Jeffery RW, Sherwood NE, Brelje K, Pronk NP, Boyle R, Boucher JL, Hase K: Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes. Int J Obes Relat Metab Disord. 2003, 27 (12): 1584-1592. 10.1038/sj.ijo.0802473.CrossRefPubMed
12.
go back to reference Yass-Reed EM, Barry NJ, Dacey CM: Examination of pretreatment predictors of attrition in a VLCD and behavior therapy weight-loss program. Addict Behav. 1993, 18 (4): 431-435. 10.1016/0306-4603(93)90060-M.CrossRefPubMed Yass-Reed EM, Barry NJ, Dacey CM: Examination of pretreatment predictors of attrition in a VLCD and behavior therapy weight-loss program. Addict Behav. 1993, 18 (4): 431-435. 10.1016/0306-4603(93)90060-M.CrossRefPubMed
13.
go back to reference Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG: Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord. 2004, 28 (9): 1124-1133. 10.1038/sj.ijo.0802727.CrossRefPubMed Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG: Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord. 2004, 28 (9): 1124-1133. 10.1038/sj.ijo.0802727.CrossRefPubMed
14.
go back to reference Lohse B, Stotts JL, Bagdonis J: Income sub stratification within a low income sample denotes dropout and completion patterns in nutrition education intervention for young adults. The FASEB Journal. 2006, 20 (5): A1312- Lohse B, Stotts JL, Bagdonis J: Income sub stratification within a low income sample denotes dropout and completion patterns in nutrition education intervention for young adults. The FASEB Journal. 2006, 20 (5): A1312-
15.
go back to reference Godin G: Godin leisure-time exercise questionnaire. Med Sci Sports Exerc. 1997, 29 (6s): S36- Godin G: Godin leisure-time exercise questionnaire. Med Sci Sports Exerc. 1997, 29 (6s): S36-
16.
go back to reference Ainsworth BE, Haskell WL, Leon AS, Jacobs DRJ, Montoye HJ, Sallis JF, Paffenbarger RSJ: Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993, 25 (1): 71-80. 10.1249/00005768-199301000-00011.CrossRefPubMed Ainsworth BE, Haskell WL, Leon AS, Jacobs DRJ, Montoye HJ, Sallis JF, Paffenbarger RSJ: Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993, 25 (1): 71-80. 10.1249/00005768-199301000-00011.CrossRefPubMed
17.
go back to reference Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav. 1983, 24 (4): 385-396. 10.2307/2136404.CrossRefPubMed Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav. 1983, 24 (4): 385-396. 10.2307/2136404.CrossRefPubMed
18.
go back to reference Stone AA: Measurement of affective response. Measuring Stress: A Guide for health and Social Scientists. Edited by: Cohen S, Kessler RC, Gordon LU. 1995, New York, NY: Oxford University Press, 148-174. Stone AA: Measurement of affective response. Measuring Stress: A Guide for health and Social Scientists. Edited by: Cohen S, Kessler RC, Gordon LU. 1995, New York, NY: Oxford University Press, 148-174.
19.
go back to reference Chang M, Nitzke S, Guilford E, Adair C, Hazard D: Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. J Am Diet Assoc. 2008, 108 (6): 1023-1028. 10.1016/j.jada.2008.03.004.CrossRefPubMed Chang M, Nitzke S, Guilford E, Adair C, Hazard D: Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. J Am Diet Assoc. 2008, 108 (6): 1023-1028. 10.1016/j.jada.2008.03.004.CrossRefPubMed
20.
go back to reference Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988, 54 (6): 1063-1070. 10.1037/0022-3514.54.6.1063.CrossRefPubMed Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988, 54 (6): 1063-1070. 10.1037/0022-3514.54.6.1063.CrossRefPubMed
21.
go back to reference Radloff LS: The CES-D scale: A self-report depression, scale for research in the general population. Applied Psychological Measurement. 1977, 1 (35): 385-401. 10.1177/014662167700100306.CrossRef Radloff LS: The CES-D scale: A self-report depression, scale for research in the general population. Applied Psychological Measurement. 1977, 1 (35): 385-401. 10.1177/014662167700100306.CrossRef
22.
go back to reference Hintze J: NCSS. 2007, Kaysville, Utah: NCSS, LLC Hintze J: NCSS. 2007, Kaysville, Utah: NCSS, LLC
23.
go back to reference Gavaler JS, Bonharn-Leyba M, Castro CA, Harman SE: The Oklahoma Postmenopausal Women's Health Study: Recruitment and Characteristics of American Indian, Asian, Black, Hispanic, and Caucasian Women. Alcoholism: Clinical and Experimental Research. 1999, 23 (2): 220-223. Gavaler JS, Bonharn-Leyba M, Castro CA, Harman SE: The Oklahoma Postmenopausal Women's Health Study: Recruitment and Characteristics of American Indian, Asian, Black, Hispanic, and Caucasian Women. Alcoholism: Clinical and Experimental Research. 1999, 23 (2): 220-223.
24.
go back to reference Damron D, Langenberg P, Anliker J, Ballesteros M, Feldman R, Havas S: Factors associated with attendance in a voluntary nutrition education program. Am J Health Promot. 1999, 13 (5): 268-275.CrossRefPubMed Damron D, Langenberg P, Anliker J, Ballesteros M, Feldman R, Havas S: Factors associated with attendance in a voluntary nutrition education program. Am J Health Promot. 1999, 13 (5): 268-275.CrossRefPubMed
26.
go back to reference Hammad TA, Havas S, Damron D, Langenberg P: Withdrawal rates for infants and children participating in WIC in Maryland. J Am Diet Assoc. 1997, 97 (8): 893-895. 10.1016/S0002-8223(97)00219-8.CrossRefPubMed Hammad TA, Havas S, Damron D, Langenberg P: Withdrawal rates for infants and children participating in WIC in Maryland. J Am Diet Assoc. 1997, 97 (8): 893-895. 10.1016/S0002-8223(97)00219-8.CrossRefPubMed
27.
go back to reference Berger PS, Powell J, Cook AS: The relation of economic factors to perceived stress in mobile families. Lifestyles. 1988, 9 (4): 297-313. 10.1007/BF00986748.CrossRef Berger PS, Powell J, Cook AS: The relation of economic factors to perceived stress in mobile families. Lifestyles. 1988, 9 (4): 297-313. 10.1007/BF00986748.CrossRef
29.
go back to reference Ryan DH, Espeland MA, Foster GD, Haffner SM, Hubbard VS, Johnson KC, Kahn SE, Knowler WC, Yanovski SZ: Look AHEAD (Action for Health in Diabetes): Design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials. 2003, 24 (5): 610-628. 10.1016/S0197-2456(03)00064-3.CrossRefPubMed Ryan DH, Espeland MA, Foster GD, Haffner SM, Hubbard VS, Johnson KC, Kahn SE, Knowler WC, Yanovski SZ: Look AHEAD (Action for Health in Diabetes): Design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials. 2003, 24 (5): 610-628. 10.1016/S0197-2456(03)00064-3.CrossRefPubMed
30.
go back to reference Fouad MN, Corbie-Smith G, Curb D, Howard BV, Mouton C, Simon M, Talavera G, Thompson J, Wang CY, White C, et al: Special populations recruitment for the Women's Health Initiative: successes and limitations. Control Clin Trials. 2004, 25 (4): 335-352. 10.1016/j.cct.2004.03.005.CrossRefPubMed Fouad MN, Corbie-Smith G, Curb D, Howard BV, Mouton C, Simon M, Talavera G, Thompson J, Wang CY, White C, et al: Special populations recruitment for the Women's Health Initiative: successes and limitations. Control Clin Trials. 2004, 25 (4): 335-352. 10.1016/j.cct.2004.03.005.CrossRefPubMed
31.
go back to reference Levkoff S, Sanchez H: Lessons learned about minority recruitment and retention from the Centers on Minority Aging and Health Promotion. Gerontologist. 2003, 43 (1): 18-26.CrossRefPubMed Levkoff S, Sanchez H: Lessons learned about minority recruitment and retention from the Centers on Minority Aging and Health Promotion. Gerontologist. 2003, 43 (1): 18-26.CrossRefPubMed
32.
go back to reference Zayas LH, McKee MD, Jankowski KR: Adapting psychosocial intervention research to urban primary care environments: a case example. Ann Fam Med. 2004, 2 (5): 504-508. 10.1370/afm.108.CrossRefPubMedPubMedCentral Zayas LH, McKee MD, Jankowski KR: Adapting psychosocial intervention research to urban primary care environments: a case example. Ann Fam Med. 2004, 2 (5): 504-508. 10.1370/afm.108.CrossRefPubMedPubMedCentral
33.
go back to reference Kreuter MW, Lukwago SN, Bucholtz RD, Clark EM, Sanders-Thompson V: Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav. 2003, 30 (2): 133-146. 10.1177/1090198102251021.CrossRefPubMed Kreuter MW, Lukwago SN, Bucholtz RD, Clark EM, Sanders-Thompson V: Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav. 2003, 30 (2): 133-146. 10.1177/1090198102251021.CrossRefPubMed
34.
go back to reference Yancey AK, Ortega AN, Kumanyika SK: Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006, 27: 1-28. 10.1146/annurev.publhealth.27.021405.102113.CrossRefPubMed Yancey AK, Ortega AN, Kumanyika SK: Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006, 27: 1-28. 10.1146/annurev.publhealth.27.021405.102113.CrossRefPubMed
35.
go back to reference Resnicow K, Campbell MK, Carr C, McCarty F, Wang T, Periasamy S, Rahotep S, Doyle C, Williams A, Stables G: Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med. 2004, 27 (2): 97-105. 10.1016/j.amepre.2004.04.009.CrossRefPubMed Resnicow K, Campbell MK, Carr C, McCarty F, Wang T, Periasamy S, Rahotep S, Doyle C, Williams A, Stables G: Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med. 2004, 27 (2): 97-105. 10.1016/j.amepre.2004.04.009.CrossRefPubMed
36.
go back to reference Arean PA, Alvidrez J, Nery R, Estes C, Linkins K: Recruitment and retention of older minorities in mental health services research. Gerontologist. 2003, 43 (1): 36-44.CrossRefPubMed Arean PA, Alvidrez J, Nery R, Estes C, Linkins K: Recruitment and retention of older minorities in mental health services research. Gerontologist. 2003, 43 (1): 36-44.CrossRefPubMed
37.
go back to reference Larkey LK, Staten LK, Ritenbaugh C, Hall RA, Buller DB, Bassford T, Altimari BR: Recruitment of Hispanic women to the Women's Health Initiative. The case of Embajadoras in Arizona. Control Clin Trials. 2002, 23 (3): 289-298. 10.1016/S0197-2456(02)00190-3.CrossRefPubMed Larkey LK, Staten LK, Ritenbaugh C, Hall RA, Buller DB, Bassford T, Altimari BR: Recruitment of Hispanic women to the Women's Health Initiative. The case of Embajadoras in Arizona. Control Clin Trials. 2002, 23 (3): 289-298. 10.1016/S0197-2456(02)00190-3.CrossRefPubMed
38.
go back to reference Robinson KA, Dennison CR, Wayman DM, Pronovost PJ, Needham DM: Systematic review identifies number of strategies important for retaining study participants. J Clin Epidemiol. 2007, 60 (8): 757-765. 10.1016/j.jclinepi.2006.11.023.CrossRefPubMedPubMedCentral Robinson KA, Dennison CR, Wayman DM, Pronovost PJ, Needham DM: Systematic review identifies number of strategies important for retaining study participants. J Clin Epidemiol. 2007, 60 (8): 757-765. 10.1016/j.jclinepi.2006.11.023.CrossRefPubMedPubMedCentral
39.
go back to reference Coday M, Boutin-Foster C, Goldman Sher T, Tennant J, Greaney ML, Saunders SD, Somes GW: Strategies for retaining study participants in behavioral intervention trials: retention experiences of the NIH Behavior Change Consortium. Ann Behav Med. 2005, 29 (Suppl): 55-65. 10.1207/s15324796abm2902s_9.CrossRefPubMed Coday M, Boutin-Foster C, Goldman Sher T, Tennant J, Greaney ML, Saunders SD, Somes GW: Strategies for retaining study participants in behavioral intervention trials: retention experiences of the NIH Behavior Change Consortium. Ann Behav Med. 2005, 29 (Suppl): 55-65. 10.1207/s15324796abm2902s_9.CrossRefPubMed
Metadata
Title
Participant recruitment and retention in a pilot program to prevent weight gain in low-income overweight and obese mothers
Authors
Mei-Wei Chang
Roger Brown
Susan Nitzke
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-424

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