The impact of participant mental health on attendance and engagement in a trial of behavioural weight management programmes: secondary analysis of the WRAP randomised controlled trial

International Journal of Behavioral Nutrition and Physical Activity

Ann Vincent¹  Stephen J. Sharp²  Julia Mueller²  Amy L. Ahern²  Rebecca A. Jones²  Simon J. Griffin³  Robbie Duschinsky⁴ 

[1]Department of Medicine, University College London, London, UK

[2]MRC Epidemiology Unit, University of Cambridge, Cambridge, UK

[3]MRC Epidemiology Unit, University of Cambridge, Cambridge, UK

[4]Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

[5]Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

关键词: Obesity;    Prevention;    Weight loss;    Mental health;    Engagement;   

DOI  :  10.1186/s12966-021-01216-6

来源: Springer

【 摘 要 】

BackgroundLow attendance and engagement in behavioural weight management trials are common. Mental health may play an important role, however previous research exploring this association is limited with inconsistent findings. We aimed to investigate whether mental health was associated with attendance and engagement in a trial of behavioural weight management programmes.MethodsThis is a secondary data analysis of the Weight loss referrals for adults in primary care (WRAP) trial, which randomised 1267 adults with overweight or obesity to brief intervention, WW (formerly Weight Watchers) for 12-weeks, or WW for 52-weeks. We used regression analyses to assess the association of baseline mental health (depression and anxiety (by Hospital Anxiety and Depression Scale), quality of life (by EQ5D), satisfaction with life (by Satisfaction with Life Questionnaire)) with programme attendance and engagement in WW groups, and trial attendance in all randomised groups.ResultsEvery one unit of baseline depression score was associated with a 1% relative reduction in rate of WW session attendance in the first 12 weeks (Incidence rate ratio [IRR] 0.99; 95% CI 0.98, 0.999). Higher baseline anxiety was associated with 4% lower odds to report high engagement with WW digital tools (Odds ratio [OR] 0.96; 95% CI 0.94, 0.99). Every one unit of global quality of life was associated with 69% lower odds of reporting high engagement with the WW mobile app (OR 0.31; 95% CI 0.15, 0.64). Greater symptoms of depression and anxiety and lower satisfaction with life at baseline were consistently associated with lower odds of attending study visits at 3-, 12-, 24-, and 60-months.ConclusionsParticipants were less likely to attend programme sessions, engage with resources, and attend study assessments when reporting poorer baseline mental health. Differences in attendance and engagement were small, however changes may still have a meaningful effect on programme effectiveness and trial completion. Future research should investigate strategies to maximise attendance and engagement in those reporting poorer mental health.Trial registrationThe original trial (ISRCTN82857232) and five year follow up (ISRCTN64986150) were prospectively registered with Current Controlled Trials on 15/10/2012 and 01/02/2018.

【 授权许可】

CC BY