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

Abstract Background Low 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 wit...

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Autores principales:	Rebecca A. Jones, Julia Mueller, Stephen J. Sharp, Ann Vincent, Robbie Duschinsky, Simon J. Griffin, Amy L. Ahern
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Obesity Prevention Weight loss Mental health Engagement Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/76d4262d016d4cc3abaebed77986c429
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spelling	oai:doaj.org-article:76d4262d016d4cc3abaebed77986c4292021-11-14T12:44:34ZThe impact of participant mental health on attendance and engagement in a trial of behavioural weight management programmes: secondary analysis of the WRAP randomised controlled trial10.1186/s12966-021-01216-61479-5868https://doaj.org/article/76d4262d016d4cc3abaebed77986c4292021-11-01T00:00:00Zhttps://doi.org/10.1186/s12966-021-01216-6https://doaj.org/toc/1479-5868Abstract Background Low 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. Methods This 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. Results Every 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. Conclusions Participants 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 registration The original trial ( ISRCTN82857232 ) and five year follow up ( ISRCTN64986150 ) were prospectively registered with Current Controlled Trials on 15/10/2012 and 01/02/2018.Rebecca A. JonesJulia MuellerStephen J. SharpAnn VincentRobbie DuschinskySimon J. GriffinAmy L. AhernBMCarticleObesityPreventionWeight lossMental healthEngagementNutritional diseases. Deficiency diseasesRC620-627Public aspects of medicineRA1-1270ENInternational Journal of Behavioral Nutrition and Physical Activity, Vol 18, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Obesity Prevention Weight loss Mental health Engagement Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270
spellingShingle	Obesity Prevention Weight loss Mental health Engagement Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270 Rebecca A. Jones Julia Mueller Stephen J. Sharp Ann Vincent Robbie Duschinsky Simon J. Griffin Amy L. Ahern 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
description	Abstract Background Low 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. Methods This 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. Results Every 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. Conclusions Participants 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 registration The original trial ( ISRCTN82857232 ) and five year follow up ( ISRCTN64986150 ) were prospectively registered with Current Controlled Trials on 15/10/2012 and 01/02/2018.
format	article
author	Rebecca A. Jones Julia Mueller Stephen J. Sharp Ann Vincent Robbie Duschinsky Simon J. Griffin Amy L. Ahern
author_facet	Rebecca A. Jones Julia Mueller Stephen J. Sharp Ann Vincent Robbie Duschinsky Simon J. Griffin Amy L. Ahern
author_sort	Rebecca A. Jones
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	BMC
publishDate	2021
url	https://doaj.org/article/76d4262d016d4cc3abaebed77986c429
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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

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