Mental health and socioeconomic status impact adherence to youth activity and dietary programs: a meta-analysis.

Purpose: Substantial efforts have gone into reducing the physiological and psychological harm of obesity in youth, but few studies have reviewed the factors contributing to adherence to pediatric weight management programs. The attrition rates to programs offering multiple components to address BMI improvement and healthy lifestyle change among youth are quite high. The purpose of this study is to review the literature for factors contributing to adherence to these programs among children and youth with obesity and determine pooled effect of these factors.

Methods: A systematic literature search and meta-analysis was conducted through the PubMed database on pediatric weight management interventions offering at least physical activity and dietary support for obese youth aged 10-17 years, where variables contributing to adherence were reported. Only those studies achieving a threshold of methodological rigour were included.

Results: Altogether, seven studies were included in the analysis. There was a pooled RR of lower socioeconomic status on non-adherence of 1.34 [95% confidence intervals 1.19-1.52] and poorer mental health on non-adherence of 1.12 [95% confidence intervals 1.08-1.17].

Conclusion: It is important to address barriers related to lower socioeconomic status in pediatric weight management programs to increase adherence. Further, addressing supports for those with poorer mental health can reduce the risk of non-adherence in multi-disciplinary programs targeting youth with obesity.