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. 2020 Apr:131:109970.
doi: 10.1016/j.jpsychores.2020.109970. Epub 2020 Feb 15.

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial

Aubrey L Shell  1 , Loretta Hsueh  1 , Elizabeth A Vrany  2 , Daniel O Clark  3 , NiCole R Keith  3 , Huiping Xu  4 , Jesse C Stewart  5
Affiliations

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial

Aubrey L Shell et al. J Psychosom Res. 2020 Apr.

Abstract

Objective: We examined whether total depressive symptoms and symptom clusters predicted behavioral weight loss attendance among economically disadvantaged adults in a randomized controlled trial.

Methods: 150 adults with obesity were randomized to 12 months of in-person, video conference, or enhanced usual care weight loss groups. We categorized percent session attendance in the intervention arms into three levels: no attendance, poorer attendance, and better attendance.

Results: Higher baseline Patient Health Questionnaire-8 (PHQ-8) score was associated with a greater odds of being in the poorer versus better attendance group (OR = 1.94, 95% CI: 1.02-3.69, p = .04). A similar relationship between PHQ-8 score and odds of being in the no attendance versus better attendance group was observed but was not statistically significant (OR = 1.63, 95% CI: 0.94-2.81, p = .08). Both cognitive/affective and somatic clusters contributed to the depressive symptoms-attendance relationships.

Conclusion: Greater depressive symptoms at the start of a behavioral weight loss program may predict poorer subsequent session attendance. Screening for and addressing depression may improve intervention uptake. ClinicalTrials.gov Identifier: NCT02057952.

Keywords: Attendance; Clinical trial; Depression; Intervention; Obesity; Weight loss.

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Conflict of interest statement

Declaration of Competing Interest The authors have no competing interest to report.

Figures

Figure 1.
Figure 1.
Results of multinomial logistic regression models examining the associations of total depressive symptom severity (PHQ-8 total z score) and depressive symptom clusters (PHQ-8 cognitive/affective and somatic z scores) with behavioral weight loss session attendance (no attendance, poorer attendance, better attendance). No attendance, poorer attendance, and better attendance groups were defined as percent of total sessions attended equal to 0% (n = 44), 0.1–32.9% (n = 24), and ≥ 33.0% (n = 26), respectively. Models included the 94 selected participants and were adjusted for age, sex, race, waist circumference, and health literacy. PHQ-8 = Patient Health Questionnaire-8. OR = odds ratio. CI = confidence interval. *p < .05
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