@article{WarschburgerKroellerHaertingetal.2016,
  author    = {Warschburger, Petra and Kr{\"o}ller, Katja and Haerting, Johannes and Unverzagt, Susanne and van Egmond-Fr{\"o}hlich, Andreas},
  title     = {Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training},
  series = {Appetite : multidisciplinary research on eating and drinking},
  volume    = {103},
  journal   = {Appetite : multidisciplinary research on eating and drinking},
  publisher = {Elsevier},
  address   = {London},
  issn      = {0195-6663},
  doi       = {10.1016/j.appet.2016.04.007},
  pages     = {148 -- 156},
  year      = {2016},
  abstract  = {Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances 'obesity-specific' parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7-13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95\% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95\% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects.},
  language  = {en}
}
@article{WarschburgerKroeller2016,
  author    = {Warschburger, Petra and Kr{\"o}ller, Katja},
  title     = {Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)},
  series = {BMC PEDIATRICS},
  volume    = {16},
  journal   = {BMC PEDIATRICS},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1471-2431},
  doi       = {10.1186/s12887-016-0727-2},
  pages     = {9},
  year      = {2016},
  abstract  = {Background: Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods: Five hundred twenty-three parents and their 7-13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Conclusions: The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.},
  language  = {en}
}
@article{WarschburgerKroeller2012,
  author    = {Warschburger, Petra and Kr{\"o}ller, Katja},
  title     = {"Childhood overweight and obesity maternal perceptions of the time for engaging in child weight management"},
  series = {BMC public health},
  volume    = {12},
  journal   = {BMC public health},
  number    = {12},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1471-2458},
  doi       = {10.1186/1471-2458-12-295},
  pages     = {8},
  year      = {2012},
  abstract  = {Background: There is an increasing awareness of the impact of parental risk perception on the weight course of the child and the parent's readiness to engage in preventive efforts, but only less is known about factors related to the parental perception of the right time for the implementation of preventive activities. The aim of this study was to examine parental perceptions of the appropriate time to engage in child weight management strategies, and the factors associated with different weight points at which mothers recognize the need for preventive actions. Methods: 352 mothers with children aged 2-10 years took part in the study. We assessed mothers' perceptions of the actual and preferred weight status of their child, their ability to identify overweight and knowledge of its associated health risks, as well as perceptions of the right time for action to prevent overweight in their child. A regression analysis was conducted to examine whether demographic and weight related factors as well as the maternal general risk perception were associated with recognizing the need to implement prevention strategies. Results: Although most of the parents considered a BMI in the 75th to 90th percentile a valid reason to engage in the prevention of overweight, 19\% of the mothers were not willing to engage in prevention until their child reached the 97th percentile. Whereas the child's sex and the identification of an elevated BMI were significant predictors for parents' recognition of the 75th percentile as right point to engage in prevention efforts, an inability to recognize physical health risks associated with overweight silhouettes emerged as a significant factor predicting which parents would delay prevention efforts until a child's BMI reached the 97th percentile. Conclusion: Parental misperceptions of overweight and associated health risks constitute unfavorable conditions for preventive actions. Feedback on the health risks associated with overweight could help increase maternal readiness for change.},
  language  = {en}
}
@misc{WarschburgerKroeller2016,
  author    = {Warschburger, Petra and Kr{\"o}ller, Katja},
  title     = {Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-100359},
  pages     = {9},
  year      = {2016},
  abstract  = {Background Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods Five hundred twenty-three parents and their 7-13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Results Objective weight data were available for 49.6 (67.0) \% of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child's quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant. Conclusions The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.},
  language  = {en}
}
@article{WarschburgerKroeller2016,
  author    = {Warschburger, Petra and Kr{\"o}ller, Katja},
  title     = {Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)},
  series = {BMC pediatrics},
  volume    = {16},
  journal   = {BMC pediatrics},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1471-2431},
  doi       = {10.1186/s12887-016-0727-2},
  pages     = {9},
  year      = {2016},
  abstract  = {Background Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods Five hundred twenty-three parents and their 7-13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Results Objective weight data were available for 49.6 (67.0) \% of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child's quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant. Conclusions The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.},
  language  = {en}
}