618 - Participant Engagement and Geographic Reach in a Virtual Versus In-Person Pediatric Intensive Lifestyle Intervention for Obesity

Poster Number: 618
Publication Number: 618.2739

Background: The COVID-19 pandemic accelerated adoption of telehealth, yet little is known about the impact of transitioning intensive lifestyle interventions (ILI) for pediatric obesity to virtual delivery on participant engagement and geographic reach.

Objective: To examine the in-person to virtual transition of Bright Bodies (BB), a well-established, family-based pediatric ILI with demonstrated effectiveness for youth with obesity.

Design/Methods: Among new participants in BB, we compared engagement (defined as the proportion of classes attended out of those available based on enrollment timing) in virtual BB (VBB, 4/2020 – 3/2022) versus in-person BB (IPBB, 1/2018 – 12/2019). We included all BB participants who enrolled within a sufficient timeframe to attend >/=10 classes. We examined the extent to which engagement varied in both VBB and IPBB programs by participants’ age, sex, season of enrollment, and enrollment timing relative to program start. Using ArcGIS, we compared route distance and travel time between participants’ homes and the IPBB location for VBB vs. IPBB programs.

Results: New VBB participants (N = 73) and new IPBB participants (N = 67) had similar baseline characteristics (55% female, mean age 11.3 ± SD 2.6y). We did not observe meaningful differences in engagement by age, sex, or season in either VBB or IPBB programs. Participants with late enrollment (after the first week) showed lower engagement in both IPBB and VBB, though this decrease in engagement was more pronounced in VBB (Table). In multivariable analyses, we also observed that enrollment timing was differentially associated with engagement in VBB versus IPBB (p = 0.048); the median engagement decreased by an additional 5.5% (95% CI: 0.1%, 11.0%) for each class number delay in enrollment timing among participants in VBB vs IPBB. Both median one-way travel time (13.3 vs 10.5 min) and distance relative to the IPBB location (9.31 vs 6.08 km) were higher (both p < 0.01) for VBB vs IPBB programs (Figure).

Conclusion(s): We did not observe meaningful differences in engagement between VBB and IPBB among participants who enrolled within the first week. Late enrollment was associated with lower participant engagement in both groups, with a more pronounced effect in VBB. Adaptation of evidence-based ILIs for telehealth delivery and ongoing efforts to increase engagement may help address distance and transportation barriers to participant enrollment and expand program impact to historically underserved regions.