Efficacy of a screening procedure to identify potentially disruptive participants in an immersion program for the treatment of adolescent obesity

Background: This study examined the efficacy of the red flag screening procedure, an approach used in a largescale immersion program for the treatment of adolescent obesity (Wellspring Camps). The intention of the red flag screening was to screen out potentially highly disruptive applicants, provide an impetus for additional support when high-risk campers were admitted, and help parents develop appropriate expectations. When compared to non-flagged peers, red-flagged campers who attended camp were expected to be sent home early more frequently. Methods: Wellspring's admissions coordinators 'red-flagged' potential campers whose enrollment forms showed evidence of a history of psychological distress, major medical challenges, and/or developmental delays; a licensed psychologist then determined whether or not to admit the child after talking with the identified applicant, parents, and health care providers. 554 overweight young people attended three Wellspring Camps in the summer of 2007 (445 females, 109 males, mean age = 15.8 years, mean BMI = 35.6 kg/m ², mean % overweight = 66.7%). Results: 8.7% of applicants were red-flagged (n = 48), and 8% of all of the campers (n = 44) were dismissed prematurely. As expected, a much higher percentage of red-flagged campers who were admitted to camp were dismissed prematurely (31,3% of the red-flagged campers) than were non-flagged campers (5,1%; p < 0.0005). Conclusion: These findings support the efficacy of Wellspring's red flag screening procedure. While further improvements can be made, such a tool may be useful to other immersion programs.