Retention strategies and predictors of attrition in an urban pediatric asthma study.
Retention strategies and predictors of attrition in an urban pediatric asthma study.
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DOI：
10.1177/1740774510373798
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
Gern JE
中科院分区：
文献类型：
--
作者：
Zook PM;Jordan C;Adams B;Visness CM;Walter M;Pollenz K;Logan J;Tesson E;Smartt E;Chen A;D'Agostino J;Gern JE
城市环境与儿童哮喘（URECA）研究是一项多中心前瞻性出生队列研究，旨在检查与城市贫民区儿童哮喘和过敏发生相关的因素。由于高流动性、不一致的电话服务、监护问题和紧张的生活状况，这些参与者的保留一直具有挑战性。在本文中，我们描述了在URECA随访的前2年中遇到的具体保留挑战以及我们用于解决这些挑战的策略。我们还研究了选择的母亲的特征和其他因素是如何与保留和错过的研究访问。参与者参与的策略包括：收集最新的和替代的联系信息，下班后给参与者打电话，有文化能力的工作人员，灵活的研究活动安排，诊所访问交通，季度通讯，保留活动，上门拜访和手机报销。内部开发的网络数据管理系统使现场小组和协调中心能够进行密切监测。使用生存分析计算失活率。使用卡方检验比较活跃和失活受试者的特征，并对研究中心进行Cochran-Mantel - Haenszel调整。使用ANOVA模型或控制研究中心的趋势检验，计算并比较前2年预期总访视的缺失比例，并按家族特征进行比较。所有分析均使用SAS 9.1版（卡里，NC）进行。2年留存率为89%。参与首次研究活动可预测随后参与研究活动。未完成首次访视的母亲更有可能错过未来事件（46.1% vs. 8.9%，p < 0.0001）和被停用（38.5% vs. 4.5%，p < 0.0001）。与年龄较大的母亲相比，18岁以下的母亲更有可能离开研究（22.7% vs. 10.1%，p = 0.02）。此外，已婚母亲错过的事件比未婚母亲少（8.8%比15.6%，p = 0.01）。此外，当孩子在3个月大时进入日托时，失活更常见（10.9%对3.6%，p = 0.05）。URECA人群主要是少数民族，因此我们的研究结果可能无法推广到其他人群。此外，我们可能无法观察到在更多样化的人群中可能存在的影响。例如，86%的母亲未婚，因此很难可靠地检查婚姻状况的影响。在研究中，成功地吸引和留住参与者对于实现研究目标至关重要。识别与错过访视和停用相关的因素是识别潜在风险参与者的第一步，可以设计有针对性的策略来留住参与者。
The Urban Environment and Childhood Asthma (URECA) study is a multicenter prospective birth cohort study designed to examine factors related to the development of childhood asthma and allergies in an inner-city population. The retention of these participants has been challenging due to high mobility, inconsistent phone service, custody issues, and stressful life situations. In this article, we describe the specific retention challenges we encountered during the first 2 years of follow-up in URECA and the strategies we utilized to address them. We also examine how selected maternal characteristics and other factors are related to retention and missed study visits. Strategies implemented to engage participants included: collecting updated and alternative contact information, after-hours phone calls to participants, culturally competent staff, flexible study event scheduling, clinic visit transportation, quarterly newsletters, retention events, drop-in home visits, and cell phone reimbursements. An internally developed web-based data management system enabled close monitoring by site teams and the coordinating center. The rate of deactivations was calculated using survival analysis. Characteristics of active and deactivated participants were compared using the chi-squared test with a Cochran–Mantel – Haenszel adjustment for study site. The proportion of missed visits of the total expected in the first 2 years was calculated and compared by family characteristics using an ANOVA model or a trend test controlling for study site. All analyses were performed using SAS version 9.1 (Cary, NC). The 2-year retention rate was 89%. Participation in the first study event predicted subsequent engagement in study activities. Mothers who did not complete the first visit were more likely to miss future events (46.1% vs. 8.9%, p < 0.0001) and to be deactivated (38.5% vs. 4.5%, p < 0.0001). Mothers under 18 years of age were more likely to leave the study compared to older mothers (22.7% vs. 10.1%, p = 0.02). Also, mothers who were married missed fewer events than those not married (8.8% vs. 15.6%, p = 0.01). In addition, deactivations were more common when the child had entered daycare by 3 months of age (10.9% vs. 3.6%, p = 0.05). The URECA population is predominantly minority, thus our findings might not be generalizable to other populations. Furthermore, we may not be able to observe the effects that might exist in a more diverse population. For example, 86% of the mothers are unmarried, making it difficult to reliably examine the effect of marital status. In research, successfully engaging and retaining participants is essential for achieving the study objectives. Identifying factors related to missed visits and deactivations are the initial step in recognizing the potential at-risk participants and can enable the design of targeted strategies to retain participants.
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影响因子：
6.6
作者：
Cox, JL;Chapman, G;Jones, P
通讯作者：
Jones, P
DOI：
10.1111/j.1744-6155.2007.00115.x
发表时间：
2007-07-01
影响因子：
1.3
作者：
Ely, Beth;Coleman, Camille
通讯作者：
Coleman, Camille
影响因子：
4.4
作者：
JOHNSON, TP;PARSONS, JA
通讯作者：
PARSONS, JA
影响因子：
3.9
作者：
Loftin, WA;Barnett, SK;Sullivan, P
通讯作者：
Sullivan, P
影响因子：
5.6
作者：
Moorman, PG;Newman, B;Sandler, DP
通讯作者：
Sandler, DP