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Teixeira R, Doetsch J, Freitas AI, Lorthe E, Santos AC, Barros H. Survey of data collection methods and retention strategies in European birth cohorts of children and adults born very preterm. Paediatr Perinat Epidemiol 2022; 36:706-714. [PMID: 34958148 DOI: 10.1111/ppe.12845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The long-term follow-up of very preterm and very low birthweight cohorts contributes to valuable evidence to understand life-course outcomes in these vulnerable populations. However, attrition is a major challenge in long-term outcome studies. Examining the techniques used by existing cohorts may help to reveal practices that enhance willingness to continue participation over time. OBJECTIVES To evaluate the effect of data collection methods and retention strategies on overall retention in European birth cohorts of individuals born very preterm and very low birthweight. METHODS A survey of European cohorts integrated in the RECAP-preterm Consortium provided data on study characteristics, retention at the most recent follow-up, data collection methods and retention strategies. Cohorts were classified according to participants' age at most recent follow-up as child (<18) or adult cohorts (≥18 years old). RESULTS Data were obtained for 17 (81%) cohorts (7 adult and 10 child) in 12 countries. Considering the baseline, at the most recent follow-up, overall retention ranged from 10% to 99%. Child cohorts presented higher median retention (68% versus 38% or 52% for adult cohorts with ≤5 or >5 follow-ups) and used relatively more retention strategies. For contact and invitation, cohorts mostly resorted to invitation letters, and to face-to-face interviews for assessments. Study duration was negatively correlated with retention and positively associated with the number of follow-up evaluation. We identified 109 retention strategies, with a median of 6 per cohort; bond-building (n = 41; 38%) was the most utilised, followed by barrier-reduction (n = 36; 33%) and reminders (n = 32; 29%). Retention was not influenced by category or number of strategies. CONCLUSIONS Regular contact with cohort participants favour retention whilst neither the number nor the categories of retention strategies used seemed to have an influence, suggesting that tailored strategies focussed on participants at higher risk of dropout might be a more effective approach.
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Affiliation(s)
- Raquel Teixeira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Julia Doetsch
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Ana Isabel Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Elsa Lorthe
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Goldstein E, Bakhireva LN, Nervik K, Hagen S, Turnquist A, Zgierska AE, Marquez LE, McDonald R, Lo J, Chambers C. Recruitment and retention of pregnant women in prospective birth cohort studies: A scoping review and content analysis of the literature. Neurotoxicol Teratol 2021; 85:106974. [PMID: 33766723 PMCID: PMC8137666 DOI: 10.1016/j.ntt.2021.106974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 11/20/2022]
Abstract
Longitudinal cohort studies present unique methodological challenges, especially when they focus on vulnerable populations, such as pregnant women. The purpose of this review is to synthesize the existing knowledge on recruitment and retention (RR) of pregnant women in birth cohort studies and to make recommendations for researchers to improve research engagement of this population. A scoping review and content analysis were conducted to identify facilitators and barriers to the RR of pregnant women in cohort studies. The search retrieved 574 articles, with 38 meeting eligibility criteria and focused on RR among English-speaking, adult women, who are pregnant or in early postpartum period, enrolled in birth cohort studies. Selected studies were birth cohort (including longitudinal) (n = 20), feasibility (n = 14), and other (n = 4) non-interventional study designs. The majority were from low-risk populations. Abstracted data were coded according to emergent theme clusters. The majority of abstracted data (79%) focused on recruitment practices, with only 21% addressing retention strategies. Overall, facilitators were reported more often (75%) than barriers (25%). Building trusting relationships and employing diverse recruitment methods emerged as major recruitment facilitators; major barriers included heterogeneous participant reasons for refusal and cultural factors. Key retention facilitators included flexibility with scheduling, frequent communication, and culturally sensitive practices, whereas participant factors such as loss of interest, pregnancy loss, relocation, multiple caregiver shifts, and substance use/psychiatric problems were cited as major barriers. Better understanding of facilitators and barriers of RR can help enhance the internal and external validity of future birth/pre-birth cohorts. Strategies presented in this review can help inform investigators and funding agencies of best practices for RR of pregnant women in longitudinal studies.
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Affiliation(s)
- Ellen Goldstein
- Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Ludmila N Bakhireva
- College of Pharmacy Substance Use Research and Education (SURE) Center, United States of America; Department of Family and Community Medicine, United States of America; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5360, Albuquerque, NM 87131, United States of America.
| | - Kendra Nervik
- Department of Sociology, University of Wisconsin, 8128 William H. Sewell Social Sciences Building, 1180 Observatory Drive, Madison, WI 53706-1393, United States of America.
| | - Shelbey Hagen
- Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Alyssa Turnquist
- Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Aleksandra E Zgierska
- Department of Family and Community Medicine, Pennsylvania State University, College of Medicine, United States of America.
| | - Lidia Enriquez Marquez
- College of Pharmacy Substance Use Research and Education (SURE) Center, United States of America.
| | - Ryan McDonald
- Department of Obstetrics & Gynecology, University of Wisconsin School of Medicine and Public Health McConnell Hall, 1010 Mound Street, Madison, WI 53715, United States of America.
| | - Jamie Lo
- Department of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L466, Portland, OR 97239, United States of America.
| | - Christina Chambers
- Departments of Pediatrics and Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, 9500 Gilman Drive, MC0828, La Jolla, CA 92093, United States of America.
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Shatila H, Fatfat Z, Talhouk R, Naalbandian S, Forman MR, Nasr R, Naja F. Nutrition and Breast Cancer Research in Arab Countries: Gaps, Opportunities, and Recommendations. Nutr Cancer 2020; 73:2113-2129. [PMID: 32972248 DOI: 10.1080/01635581.2020.1823435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
According to the WHO, Arab countries have the highest relative increase in Breast Cancer (BC) rates worldwide. Current shifts in dietary patterns in these countries are postulated as important modifiable risk factors of the disease. The objectives of this review were to examine the gaps and opportunities in the extent, range and nature of nutrition-related BC research in Arab countries. Studies (n = 286) were identified through searching 14 electronic databases. Among the gaps identified were limited international collaborations, preponderance of laboratory-based research at the expense of population-based research, focus on single supplement/nutrient/food research, limited use of dietary assessment tools, and studying nutrition in isolation of other environmental factors. Despite these gaps, several opportunities appeared. The distribution of papers among Arab countries suggested that collaboration between high and middle income countries could create a positive synergy between research expertise and wealth. In addition, the steady increase in the number of articles published during the last two decades reflected a promising momentum in nutrition and BC research in the Arab world. These gaps and opportunities constituted context-specific evidence to orient nutrition and BC research in Arab countries which could ultimately lead to development of effective interventions for prevention of BC in these countries.
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Affiliation(s)
- Hibeh Shatila
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Zaynab Fatfat
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Rabih Talhouk
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Salpy Naalbandian
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Michele R Forman
- Nutrition Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Rihab Nasr
- Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.,Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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Giannakou K. Perinatal epidemiology: Issues, challenges, and potential solutions. Obstet Med 2020; 14:77-82. [PMID: 34394715 DOI: 10.1177/1753495x20948984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/16/2020] [Indexed: 12/14/2022] Open
Abstract
Perinatal epidemiology research is concerned with identifying the effects of events during pregnancy on pregnancy outcomes that include maternal, fetal, and neonatal health outcomes. Randomized trials in perinatal research face many challenges, including randomization difficulties, ethical considerations, and inadequate statistical power due to the small number of subjects eligible for participation. For these reasons, most epidemiological studies conducted in this research field are observational and include different types of bias. This review describes the key methodological difficulties in the design and analysis of randomized and observational studies in perinatal epidemiology, and provides potential corrective approaches.
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Brennan M, Clarke M, Devane D, Dowling M. A qualitative study of the factors influencing recruitment to a pilot trial on the prevention of striae gravidarum. BMC Pregnancy Childbirth 2020; 20:103. [PMID: 32050916 PMCID: PMC7017448 DOI: 10.1186/s12884-020-2781-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 01/30/2020] [Indexed: 11/30/2022] Open
Abstract
Background Striae gravidarum are a common occurrence in pregnancy and many women use a topical product to prevent their development or lessen their appearance if they do develop. There is a lack of evidence on the effectiveness of many of the products used by women. This study arose from challenges in recruitment to a pilot randomised trial (ISRCTN trial registration number:76992326) designed to evaluate the feasibility of a definitive trial to compare a moisturising oil to no treatment in the prevention and reduction in severity of striae gravidarum. The study reported here explored the factors influencing recruitment to that pilot trial. Methods A qualitative descriptive study was undertaken involving primigravid women attending an Irish maternity hospital. Data were collected by semi-structured telephone interviews over a four-week period and analysed using the framework method of analysis. Fifteen interview transcripts were included in the analysis. Results Four main themes consisting of twelve categories were identified from the interview data. The themes focused on women’s prevention of stretch marks and their choice of anti-stretch mark product, who and what influenced that choice and influences on trial participation. In relation to influences on trial participation, the possibility of being randomised to the non- intervention or control group was a deterrent for many women. Conclusions The prevention of stretch marks is important to pregnant women, as is their choice of product to prevent them. Offering women the opportunity to be part of a trial that would be of low burden and would test a well-known product may optimise recruitment. However, reluctance to be randomised because of the possibility of being allocated to the non-intervention control group suggests that further work is needed in this field on how best to communicate uncertainty to potential participants.
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Affiliation(s)
- Miriam Brennan
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, Galway, H91 TK33, Ireland.
| | - Mike Clarke
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Institute of Clinical Sciences, Block B, Queen's University Belfast, Royal Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
| | - Declan Devane
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, Galway, H91 TK33, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, Galway, H91 TK33, Ireland
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Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort. PLoS One 2019; 14:e0219248. [PMID: 31265481 PMCID: PMC6605672 DOI: 10.1371/journal.pone.0219248] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48–6.91; OR: 2.84, CI: 1.15–7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.
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