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Paisi M, Allen Z, Shawe J. New Home, New You: A retrospective mixed-methods evaluation of a health-related behavioural intervention programme supporting social housing tenants. Health Expect 2023; 26:752-764. [PMID: 36628614 PMCID: PMC10010073 DOI: 10.1111/hex.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 11/15/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Social housing tenants are at greater risk of engaging in unhealthy behaviours than the general population. Housing association employees are in an ideal position to contribute positively to their tenants' health. 'New Home, New You' (NHNY) is a joint venture between a social housing association, a city council and a community healthcare provider in the South West of England. It was designed with the aim of improving the health and well-being of social housing tenants. OBJECTIVES The aim of this retrospective evaluation was to establish whether social housing tenants were benefiting from this health-related behavioural intervention in terms of their mental well-being and health-related behaviours. METHODS This was a mixed-methods evaluation. The outcome evaluation was a secondary analysis of quantitative data collected during the NHNY project. The process of delivering and receiving the intervention was evaluated using qualitative, semi-structured interviews with housing officers and tenants who had participated in the programme. The development of the intervention was evaluated through a focus group and additional semistructured interviews with key stakeholders. Quantitative data were analysed using the Statistical Package for the Social Sciences. Qualitative interviews were analysed using thematic analysis. RESULTS Six key stakeholders and a total of seven housing officers from several teams and seven tenants were interviewed. Of the 1016 tenants who were invited to participate in NHNY, 226 enroled in the programme. For participating tenants, the scope for health-related behaviour change was greatest in relation to eating and smoking. Small positive statistically significant changes in mental health were found between the 6- and 12-month mean score and between the baseline and the 12-month score. CONCLUSIONS The findings indicate that NHNY may have been beneficial for some participating tenants. Housing officers can have a significant role in promoting health messages and embedding behaviour change among their tenants. Although the programme was implemented as a service improvement rather than a controlled trial and focused on a particular intervention and geographical area, other housing associations may find this evaluation useful for considering whether to adopt some of the principles applied in NHNY in other settings. PATIENT OR PUBLIC CONTRIBUTION A social housing tenant representative provided input on the methodology and methods used to evaluate NHNY, as well as the information sheet.
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Affiliation(s)
- Martha Paisi
- School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK.,Peninsula Dental School, University of Plymouth, Plymouth, Devon, UK
| | - Zoe Allen
- Peninsula Dental School, University of Plymouth, Plymouth, Devon, UK
| | - Jill Shawe
- School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK
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Addressing Challenges in Recruiting Diverse Populations for Research: Practical Experience From a P20 Center. Nurs Res 2022; 71:218-226. [PMID: 35067645 PMCID: PMC9038626 DOI: 10.1097/nnr.0000000000000577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Improving the recruitment and retention of underrepresented groups in all research areas is essential for health equity. However, achieving and retaining diverse samples is challenging. Barriers to recruitment and retention of diverse participants include socioeconomic and cultural factors and practical challenges (e.g., time and travel commitments). OBJECTIVES The purpose of this article is to describe the successful recruitment and retention strategies used by two related studies within a P20 center funded by the National Institute of Nursing Research focused on precision health research in diverse populations with multiple chronic conditions, including metabolic syndrome. METHODS To address the complexity, biodiversity, and effect of metabolic syndrome and multiple chronic conditions, we developed culturally appropriate, multipronged recruitment and retention strategies for a pilot intervention study and a longitudinal observational pilot study within our P20 center. The following are the underlying principles that guided the recruitment and retention strategies: (a) flexibility, (b) active listening and bidirectional conversations, and (c) innovative problem solving. RESULTS The intervention study (Pilot 1) enrolled 49 participants. The longitudinal observational study (Pilot 2) enrolled 45 participants. Women and racial/ethnic minorities were significantly represented in both. In Pilot 1, most of the participants completed the intervention and all phases of data collection. In Pilot 2, most participants completed all phases of data collection and chose to provide biorepository specimens. DISCUSSION We developed a recruitment and retention plan building on standard strategies for a general medical population. Our real-world experiences informed the adaption of these strategies to facilitate the participation of individuals who often do not participate in research-specifically, women and racial/ethnic populations. Our experience across two pilot studies suggests that recruiting diverse populations should build flexibility in the research plan at the outset.
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Kohlasch KL, Cioffredi LA, Lenninger C, Stewart E, Vatalaro T, Garavan H, Graham A, Heil SH, Krans EE, Robakis T, Rommel A, Sullivan EL, Thomason M, Potter A. Factors associated with parent views about participation in infant MRI research provide guidance for the design of the Healthy Brain and Child Development (HBCD) study. Dev Cogn Neurosci 2021; 50:100986. [PMID: 34242880 PMCID: PMC8267558 DOI: 10.1016/j.dcn.2021.100986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/04/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The National Institutes of Health announced the Healthy Brain and Child Development (HBCD) study to further understanding of infant brain development. This study examined perceptions and knowledge about research among the demographic groups to be studied in HBCD. METHOD 1164 participants (n = 548 pregnant people and 616 mothers of infants < 12 months) completed anonymous, on-line surveys. Domains included research literacy, MRI knowledge, and attitudes about research incentives and biospecimen collection. Logistic regression was used to examine factors related to outcome variables. RESULTS Knowledge of MRI safety was low and research literacy was high across participants. Likelihood of participation given various incentives differed between participants. Those with lower education were less likely to rate any items as increasing likelihood of participation. Substance use during pregnancy improved the model fit only for items about alternate visit structures (home and telephone visits) and confidentiality. CONCLUSION Overall results support the feasibility of infant imaging studies, such as HBCD with respondents having high research literacy and interest in learning about their baby's development. Educating potential participants about MRI safety and providing flexible incentives for participation will improve the success of infant MRI studies.
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Affiliation(s)
- Kaelyn L Kohlasch
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Leigh-Anne Cioffredi
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Carly Lenninger
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Ellen Stewart
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States.
| | - Tessa Vatalaro
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Hugh Garavan
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
| | - Sarah H Heil
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
| | - Elizabeth E Krans
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, United States.
| | - Thalia Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Anna Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, 505 N W 185th Avenue, Beaverton, OR 97006, United States.
| | - Moriah Thomason
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Alexandra Potter
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States; Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
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Heid AR, Cartwright FP, Wilson-Genderson M, Pruchno R. Understanding Attrition and Bolstering Retention in a Longitudinal Panel of Older Adults: ORANJ BOWL. Innov Aging 2021; 5:igab010. [PMID: 33898761 PMCID: PMC8054864 DOI: 10.1093/geroni/igab010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Attrition from longitudinal studies can affect the generalizability of findings especially when studying developmental constructs such as successful aging. Research Design and Methods Using data from a 12-year (6-wave) panel of 5,688 older people (aged 50-74 at baseline), we compared people retained in the panel with people lost to follow-up on demographic characteristics and measures of successful aging. After instituting expanded retention strategies at Wave 6 (i.e., a team-based approach, social media, and paid web search engines), we compared different groups of people lost to follow-up (i.e., deceased and withdrawn due to lack of interest) and different types of completers (i.e., full completers vs. lost and reengaged completers). Results At baseline, Wave 6 completers were significantly younger, less likely to be African American, more likely to be married, reported higher levels of income and education, were more likely to be working full-time, had less pain and fewer chronic illnesses, and reported higher levels of subjective successful aging and functional ability than those lost to follow-up. Analyses demonstrated differences across groups based on the reason for loss (i.e., deceased, impaired, and not interested). Participants who missed an interview but returned to the panel were significantly different from those who participated in all waves of data collection. Expanded retention efforts improved generalizability, as people returning to the panel reported lower levels of education, lower levels of income, and were more likely to be African American. Discussion and Implications Biased attrition within longitudinal research affects the interpretation of study findings, especially when studying developmental outcomes. However, expanded retention strategies can reduce bias and loss and should be used to enhance retention efforts in longitudinal work.
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Affiliation(s)
| | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
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Vijayaraghavan M, Elser H, Frazer K, Lindson N, Apollonio D. Interventions to reduce tobacco use in people experiencing homelessness. Cochrane Database Syst Rev 2020; 12:CD013413. [PMID: 33284989 PMCID: PMC8130995 DOI: 10.1002/14651858.cd013413.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Populations experiencing homelessness have high rates of tobacco use and experience substantial barriers to cessation. Tobacco-caused conditions are among the leading causes of morbidity and mortality among people experiencing homelessness, highlighting an urgent need for interventions to reduce the burden of tobacco use in this population. OBJECTIVES To assess whether interventions designed to improve access to tobacco cessation interventions for adults experiencing homelessness lead to increased numbers engaging in or receiving treatment, and whether interventions designed to help adults experiencing homelessness to quit tobacco lead to increased tobacco abstinence. To also assess whether tobacco cessation interventions for adults experiencing homelessness affect substance use and mental health. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register, MEDLINE, Embase and PsycINFO for studies using the terms: un-housed*, homeless*, housing instability, smoking cessation, tobacco use disorder, smokeless tobacco. We also searched trial registries to identify unpublished studies. Date of the most recent search: 06 January 2020. SELECTION CRITERIA We included randomized controlled trials that recruited people experiencing homelessness who used tobacco, and investigated interventions focused on the following: 1) improving access to relevant support services; 2) increasing motivation to quit tobacco use; 3) helping people to achieve abstinence, including but not limited to behavioral support, tobacco cessation pharmacotherapies, contingency management, and text- or app-based interventions; or 4) encouraging transitions to long-term nicotine use that did not involve tobacco. Eligible comparators included no intervention, usual care (as defined by the studies), or another form of active intervention. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Tobacco cessation was measured at the longest time point for each study, on an intention-to-treat basis, using the most rigorous definition available. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study where possible. We grouped eligible studies according to the type of comparison (contingent reinforcement in addition to usual smoking cessation care; more versus less intensive smoking cessation interventions; and multi-issue support versus smoking cessation support only), and carried out meta-analyses where appropriate, using a Mantel-Haenszel random-effects model. We also extracted data on quit attempts, effects on mental and substance-use severity, and meta-analyzed these outcomes where sufficient data were available. MAIN RESULTS We identified 10 studies involving 1634 participants who smoked combustible tobacco at enrolment. One of the studies was ongoing. Most of the trials included participants who were recruited from community-based sites such as shelters, and three included participants who were recruited from clinics. We judged three studies to be at high risk of bias in one or more domains. We identified low-certainty evidence, limited by imprecision, that contingent reinforcement (rewards for successful smoking cessation) plus usual smoking cessation care was not more effective than usual care alone in promoting abstinence (RR 0.67, 95% CI 0.16 to 2.77; 1 trial, 70 participants). We identified very low-certainty evidence, limited by risk of bias and imprecision, that more intensive behavioral smoking cessation support was more effective than brief intervention in promoting abstinence at six-month follow-up (RR 1.64, 95% CI 1.01 to 2.69; 3 trials, 657 participants; I2 = 0%). There was low-certainty evidence, limited by bias and imprecision, that multi-issue support (cessation support that also encompassed help to deal with other challenges or addictions) was not superior to targeted smoking cessation support in promoting abstinence (RR 0.95, 95% CI 0.35 to 2.61; 2 trials, 146 participants; I2 = 25%). More data on these types of interventions are likely to change our interpretation of these data. Single studies that examined the effects of text-messaging support, e-cigarettes, or cognitive behavioral therapy for smoking cessation provided inconclusive results. Data on secondary outcomes, including mental health and substance use severity, were too sparse to draw any meaningful conclusions on whether there were clinically-relevant differences. We did not identify any studies that explicitly assessed interventions to increase access to tobacco cessation care; we were therefore unable to assess our secondary outcome 'number of participants receiving treatment'. AUTHORS' CONCLUSIONS There is insufficient evidence to assess the effects of any tobacco cessation interventions specifically in people experiencing homelessness. Although there was some evidence to suggest a modest benefit of more intensive behavioral smoking cessation interventions when compared to less intensive interventions, our certainty in this evidence was very low, meaning that further research could either strengthen or weaken this effect. There is insufficient evidence to assess whether the provision of tobacco cessation support and its effects on quit attempts has any effect on the mental health or other substance-use outcomes of people experiencing homelessness. Although there is no reason to believe that standard tobacco cessation treatments work any differently in people experiencing homelessness than in the general population, these findings highlight a need for high-quality studies that address additional ways to engage and support people experiencing homelessness, in the context of the daily challenges they face. These studies should have adequate power and put effort into retaining participants for long-term follow-up of at least six months. Studies should also explore interventions that increase access to cessation services, and address the social and environmental influences of tobacco use among people experiencing homelessness. Finally, studies should explore the impact of tobacco cessation on mental health and substance-use outcomes.
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Affiliation(s)
- Maya Vijayaraghavan
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Holly Elser
- Epidemiology, University of California, Berkeley, Berkeley, California, USA
| | - Kate Frazer
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin 4, Ireland
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Dorie Apollonio
- Clinical Pharmacy, University of California San Francisco, San Francisco, CA, USA
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Beasley LO, Ciciolla L, Jespersen JE, Chiaf AL, Schmidt M, Shreffler KM, Breslin FJ, Bakhireva LN, Sanjuan PM, Stephen JM, Coles CD, Chambers CD, Kable JA, Leeman L, Singer LT, Zellner J, Morris AS, Croff JM. Best Practices for Engaging Pregnant and Postpartum Women at Risk of Substance Use in Longitudinal Research Studies: a Qualitative Examination of Participant Preferences. ACTA ACUST UNITED AC 2020; 1:235-246. [PMID: 33134976 PMCID: PMC7592139 DOI: 10.1007/s42844-020-00019-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
There are significant barriers in engaging pregnant and postpartum women that are considered high-risk (e.g., those experiencing substance use and/or substance use disorders (SUD)) into longitudinal research studies. To improve recruitment and retention of this population in studies spanning from the prenatal period to middle childhood, it is imperative to determine ways to improve key research engagement factors. The current manuscript uses a qualitative approach to determine important factors related to recruiting, enrolling, and retaining high-risk pregnant and postpartum women. The current sample included 41 high-risk women who participated in focus groups or individual interviews. All interviews were analyzed to identify broad themes related to engaging high-risk pregnant and parenting women in a 10-year longitudinal research project. Themes were organized into key engagement factors related to the following: (1) recruitment strategies, (2) enrollment, and (3) retention of high-risk pregnant and parenting women in longitudinal research studies. Results indicated recruitment strategies related to ideal recruitment locations, material, and who should share research study information with high-risk participants. Related to enrollment, key areas disclosed focused on enrollment decision-making, factors that create interest in joining a research project, and barriers to joining a longitudinal research study. With regard to retention, themes focused on supports needed to stay in research, barriers to staying in research, and best ways to stay in contact with high-risk participants. Overall, the current qualitative data provide preliminary data that enhance the understanding of a continuum of factors that impact engagement of high-risk pregnant and postpartum women in longitudinal research with current results indicating the need to prioritize recruitment, enrollment, and retention strategies in order to effectively engage vulnerable populations in research.
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Affiliation(s)
- Lana O Beasley
- Department of Human Development and Family Science, Oklahoma State University, 338 Human Sciences, Stillwater, OK 74078 USA
| | - Lucia Ciciolla
- Department of Psychology, Oklahoma State University, Stillwater, OK USA
| | - Jens E Jespersen
- Department of Human Development and Family Science, Oklahoma State University, 338 Human Sciences, Stillwater, OK 74078 USA
| | - Ashleigh L Chiaf
- National Center for Wellness and Recovery, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
| | - Mallory Schmidt
- Department of Human Development and Family Science, Oklahoma State University, 338 Human Sciences, Stillwater, OK 74078 USA
| | - Karina M Shreffler
- Department of Human Development and Family Science, Oklahoma State University, 338 Human Sciences, Stillwater, OK 74078 USA
| | | | - Ludmila N Bakhireva
- Department of Pharmacy Practice, University of New Mexico School of Pharmacy, Albuquerque, NM USA.,Department of Family and Community Medicine, and Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM USA
| | - Pilar M Sanjuan
- Department of Psychology, University of New Mexico School of Medicine, Albuquerque, NM USA
| | - Julia M Stephen
- Department of Neurosciences, University of New Mexico School of Medicine, & The Mind Research Network, Albuquerque, NM USA
| | - Claire D Coles
- Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Emory University School of Medicine, Atlanta, GA USA
| | - Christina D Chambers
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
| | - Julie A Kable
- Departments of Psychiatry and Behavioral Sciences, and Pediatrics, Emory University School of Medicine, Atlanta, GA USA
| | - Lawrence Leeman
- Department of Family & Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM USA
| | - Lynn T Singer
- Departments of Pediatrics, Psychiatry and Psychology, School of Medicine at Case Western Reserve University, Cleveland, OH USA
| | - Jennifer Zellner
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
| | - Amanda S Morris
- Department of Human Development and Family Science, Oklahoma State University, 338 Human Sciences, Stillwater, OK 74078 USA
| | - Julie M Croff
- National Center for Wellness and Recovery, Oklahoma State University Center for Health Sciences, Tulsa, OK USA.,Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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Frampton GK, Shepherd J, Pickett K, Griffiths G, Wyatt JC. Digital tools for the recruitment and retention of participants in randomised controlled trials: a systematic map. Trials 2020; 21:478. [PMID: 32498690 PMCID: PMC7273688 DOI: 10.1186/s13063-020-04358-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 04/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Recruiting and retaining participants in randomised controlled trials (RCTs) is challenging. Digital tools, such as social media, data mining, email or text-messaging, could improve recruitment or retention, but an overview of this research area is lacking. We aimed to systematically map the characteristics of digital recruitment and retention tools for RCTs, and the features of the comparative studies that have evaluated the effectiveness of these tools during the past 10 years. METHODS We searched Medline, Embase, other databases, the Internet, and relevant web sites in July 2018 to identify comparative studies of digital tools for recruiting and/or retaining participants in health RCTs. Two reviewers independently screened references against protocol-specified eligibility criteria. Included studies were coded by one reviewer with 20% checked by a second reviewer, using pre-defined keywords to describe characteristics of the studies, populations and digital tools evaluated. RESULTS We identified 9163 potentially relevant references, of which 104 articles reporting 105 comparative studies were included in the systematic map. The number of published studies on digital tools has doubled in the past decade, but most studies evaluated digital tools for recruitment rather than retention. The key health areas investigated were health promotion, cancers, circulatory system diseases and mental health. Few studies focussed on minority or under-served populations, and most studies were observational. The most frequently-studied digital tools were social media, Internet sites, email and tv/radio for recruitment; and email and text-messaging for retention. One quarter of the studies measured efficiency (cost per recruited or retained participant) but few studies have evaluated people's attitudes towards the use of digital tools. CONCLUSIONS This systematic map highlights a number of evidence gaps and may help stakeholders to identify and prioritise further research needs. In particular, there is a need for rigorous research on the efficiency of the digital tools and their impact on RCT participants and investigators, perhaps as studies-within-a-trial (SWAT) research. There is also a need for research into how digital tools may improve participant retention in RCTs which is currently underrepresented relative to recruitment research. REGISTRATION Not registered; based on a pre-specified protocol, peer-reviewed by the project's Advisory Board.
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Affiliation(s)
- Geoff K. Frampton
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Karen Pickett
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton and Southampton University Hospital NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD UK
| | - Jeremy C. Wyatt
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
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Herrera L, Markle SL, Fukuda M, Aroca P, Villar A, Wang Y, Dominique G, Umoren O, Alegría M. Predictors of Research Assessment Completion in a Latino Sample with Dual Disorders. J Immigr Minor Health 2020; 22:1094-1100. [PMID: 32347414 DOI: 10.1007/s10903-020-01010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Latinos are underrepresented in clinical trials, where they encounter challenges in participation and a lack of effective recruitment and retention strategies. For Latino migrants with mental health and substance use problems, these challenges are even greater. Analyzing results from a multicenter randomized clinical trial for Latino migrants with mental health and substance use problems in Boston, Massachusetts, USA as well as Madrid and Barcelona, Spain, we describe six retention strategies used to facilitate participant engagement in follow-up assessments, and report the sociodemographic, clinical, and educational factors associated with research assessment completion. Among 341 randomized participants, 77% completed the 12-month follow-up and 75% completed at least 3 of the 4 follow-up assessments. Having a high school diploma, being recruited at community centers versus other sites, and having a less severe mental health condition were significantly associated with completing more follow-up interviews. Rigorous and customized methods reflecting participant's individual context can bolster research assessment completion for diverse Latino populations with behavioral health concerns.
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Affiliation(s)
- Lizbeth Herrera
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Sheri Lapatin Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Marie Fukuda
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Paloma Aroca
- Department of Psychiatry, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, Madrid, Spain
| | - Ana Villar
- Department of Psychiatry, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - Ye Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Georgina Dominique
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Olivia Umoren
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA. .,Departments of Medicine and Psychiatry, Harvard Medical School, Boston, MA, USA.
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9
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Yu SH, Gumport NB, Mirzadegan IA, Mei YJ, Hein K, Harvey AG. Addressing the Challenges of Recruitment and Retention in Sleep and Circadian Clinical Trials. Behav Sleep Med 2020; 18:23-34. [PMID: 31030562 PMCID: PMC6819244 DOI: 10.1080/15402002.2018.1518230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective/Background: Sleep and circadian disorders are prevalent worldwide and frequently comorbid with physical and mental illnesses. Thus, recruiting and retaining samples for sleep and circadian research are high priorities. The aims of this paper are to highlight barriers to recruitment and retention for participants with sleep or circadian dysfunction, and to share strategies used across two randomized controlled trials (RCTs) testing the efficacy of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) to address these challenges. Participants: The first RCT recruited 176 adolescents with an evening circadian chronotype, who were at risk in at least one of five health domains: behavioral, cognitive, emotional, physical, and social. The second RCT recruited 121 low-income, racial or ethnic minority adults diagnosed with severe mental illness (SMI) and comorbid sleep or circadian dysfunction. Methods: The current study examined participant, environment, and research factors that impacted recruitment and retention of participants with sleep or circadian dysfunction, and identified strategies to enhance recruitment and retention. Results: Strategies used to recruit participants included community-based recruiting, reducing stigma, and alleviating burdensome sleep data collection. Strategies used to retain participants in our studies included flexible scheduling, mitigating participant barriers, building rapport with participants through empathic and positive interactions, creative problem solving, consulting participant networks, and utilizing incentives and other positive engagement tools. Conclusion: Both at-risk adolescents and low-income, minority adults with comorbid SMI and sleep or circadian dysfunction experience significant barriers to research participation. Recruitment and retention strategies were creatively tailored to meet the unique barriers of these diverse populations.
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Affiliation(s)
| | | | | | - Yuh-Jang Mei
- University of California, Berkeley, California, USA
| | - Kerrie Hein
- University of California, Berkeley, California, USA
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10
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Kim M, Leierer S, Jeon J. Predictors of Post-Treatment Employment for Individuals with Substance Use Disorders. Community Ment Health J 2019; 55:1236-1245. [PMID: 31267298 DOI: 10.1007/s10597-019-00439-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
This study examined the influence of gender, post-treatment issue severities, and treatment participation rate on the post-treatment employment status of consumers with substance use disorders. The study analyzed the archival data of 100 unemployed and underemployed participants from a substance abuse intensive outpatient program. We found significant differences in the characteristics of gender, severity of alcohol use, drug use, psychiatric issues, and treatment participation rate. Female gender and low treatment participation rates negatively predicted employment. This study increased understanding about the interplay of alcohol, drug, and psychiatric influences on post-treatment employment status.
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Affiliation(s)
- Min Kim
- Incheon National University, Dept. of Social Welfare, #13-409, 119 Academy-ro Yeonsu-gu, Incheon, South Korea
| | - Stephen Leierer
- Department of Addictions and Rehabilitation Studies, East Carolina University, Health Sciences Building, Greenville, NC, 27834, USA
| | - JiHye Jeon
- Incheon National University, Dept. of Social Welfare, #13-409, 119 Academy-ro Yeonsu-gu, Incheon, South Korea.
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11
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Metse AP, Stockings E, Bailey J, Regan T, Bartlem K, Wolfenden L, Taylor G, Wiggers J, Bowman J. Rates of retention of persons with a mental health disorder in outpatient smoking cessation and reduction trials, and associated factors: protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e030646. [PMID: 31488491 PMCID: PMC6731776 DOI: 10.1136/bmjopen-2019-030646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/20/2019] [Accepted: 07/31/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Smoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors. METHODS AND ANALYSIS PsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2 >50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression. ETHICS AND DISSEMINATION This study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.
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Affiliation(s)
- Alexandra Patricia Metse
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
- Discipline of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Bailey
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Timothy Regan
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate Bartlem
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Gemma Taylor
- Department of Psychology, University of Bath, Bath, BA2 7AY, United Kingdom
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Jenny Bowman
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
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12
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Bhatia-Lin A, Boon-Dooley A, Roberts MK, Pronai C, Fisher D, Parker L, Engstrom A, Ingraham L, Darnell D. Ethical and Regulatory Considerations for Using Social Media Platforms to Locate and Track Research Participants. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2019; 19:47-61. [PMID: 31135323 PMCID: PMC7183769 DOI: 10.1080/15265161.2019.1602176] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team's experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as part of informed consent.
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Affiliation(s)
| | | | | | | | | | - Lea Parker
- a University of Washington School of Medicine
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13
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Metse AP, Hizam NAN, Wiggers J, Wye P, Bowman JA. Factors associated with retention in a smoking cessation trial for persons with a mental illness: a descriptive study. BMC Med Res Methodol 2018; 18:177. [PMID: 30587149 PMCID: PMC6307187 DOI: 10.1186/s12874-018-0640-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/10/2018] [Indexed: 01/06/2023] Open
Abstract
Background Exploring factors associated with retention in randomised trials provides insight into potential threats to internal and external study validity, and may inform the development of interventions to increase retention in future trials. Given a paucity of existing research in the field, a study was conducted to explore factors associated with retention in a smoking intervention trial involving persons with a mental illness, considering demographic and smoking characteristics, treatment condition and engagement in prior follow-up assessments. Method A descriptive study was undertaken using data derived from a RCT of a smoking cessation intervention initiated in four adult psychiatric inpatient units in New South Wales (NSW), Australia. Retention assessment was undertaken at 1, 6 and 12-months post-discharge. A Generalised Linear Mixed Model was adopted to explore associations between retention at any follow up time point and demographic and smoking characteristics. Chi square analyses explored the association between retention at all follow up time points and treatment condition, and binary logistic regression analyses assessed for relationships between retention at 12-month follow up and engagement in prior follow up assessments. Results Retention rates were 63, 56 and 60% at the 1, 6 and 12-month assessments, respectively. No association was found between retention at any follow-up time point and 13 of 15 demographic and smoking characteristics. Younger participants and those who identified to be Aboriginal and/or Torres Strait Islander were more likely to be retained (both ps > 0.05). Retention rates did not vary according to treatment condition at any follow-up time point. Participants who completed a prior assessment were more likely to complete the 12 month assessment (both prior assessments: OR 10.7, p < 0.001; 6 month assessment: OR 6.01, p < 0.001; and 1 month assessment: OR 1.8, p = 0.002). Conclusion The underrepresentation of younger participants and those identifying to be Aboriginal and/or Torres Strait Islander may limit the generalisability of findings. Findings suggest that inclusion of multiple contacts during a trial follow up period may increase retention at the final assessment. Interventions to improve retention, overall and for those sub-groups less likely to be retained, in smoking trials involving persons with a mental illness are needed. Further assessment of sample characteristics, and also trial design factors, associated with retention in this field is warranted.
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Affiliation(s)
- Alexandra P Metse
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. .,Murdoch University, South Street, Murdoch, WA, 6150, Australia.
| | - Nur Ashikin Noor Hizam
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Longworth Ave, Wallsend, NSW, 2287, Australia
| | - Paula Wye
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Jenny A Bowman
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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14
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Reynolds M, Driver S, Bennett M, Patel S, Rainey E, Warren AM. Examining the relationship between obesity and mental health outcomes among individuals admitted to a level I trauma centre. Clin Obes 2018; 8:337-344. [PMID: 30066450 DOI: 10.1111/cob.12264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/22/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
Abstract
The increased incidence of obesity in the general population translates into clinicians caring for an increased number of trauma patients with obesity. Previous research has documented the unique anatomical and physiological challenges that clinicians face when caring for trauma patients with obesity; however, little is known about psychological challenges that trauma patients with obesity may also experience in the months following injury. The aim of this study is to determine the relationship between obesity and (i) mental health, (ii) demographic and injury-related variables and (iii) quality-of-life outcomes among trauma patients between hospitalization and 3-months post-injury. This is a prospective, longitudinal study conducted between March 2012 and May 2014 at a single, level I trauma centre in the southwest United States. Inclusion criteria for this convenience sample consisted of patients who were admitted to the trauma or orthopaedic trauma service ≥24 h, medically stable, spoke English or Spanish and ≥18 years of age. In total, 455 eligible patients were consented and enrolled; 343 (70.87%) completed 3-month follow-up. The objective of this study is to investigate the relationship between obesity and mental health among trauma patients in the months following injury. Demographic and injury-related data were also collected; patients' height and weight were used to determine body mass index. Health outcomes were assessed during initial hospitalization and at 3-month follow-up and included depression, post-traumatic stress symptoms, pain and return to work. Prior to data collection, it was hypothesized that obesity would have a negative effect on mental health outcomes among patients 3 months post-injury. The final sample consisted of 343 participants; average age was 46.4 ± 17.3 years; majority male (n = 213, 63%) and Caucasian (n = 231, 69%). Patients with obesity had higher odds of screening positive for depression (odds ratio [OR] = 2.36, P = 0.02) and overweight patients had lower odds of returning to work (OR = 0.31, P = 0.01) 3 months post-injury compared to patients of normal weight (65% vs. 40%). No other significant differences were found. Results of the current study are novel in that they identify psychological challenges that overweight and trauma patients with obesity may experience. These results demonstrate the need for mental health professionals to be involved in follow-up care to extending in the months following injury.
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Affiliation(s)
- M Reynolds
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - S Driver
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - M Bennett
- Center for Clinical Effectiveness, Baylor Scott and White Health, Dallas, Texas, USA
| | - S Patel
- Physical Medicine and Rehabilitation, Salem Health Hospitals and Clinics, Salem, Oregon, USA
| | - E Rainey
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - A M Warren
- Division of Trauma, Critical Care and Acute Care, Baylor University Medical Center, Dallas, Texas, USA
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15
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Self-Brown S, Osborne MC, Boyd C, DeVeausse Brown N, Rostad W, Patterson A, Baker E, Thomas A, McAdam EM, Jackson M, Glasheen TL, Lai B. The impact of SafeCare® Dads to Kids program on father maltreatment risk and involvement: Outcomes and lessons learned from an efficacy trial. CHILD ABUSE & NEGLECT 2018; 83:31-41. [PMID: 30016743 DOI: 10.1016/j.chiabu.2018.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 05/28/2023]
Abstract
Child Maltreatment (CM) is a public health problem, and experts recommend parent training programs as a prevention method. Few programs target fathers, even though male caregivers are involved as perpetrators in approximately 45% of substantiated CM cases. This study examines the efficacy of an adapted version of SafeCare (Dad2K) with marginalized fathers. Participants include a convenience sample of fathers with children ages 2-5 years. Fathers (n=99) were randomized to an 1) intervention group (SafeCare Dad2K) or to a 2) comparison group (receiving parenting information in the mail). Quantitative data were collected at baseline, post-intervention (7-weeks post-baseline), and 3-months post-intervention. Qualitative data (semi-structured interviews) were collected from 11 intervention father completers following the second quantitative data collection timepoint. Multi-level modeling results indicated no statistically significant time-by-treatment findings for father involvement (b=0.03, 95% confidence interval [CI]: -0.03, 0.08, p=0.38), total corporal punishment (b=-0.03, 95% CI: -0.47, 0.41, p=0.89), or neglect (b=-0.13, 95% CI: -1.93, 1.68, p=0.89). Qualitative findings indicated that Dad2K completers exhibited positive knowledge and behavioral change related to parenting. Study limitations, lessons learned from this formative work, and recommendations for future research are discussed.
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Affiliation(s)
| | | | - Clinton Boyd
- School of Public Health, Georgia State University, United States
| | | | - Whitney Rostad
- School of Public Health, Georgia State University, United States
| | | | - Evander Baker
- School of Public Health, Georgia State University, United States
| | - Akilah Thomas
- School of Public Health, Georgia State University, United States
| | | | - Matt Jackson
- School of Public Health, Georgia State University, United States
| | | | - Betty Lai
- School of Public Health, Georgia State University, United States
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16
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Ridley-Merriweather KE, Head KJ. African American Women's Perspectives on Donating Healthy Breast Tissue for Research: Implications for Recruitment. HEALTH COMMUNICATION 2017; 32:1571-1580. [PMID: 27911088 DOI: 10.1080/10410236.2016.1250191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
African American women die of breast cancer at a higher rate than any other racial group. The Komen Tissue Bank (KTB) is an ongoing clinical trial that collects healthy breast tissue from women of all racial groups to use as controls in research and represents a critical tool in efforts to treat and prevent breast cancer; however, African Americans display reticence toward donating breast tissue to the KTB. Through the lens of the Integrated Behavioral Model, this study recruited African American women to share their perspectives on donating breast tissue for research purposes. Seventy-one (N = 71) eligible Black women who were previous tissue donors to the KTB responded to an online questionnaire. Findings revealed that (a) participants had positive instrumental attitudes or reasons for donating; (b) participants felt generally supported in their decision to donate, but revealed that the lack of Black women participating in the KTB meant that they themselves were setting the norm for others; and (c) their race was an important element in their donation decision. While acknowledging the negative history of African Americans in medical research, they offered their perceptions regarding the importance of involving themselves in medical research, and suggested that health communication strategies to recruit African Americans into research should embrace race as part of the message. The findings from this study have important implications for other those who work in applied clinical settings and are interested in addressing racial disparities in medical research through more effective and targeted recruitment messaging.
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Affiliation(s)
- Katherine E Ridley-Merriweather
- a Susan G. Komen® Tissue Bank at the IU Simon Cancer Center (Indianapolis)
- b Department of Communication Studies , Indiana University-Purdue University Indianapolis
| | - Katharine J Head
- a Susan G. Komen® Tissue Bank at the IU Simon Cancer Center (Indianapolis)
- b Department of Communication Studies , Indiana University-Purdue University Indianapolis
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17
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Self-Brown S, Osborne MC, Lai BS, De Veauuse Brown N, Glasheen TL, Adams MC. Initial Findings from a Feasibility Trial Examining the SafeCare Dad to Kids Program with Marginalized Fathers. JOURNAL OF FAMILY VIOLENCE 2017; 32:751-766. [PMID: 29307956 PMCID: PMC5754193 DOI: 10.1007/s10896-017-9940-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Few studies have explored the direct impact of behavioral parent training programs on child maltreatment behaviors among marginalized, at-risk fathers. This feasibility study examined SafeCare® Dad to Kids (Dad2K), an augmented version of the evidence-based child maltreatment prevention program SafeCare, to determine the acceptability and initial efficacy of the program for improving father parenting skills and reducing maltreatment risk. Ninety-nine fathers were enrolled in the study and randomized to the SafeCare Dad2K Intervention (n=51) or comparison (n=48). Intervention fathers participated in 6 home visiting sessions and comparison fathers received parenting materials via mail. All fathers participating in the study completed a baseline and 8-week assessment (post-intervention) of maltreatment behaviors. In addition, intervention fathers completed feasibility and parenting skill measures. A significant main effect emerged indicating decreases for both groups in psychologically aggressive behaviors. No significant group by time findings emerged for child maltreatment behaviors. Father intervention completers endorsed high satisfaction ratings for the program and demonstrated significant improvements in targeted father-child interaction skills. Based on the high rates of acceptability and initial improvement in positive parenting skills, findings demonstrate the feasibility for involving at-risk fathers in behavioral parent training programs targeting child maltreatment prevention.
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Affiliation(s)
| | | | - Betty S Lai
- Georgia State University, School of Public Health
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18
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Kannisto KA, Korhonen J, Adams CE, Koivunen MH, Vahlberg T, Välimäki MA. Factors Associated With Dropout During Recruitment and Follow-Up Periods of a mHealth-Based Randomized Controlled Trial for Mobile.Net to Encourage Treatment Adherence for People With Serious Mental Health Problems. J Med Internet Res 2017; 19:e46. [PMID: 28223262 PMCID: PMC5340923 DOI: 10.2196/jmir.6417] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/02/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022] Open
Abstract
Background Clinical trials are the gold standard of evidence-based practice. Still many papers inadequately report methodology in randomized controlled trials (RCTs), particularly for mHealth interventions for people with serious mental health problems. To ensure robust enough evidence, it is important to understand which study phases are the most vulnerable in the field of mental health care. Objective We mapped the recruitment and the trial follow-up periods of participants to provide a picture of the dropout predictors from a mHealth-based trial. As an example, we used a mHealth-based multicenter RCT, titled “Mobile.Net,” targeted at people with serious mental health problems. Methods Recruitment and follow-up processes of the Mobile.Net trial were monitored and analyzed. Recruitment outcomes were recorded as screened, eligible, consent not asked, refused, and enrolled. Patient engagement was recorded as follow-up outcomes: (1) attrition during short message service (SMS) text message intervention and (2) attrition during the 12-month follow-up period. Multiple regression analysis was used to identify which demographic factors were related to recruitment and retention. Results We recruited 1139 patients during a 15-month period. Of 11,530 people screened, 36.31% (n=4186) were eligible. This eligible group tended to be significantly younger (mean 39.2, SD 13.2 years, P<.001) and more often women (2103/4181, 50.30%) than those who were not eligible (age: mean 43.7, SD 14.6 years; women: 3633/6514, 55.78%). At the point when potential participants were asked to give consent, a further 2278 refused. Those who refused were a little older (mean 40.2, SD 13.9 years) than those who agreed to participate (mean 38.3, SD 12.5 years; t1842=3.2, P<.001). We measured the outcomes after 12 months of the SMS text message intervention. Attrition from the SMS text message intervention was 4.8% (27/563). The patient dropout rate after 12 months was 0.36% (4/1123), as discovered from the register data. In all, 3.12% (35/1123) of the participants withdrew from the trial. However, dropout rates from the patient survey (either by paper or telephone interview) were 52.45% (589/1123) and 27.8% (155/558), respectively. Almost all participants (536/563, 95.2%) tolerated the intervention, but those who discontinued were more often women (21/27, 78%; P=.009). Finally, participants’ age (P<.001), gender (P<.001), vocational education (P=.04), and employment status (P<.001) seemed to predict their risk of dropping out from the postal survey. Conclusions Patient recruitment and engagement in the 12-month follow-up conducted with a postal survey were the most vulnerable phases in the SMS text message-based trial. People with serious mental health problems may need extra support during the recruitment process and in engaging them in SMS text message-based trials to ensure robust enough evidence for mental health care. ClinicalTrial International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6oHcU2SFp)
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Affiliation(s)
- Kati Anneli Kannisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Joonas Korhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Sciences, Turku, Finland
| | - Clive E Adams
- Institute of Mental Health, Division of Psychiatry, University of Nottingham, Nottingham, United Kingdom
| | - Marita Hannele Koivunen
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Tero Vahlberg
- Department of Biostatistics, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Maritta Anneli Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
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19
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Courtney RJ, Clare P, Boland V, Martire KA, Bonevski B, Hall W, Siahpush M, Borland R, Doran CM, West R, Farrell M, Mattick RP. Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers. Addict Behav 2017; 64:13-20. [PMID: 27533077 DOI: 10.1016/j.addbeh.2016.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/20/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Little is known about the factors associated with retention in smoking cessation trials, especially for low-socioeconomic status (low-SES) smokers. This study examined the factors associated with retention of low-SES smokers in the Australian Financial Interventions for Smoking Cessation Among Low-Income Smokers (FISCALS) trial. DESIGN A two-group parallel block randomised open-label trial with allocation concealment. SETTING Australia. The study was conducted primarily by telephone-based interviews with nicotine replacement therapy delivered via mail. PARTICIPANTS 1047 low-SES smokers interested in quitting smoking were randomised. MEASUREMENTS Participants completed computer assisted telephone interviews (CATIs) at baseline, 2-month and 8-month follow-up. Smoking-related, substance use, mental or physical health, general psychological constructs, sociodemographic and recruitment sources association with retention at 8-month follow-up were examined using binary logistic regression. FINDINGS 946 participants (90%) completed the 2-month follow-up interview and 880 participants (84%) completed the 8-month follow-up interview. Retention at 8-months was associated with higher motivation to quit (OR: 1.15; 95% CI: 1.04, 1.27 p<0.01), more recent quit attempts (OR: 1.20; 95% CI: 1.04, 1.40 p<0.05), increasing age (OR: 1.05; 95% CI: 1.03, 1.07 p<0.01), and higher level of education (OR: 2.24; 95% CI: 1.45, 3.46 p<0.01). Lower retention at 8-months occurred for those participants recruited from posters placed in Department of Human Service Centrelink Offices (OR: 0.56; 95% CI: 0.35, 0.89, p<0.05) compared to participants recruited from Quitline services. No significant differences in retention were found for participants recruited via newspaper advertisements or word of mouth compared to Quitline services. No significant associations were found between health-related or behavioural factors and retention. CONCLUSIONS In the context of high overall retention rates from disadvantaged smokers in a randomised trial, retention was greater in those smokers with higher motivation to quit, more recent quit attempts, increased age, higher level of education and for those recruited through Quitline or newspaper advertisements.
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Affiliation(s)
- Ryan J Courtney
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia.
| | - Philip Clare
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Veronica Boland
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Kristy A Martire
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia; School of Psychology, UNSW, Australia. http://orcid.org/0000-0002-5324-0732
| | - Billie Bonevski
- School of Medicine & Public Health, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Wayne Hall
- Centre for Clinical Research, University of Queensland, Australia
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, United States
| | - Ron Borland
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Australia
| | - Christopher M Doran
- School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Australia
| | - Robert West
- UCL Department of Epidemiology & Public Health, University College London, UK
| | - Michael Farrell
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
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20
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Farabee D, Schulte M, Gonzales R, Grella CE. Technological aids for improving longitudinal research on substance use disorders. BMC Health Serv Res 2016; 16:370. [PMID: 27509830 PMCID: PMC4980796 DOI: 10.1186/s12913-016-1630-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 08/04/2016] [Indexed: 01/17/2023] Open
Abstract
Background There is a broad consensus that addictive behaviors tend to be chronic and relapsing. But for field studies of substance users, successfully tracking, locating, and following up with a representative sample of subjects is a challenge. Methods The purpose of this paper is to provide a general overview of how current technological aids can support and improve the quality of longitudinal research on substance use disorders. The review is grouped into four domains: (1) tracking and locating, (2) prompting/engaging, (3) incentivizing, and (4) collecting data. Results & conclusions Although the technologies described in this review will be modified or replaced over time, our findings suggest that incorporating some or all of these currently available approaches may improve research efficiency, follow-up rates, and data quality.
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Affiliation(s)
- David Farabee
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA.
| | - Marya Schulte
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA
| | - Rachel Gonzales
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA
| | - Christine E Grella
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA
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Hickman NJ, Delucchi KL, Prochaska JJ. Treating Tobacco Dependence at the Intersection of Diversity, Poverty, and Mental Illness: A Randomized Feasibility and Replication Trial. Nicotine Tob Res 2016; 17:1012-21. [PMID: 26180227 DOI: 10.1093/ntr/ntv034] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION In an ethnically-diverse, uninsured psychiatric sample with co-occurring drug/alcohol addiction, we evaluated the feasibility and reproducibility of a tobacco treatment intervention. The intervention previously demonstrated efficacy in insured psychiatric and nonpsychiatric samples with 20.0%-25.0% abstinence at 18 months. METHODS Daily smokers, recruited in 2009-2010 from psychiatric units at an urban public hospital, were randomized to usual care (on-unit nicotine replacement plus quit advice) or intervention, which added a Transtheoretical-model tailored, computer-assisted intervention, stage-matched manual, brief counseling, and 10-week post-hospitalization nicotine replacement. RESULTS The sample (N = 100, 69% recruitment rate, age M = 40) was 56% racial/ethnic minority, 65% male, 79% unemployed, and 48% unstably housed, diagnosed with unipolar (54%) and bipolar (14%) depression and psychotic disorders (46%); 77% reported past-month illicit drug use. Prior to hospitalization, participants averaged 19 (SD = 11) cigarettes/day for 23 (SD = 13) years; 80% smoked within 30 minutes of awakening; 25% were preparing to quit. Encouraging and comparable to effects in the general population, 7-day point prevalence abstinence for intervention versus control was 12.5% versus 7.3% at 3 months, 17.5% versus 8.5% at 6 months, and 26.2% versus 16.7% at 12 months. Retention exceeded 80% over 12 months. The odds of abstinence increased over time, predicted by higher self-efficacy, greater perceived social status, and diagnosis of psychotic disorder compared to unipolar depression. CONCLUSIONS Findings indicate uninsured smokers with serious mental illness can engage in tobacco treatment research with quit rates comparable to the general population. A larger investigation is warranted. Inclusion of diverse smokers with mental illness in clinical trials is supported and encouraged.
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Affiliation(s)
- Norval J Hickman
- Tobacco-Related Disease Research Program, University of California, Office of the President, Oakland, CA;
| | - Kevin L Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
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22
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Michalek AK, Kan D, Prochaska J. Engaging veterans with substance abuse disorders into a research trial: success with study branding, networking, and presence. Transl Behav Med 2015; 5:167-76. [PMID: 26029279 PMCID: PMC4444706 DOI: 10.1007/s13142-014-0302-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Recruiting and retaining clients in health interventions can be challenging especially when targeting multiple behavior change in high-risk populations. To inform the methods of trials working with similarly complex clinical populations, we describe multi-pronged efforts to recruit and retain a representative sample. In a two-group RCT, veterans were recruited from a Veteran Affairs Medical Center. The goal was to enroll 200 participants over a 25-month period, and to exceed 70 % follow-up for all treatment arms. To meet these goals, a four-pronged strategy was developed: branding, outreach/networking, onsite presence, and incentives. In month 1, 32 % of the proposed sample size was met (n = 64), and by month 2, 45 % (n = 90); the recruitment goal (n = 200) was achieved 13 months ahead of schedule. Retention exceeds 90 % at all time points out to 18 months. The multipronged recruitment and retention plan was efficient, cost effective, and may generalize to other health promotion initiatives.
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Affiliation(s)
- Anne Kathryn Michalek
- />Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143-0984 USA
| | - David Kan
- />San Francisco Veteran Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121 USA
| | - Judith Prochaska
- />Stanford Prevention Research Center, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA 94305-5411 USA
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23
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Torres LN, Turok DK, Sanders JN, Jacobson JC, Dermish AI, Ward K. We should really keep in touch: predictors of the ability to maintain contact with contraception clinical trial participants over 12 months. Contraception 2014; 90:575-80. [PMID: 25242443 DOI: 10.1016/j.contraception.2014.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 07/23/2014] [Accepted: 07/27/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study assesses the ability to maintain contact with participants enrolled in an emergency contraception (EC) trial with 12 months of follow-up based on the modes of contact they provided at enrollment. STUDY DESIGN Data came from a clinical trial offering women the copper intrauterine device or oral levonorgestrel for EC. A modified Poisson regression was used to assess predictors associated with the ability to contact study participants 12 months after enrollment. RESULTS Data were available for 542 participants; 443 (82%) could be contacted at 12 months. Contact at 12 months was greatest for those whose preferred the method of contact was text messaging, e-mail or any (62/68; 91% contacted) and worst for the 18 who had a landline phone (only 7 contacted; 39%). After controlling for age, having an e-mail address, text messaging, language preference, type of EC chosen and insurance, preferred contact other than phone increased the likelihood of follow-up by 10% [risk ratio (RR) 1.1 95% confidence interval (CI) 1.0-1.2], while having a landline reduced a woman's likelihood of being contacted at 12 months by 50% compared to women with a contract cell (RR 0.5, 95% CI 0.3-1.0). CONCLUSION The few women with a landline for contact had poor follow-up at 1 year, while women who preferred e-mail or text had the highest rate of follow-up. IMPLICATIONS Understanding how best to reduce loss to follow-up is an essential component of conducting a contraceptive clinical trial. Improved participant retention maximizes internal validity and allows for important clinical outcomes, such as pregnancy, to be assessed.
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Affiliation(s)
- Leah N Torres
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.
| | - David K Turok
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Jessica N Sanders
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Janet C Jacobson
- Planned Parenthood of Orange and San Bernardino Counties, Orange, CA, USA
| | | | - Katherine Ward
- University of Utah College of Nursing, Salt Lake City, UT, USA
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