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APHA Scientific Session and Event Listing

Linda C. Pugh, PhD¹, Kevin Frick, PhD², Renee Milligan¹, Colleen Clapp, BA¹, Pam Homiak, MPH¹, and Letta Grant¹. (1) School of Nursing, Johns Hopkins University, 525 N. Wolfe St, Baltimore, MD 21205, 410-614-5311, lpugh@son.jhmi.edu, (2) Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm 606, Baltimore, MD 21205-1901

Combating high rates of attrition can be one of the greatest challenges for longitudinal studies of low-income, urban populations. This common roadblock encountered by researchers working on studies of low-income vulnerable women has been well-documented. In this clinical community based trial of a breastfeeding intervention, strategies to increase retention – including monetary incentives, frequent mailings, unscheduled home visits, and night and weekend visits meant to accommodate participants' hectic lives were helpful. In an effort to better focus strategies, the 185 women who were 12 months from recruitment were evaluated to determine whether a predictive model of risk factors for attrition could be identified.

Potential attrition risk factors for attrition were obesity, postpartum depression, marital status, education, number of children, type of delivery, employment, age, and race. Bivariate analyses were conducted. Employed was significantly negatively associated with being retained in the study until 12 months (p < 0.015).

Logistic regression was conducted. The dependent variable was retention or not at 12 months. Risk variables were entered simultaneously. The significant predictor (p<.05) for retention was employed (OR=0.357). Being obese was marginally significant (p value 0.072, OR=0.488), demonstrating two risks of not being retained in the study.

The unpredictable nature of attrition in longitudinal studies and the increased challenges encountered by low-income women as a result of the Welfare reform implemented in 1996 suggest that future research on low-income urban populations should include efforts to better understand effective means of retaining participants for the duration of the study.

Learning Objectives:

At the conclusion of this session, the participant will be able to
• identify three potential barriers that affect retention in longitudinal studies
• articulate two strategiew to decrease attrition in longituidnal studies.
• recognize the complex and unpredictable nature of attrition in longitudinal studies of low-income women.

Keywords: Breastfeeding, Research

Presenting author's disclosure statement:

Not Answered