263317 Participant and site characteristics related to short-term and long-term retention in a diabetes prevention translational project: A multilevel analysis

Monday, October 29, 2012 : 12:30 PM - 12:45 PM

Luohua Jiang , Epidemiology and Biostatistics, Texas A&M Health Science Center, College Station, TX
Spero Manson, PhD , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Edward Dill , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Janette Beals, PhD , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Ann Johnson , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Haixiao Huang , Centers for American Indian and Alaska Native Health, University of Colorado Denver, Aurora, CO
Kelly Acton , Office of the Assistant Secretary of Health, US Department of Health & Human Services, San Francisco, CA
Yvette Roubideaux , Office of the Director, Indian Health Service, Rockville, MD
Objective: Using multilevel analysis, this study investigated participant and site characteristics associated with participant retention in a multi-site diabetes prevention translational project among American Indian and Alaska Natives.

Design and Methods: We analyzed data from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), a lifestyle intervention program to prevent diabetes implemented in 36 AI/AN grantee sites. A total of 2,553 participants were recruited and started the intervention between 01/01/2006 and 07/31/2008. They were offered the 16-session Lifestyle Balance Curriculum from the Diabetes Prevention Program (DPP) in the first 16-20 weeks of intervention. Generalized estimating equation models and proportional hazards models with robust standard error estimates were used to evaluate the relationships of participant and site characteristics with retention while accounting for the intra-class correlation among participants from the same site.

Results: As of 07/31/2009, about 50% of SDPI-DP participants were lost to follow-up. Those who were younger, male, with lower household income, no family support person, and more chronic pain were at higher risk for both short-term and long-term retention failure (i.e., not completing all 16 DPP sessions and loss to follow-up, respectively). Sites with large user population size had lower likelihood of retaining participants. Other site characteristics related to higher risk for retention failure included low average participant interest in the program and lack of transportation or child/elder care among participants, as reported by site staff.

Conclusions: Future translational initiatives need to pay attention to both participant and site level factors in order to maximize participant retention.

Learning Areas:
Biostatistics, economics
Epidemiology
Social and behavioral sciences

Learning Objectives:
Assess participant and site characteristics associated with participant retention in a multi-site diabetes prevention translational project. Demonstrate how to use generalized estimating equation models and proportional hazards models with robust standard error estimates to analyze multilevel binary and survival data from a community translational effort.

Keywords: Minority Health, Biostatistics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have designed the study, analyzed the data, and been responsible for writing the draft of the manuscript.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3271.0: Statistical Applications in Diabetic Research