142nd APHA Annual Meeting and Exposition

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306068
Maximizing Retention in an Urban Prospective Cohort Study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 9:15 AM - 9:30 AM

Elaina Murray, BS , College for Public Health and Social Justice, Saint Louis University, St Louis, MO
Kate E. Beatty, PHD, MPH , School of Public Health, Saint Louis University, St Louis, MO
Louise H. Flick, DrPH, MPE, MSN , Department of Epidemiology, Saint Louis University, College of Public Health & Social Justice, St Louis, MO
Micheal Elliott, PHD , College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO
Lisa V. John, PhD , Center for Analytics and Public Health, Battelle Memorial Institute, St Louis, MO
Vetta Thompson-Sanders, PHD , George Warren Brown School of Social Work, Washington University in St. Louis, Saint Louis, MO
Allison King, MD, MPH , Program in Occupational Therapy and the Department of Pediatrics, Washington University in St. Louis, St Louis, MO
Laura W. Bernaix, PhD, RN , School of Nursing, Southern Illinois University Edwardsville, Edwardsville, IL
Candi LeDuc, RN , Southern Illinois University Edwardsville, Edwardsville, IL
Elizabeth Lacy, RN , Southern Illinois University Edwardsville, Edwardsville, IL
Kristi Helmkamp, RN , Battelle St. Louis Operations, Saint Louis, MO
Amanda S. Harrod, MPH , College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
Nicole I. Weinstein, MSW , St. Louis City Field Office, National Children's Study, Battelle Centers for Public Health Research, St Louis, MO
  
BACKGROUND: Retaining participants in multi-year prospective cohort studies presents challenges, especially in urban settings. Early identification of participants at risk for attrition may enhance retention. We examine the validity of two risk for loss-to-follow-up assessments and early retention efforts in one Primary Sampling Unit during the National Children’s Study pilot. Our goal was to identify cases requiring additional attention. Retention challenges included high poverty, frequent moves, lack of spousal support, and mistrust of research.

METHODS: Recruitment ended in 2012 and research activities shifted to retention. Data collectors (DC) completed subjective risk assignments (low, medium, high) based on knowledge of participants. Descriptive statistics compared risk assessments to socio-demographic characteristics, responses regarding participation, and missed appointments 11 months after risk assessment

RESULTS: We recruited approximately 100 participants. Higher perceived risk was associated with greater likelihood for mothers to be minorities, younger, and have lower education and income (X2=15.362, p<.01; X2=12.118, p<.05; X2=9.947. p<.01; and X2= 7.720, p<.05 respectively). Participants with income below federal poverty placed higher values on receiving incentives (X2= 6.011 p<.05). African American or “other” race participants placed a higher value on feeling comfortable with the interviewers than White respondents (X2=12.539 p<.01). Risk assignment and race were associated with number of missed appointments (X2=8.698 p<.01; X2 =4.307, p<.05).

CONCLUSION: Results suggest DCs’ subjective assessment of risk predicts number of missed appointments.  Future research might consider strategies to improve African American and “other” race participants’ comfort with interviewers. The ethics of dollar amounts for incentives among low-income participants remain a concern.

Learning Areas:

Epidemiology
Public health or related research

Learning Objectives:
Evaluate two approaches to measuring risk of loss-to-follow up in a longitudinal study. Identify socio-demographic characteristics associated with retention in one urban location.

Keyword(s): Methodology, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Provider Liaison on the National Children's Study for 2.5 years and actively aided in the collection and analysis of Study data.
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: 3031.0: Methods and Models in Epidemiologic Practice and Theory