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Abstract Objective Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition.
We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research. We also examined reference lists of eligible articles and relevant reviews.
A data-driven thematic analysis of the retention strategies identified common themes. Results We retrieved 3, citations, 21 studies were eligible for inclusion. We abstracted strategies and from these identified 12 themes. The studies reported a median of 17 strategies across a median of six themes.
The most commonly reported strategies were systematic methods of participant contact and scheduling.
There was no difference in the number of themes used. Conclusion Available evidence suggests that investigators should consider using a number of retention strategies across several themes to maximize the retention of participants.
Further research, including explicit evaluation of the effectiveness of different strategies, is needed. The study results may be biased by differential dropout between comparison groups or by differences between those participants who drop out and those that continue to participate.
Loss to follow-up also may threaten the generalizability of a study, as well as its statistical power. Despite these threats, little attention has been paid to the optimal methods of maintaining participants in a study.
For example, based on their experiences in studies of people over 65 years old, Cassidy et al suggested that personalized attention, empathy and support from study staff resulted in higher participant completion[ 3 ].
Shumaker et al similarly drew on their own experiences to outline approaches to promote retention including screening out those likely to not remain in the study and early identification and tracking of study participants who are poor or non-adherers[ 4 ].
Coday et al collected lessons learned from 14 NIH-funded behavioral change trials [ 5 ]. They elicited perceived barriers to participant retention and 61 retention strategies from the project staff and investigators from these trials.
The retention strategies were categorized into eight themes which study personnel then ranked based on perceived effectiveness. The strategy category of flexibility followed by incentives, benefits and persistence were rated as most effective by the study personnel.
Davis et al completed a review of trials between and identifying 21 studies that included a description of retention strategies and retention rates[ 6 ]. The authors provided a table listing the trials rank-ordered based on the retention rate specifics not provided and suggested that those studies with higher retention were those using a combination of strategies.
The paper combined discussion about retention and recruitment strategies as well as about studies with mail or telephone follow-up versus those with in-person visits.
In the existing literature, we could not identify any explicit evaluation of the effectiveness of retention strategies, such as a comparison of follow-up rates using different strategies.
To help comprehensively synthesize strategies for participant retention in research studies and to evaluate areas for future methodological research in this field, we conducted a systematic review of studies which described strategies for maximizing retention for in-person follow-up.
We reviewed only those published reports with a primary focus on retention strategies. We included studies that provided data on retention rates, described data from a primary study, and provided information regarding strategies used to retain participants.
The specific search strategies are provided in Appendix I. We also examined the reference lists of eligible articles and relevant reviews [ 3 ; 7 — 31 ].
All retrieved citations were screened independently by two authors to determine eligibility. Data Abstraction and Synthesis Two reviewers abstracted information about the study, including design, location and target population and health condition.
We also abstracted all retention strategies and retention rates at all follow-up time points.
We completed a data-driven thematic analysis of the retention strategies[ 32 ]. Using an iterative, multi-step process, we reviewed all abstracted retention strategies to identify themes and to classify each strategy within these themes. Initially, two authors independently reviewed the strategies and identified themes.
Second, a third author reviewed these independent results, reconciled differences and proposed a list of common themes. Third, this list of themes and categorization of strategies was discussed at a team meeting and we developed consensus on a final list of themes.
Fourth, two authors independently re-reviewed the strategies and assigned each strategy to one of the themes from the final list. Finally, a third author adjudicated all assigned themes. Any remaining disagreements were discussed and resolved at a team meeting. Of thesewe excluded an additional 94 primarily because the article did not describe a primary study e.
There were 21 articles that met our eligibility criteria.See the 7 reasons why you have trouble remembering what you learn and 15 memory improvement strategies that will help increase your retention.
How To Retain Information. it’s important to schedule periodic study sessions and constantly review information in your mind. 3. Psychological. Motivated forgetting – according to famous. Study skills, academic skill, or study strategies are approaches applied to learning.
They are generally critical to success in school, considered essential for acquiring good grades, and useful for learning throughout one's life. Study skills are an array of skills which tackle the process of organizing and taking in new information, retaining information, or .
Reading comprehension is basically understanding and retaining what you read. This lesson explored five different reading comprehension strategies that can be used by themselves or in a combination. The study, which is part of an ongoing series of research projects by DCV and ARC, follows a similar survey we conducted last year [see "Nine ways to boost warehouse performance Four management strategies for retaining labor">contact Chief .
In this lesson, we'll define agile talent. You'll learn about the importance of retaining agile talent, why they leave and strategies to embrace their expertise and keep them on board.
Study strategies come in dozens of types, but the key is to determine your needs or weaknesses, and use strategies that work for you to strengthen yourself in those areas.