Abstract
BackgroundIdentifying successful strategies to improve participant retention in longitudinal studies remains a challenge. In this study we evaluated whether non-traditional fieldworker shifts (after hours during the week and weekends) enhanced participant retention when compared to retention during traditional weekday shifts in the HPTN 071 (PopART) population cohort (PC).MethodsHPTN 071 (PopART) PC participants were recruited and followed up in their homes on an annual basis by research fieldworkers over a 3-4 year period. The average number of successful follow-up visits, where a PC participant was found and retained in the study, was calculated for each of 3 visit schedules (early weekday shift, late weekday shift, and Saturday shift), and standardized to account for variation in fieldwork shift duration. We used one-way univariate analysis of variance (ANOVA) to describe differences in mean-successful visits and 95% confidence intervals between the shift types.ResultsData on 16 651 successful visits were included. Successful visit rates were higher when conducting Saturday visits (14.0; 95% CI: 11.3-16.6) compared to both regular (4.5; 95% CI: 3.7-5.3) and late weekday shifts (5.3; 95% CI: 4.7-5.8) overall and in all subgroup analyses (P<0.001). The successful visit rate was higher amongst women than men were during all shift types (3.2 vs. 1.3, p<0.001). Successful visit rates by shift type did not differ significantly by age, over time, by PC round or by community triplet.ConclusionThe number of people living with HIV continues to increase annually. High quality evidence from longitudinal studies remains critical for evaluating HIV prevention and treatment strategies. This study showed a significant benefit on participant retention through introduction of Saturday shifts for home visits and these data can make an important contribution to the emerging body of evidence for improving retention in longitudinal research.Trial registrationPopART was approved by the Stellenbosch University Health Research Ethics Committees (N12/11/074), London School of Hygiene and Tropical Medicine (6326) ethics committee and the Division of AIDS (DAIDS) (Protocol ID 11865). PopART was registered with ClinicalTrials.gov (registration number NCT01900977).
Highlights
Identifying successful strategies to improve participant retention in longitudinal studies remains a chal‐ lenge
Data on 9765 (PC12) and 6885 (PC24) participants upon completion of a successful household visit at successive population cohort (PC) rounds were included in this study
There were a few exceptions to the standard duration of shift types, but most days were of standard duration: 53/55 (96.4%) of 8 hour early weekday and 125/141 (88.7%) of 8 hour late weekday shifts, and 100% of 5 hour Saturday shifts (Table 1)
Summary
Identifying successful strategies to improve participant retention in longitudinal studies remains a chal‐ lenge. In spite of advances in HIV prevention and treatment services, antiretroviral treatment (ART) coverage in high burden settings like South Africa remains low, with 68% of PLHIV on ART, well below the WHO target of 80% [2]. There remain extensive gaps in published evidence to guide strategies for implementation of HIV treatment and prevention services in high burden settings and successful completion of studies required to provide this evidence is challenging [2]. To illustrate; in a cohort study by Seed et al that recruited mother and infant pairs and evaluated childhood development, attrition rates of 62%, were recorded in a four-year follow up period [5]. In a further cohort study by Whiteman et al, which evaluated waste site exposure in Queensland Australia, high attrition rates of 53% were experienced over a 12 month follow up period [6]
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