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Abstract
BackgroundNon-participation and attrition are rarely studied despite being important methodological issues when performing post-disaster studies. A longitudinal survey of civilians exposed to the January 2015 terrorist attacks in Paris, France, was conducted 6 (Wave 1) and 18 months (Wave 2) after the attacks. We described non-participation in Wave 1 and determined the factors associated with attrition in Wave 2.MethodsMultivariate logistic regression models were used to compare participants in both waves with those who participated in the first wave only. Analyses were performed taking the following factors into account: socio-demographic characteristics, exposure to terror, peri-traumatic reactions, psychological support, perceived social support, impact on work, social and family life, and mental health disorders. Characteristics of new participants in Wave 2 were compared with participants in both waves using a chi-square test.ResultsOf the 390 persons who were eligible to participate in the survey, 190 participated in Wave 1 (participation rate: 49%). The most frequently reported reason for non-participation was to avoid being reminded of the painful event (32%, n = 34/105). In Wave 2, 67 were lost to follow-up, 141 people participated, of whom 123 participated in Wave 1 (re-participation rate: 65%) and 18 were new. Attrition in Wave 2 was associated with socio-demographic characteristics (age, French origin) and location during the attacks, but not with terror exposure or mental health disorders. Compared with those who participated in both waves, new participants declared less social and psychological support since the attacks.ConclusionsAttrition at 6 months was not associated with exposure to terror or mental health disorders, which indicates that any bias in future analyses on IMPACTS on mental health outcomes will be limited. Our findings suggest the importance of adapting similar surveys for people of foreign origin and of improving strategies to avoid attrition of younger people, for example by using social media, peers, and the educational environment. The present study also revealed that a high level of exposure to terror and a lack of social and psychological support after a terrorist event could impede individuals’ participation in similar surveys in the short term.
Highlights
Non-participation and attrition are rarely studied despite being important methodological issues when performing post-disaster studies
We aimed to describe reasons why some civilians exposed to terror did not wish to participate in Wave 1 of IMPACTS, to determine the factors associated with attrition in Wave 2 in order to describe any selection bias, and to compare characteristics of new participants in Wave 2 with participants of both waves in order to examine the benefit of the open cohort design
We studied whether sociodemographic characteristics at baseline, terror exposure characteristics, peri-traumatic reactions, psychological support given by professionals, social support and certain diagnosed mental health disorders were different between 1) participants in both waves, 2) participants in Wave 1 who were subsequently lost to follow-up in Wave 2, and 3) participants not included at Wave 1 but who participated in Wave 2
Summary
Non-participation and attrition are rarely studied despite being important methodological issues when performing post-disaster studies. A longitudinal survey of civilians exposed to the January 2015 terrorist attacks in Paris, France, was conducted 6 (Wave 1) and 18 months (Wave 2) after the attacks. In order to investigate the impact of these terrorist attacks on civilians and on rescue workers’ mental health and social functioning, as well as to assess the social support and mental health care they received in short- and in long-term care, Santé publique France (the French National Public Health Agency), with the support of the Greater Paris regional health agency, launched the IMPACTS survey (the French acronym for Investigation of Trauma Consequences in People Exposed to the January 2015 Terrorist Attacks and their Support and Mental care) [4].
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