Abstract
BackgroundEffective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources. Yet standardized guidelines for planning and reporting on retention efforts have been lacking. As with randomized controlled trial (RCT) and systematic review (SR) protocols, retention protocols are an opportunity to improve transparency and rigor. An RCT being conducted in British Columbia (BC), Canada provides a case example for developing a priori retention frameworks for use in protocol planning and reporting.MethodsThe BC Healthy Connections Project RCT is examining the effectiveness of a nurse home-visiting program in improving child and maternal outcomes compared with existing services. Participants (N = 739) were girls and young women preparing to parent for the first time and experiencing socioeconomic disadvantage. Quantitative data were collected upon trial entry during pregnancy and during five follow-up interviews until participants’ children reached age 2 years. A framework was developed to guide retention of this study population throughout the RCT. We reviewed relevant literature and mapped essential retention activities across the study planning, recruitment and maintenance phases. Interview completion rates were tracked.ResultsResults from 3302 follow-up interviews (in-person/telephone) conducted over 4 years indicate high completion rates: 90% (n = 667) at 34 weeks gestation; and 91% (n = 676), 85% (n = 626), 80% (n = 594) and 83% (n = 613) at 2, 10, 18 and 24 months postpartum, respectively. Almost all participants (99%, n = 732) provided ongoing consent to access administrative health data. These results provide preliminary data on the success of the framework.ConclusionsOur retention results are encouraging given that participants were experiencing considerable socioeconomic disadvantage. Standardized retention planning and reporting may therefore be feasible for health research in general, using the framework we have developed. Use of standardized retention protocols should be encouraged in research to promote consistency across diverse studies, as now happens with RCT and SR protocols. Beyond this, successful retention approaches may help inform health policy-makers and practitioners who also need to better reach, engage and retain underserved populations.Trial registrationClinicalTrials.gov, NCT01672060. Registered on 24 August 2012.
Highlights
Effective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources
An randomized controlled trial (RCT) being conducted in British Columbia (BC), Canada provides a case example to highlight the importance of a priori retention protocol planning and standardized reporting in general, and to offer our trial as an example—to encourage the development of new collective approaches to planning and reporting, parallel to what the research community has achieved, for example, with consensus for RCTs (CONSORT) and PRISMA and PROSPERO
BC Healthy Connections Project retention framework Informed by the literature review and the adapted ecological model, we developed the BCHCP retention framework
Summary
Effective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources. Longitudinal observational studies and randomized controlled trials (RCTs) provide important opportunities to explore the processes underlying human development and the influences on health over time [1]. Such studies are often complex, typically requiring substantive resources to implement as well as significant investments of time by participants. A better understanding of how to reach, engage and maintain contact with these groups can inform health research, as well as the provision of health and social services, in turn contributing to reducing health inequities [10,11,12,13]
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