Differential Attrition Rates Research Articles

Teletherapy Versus In-Person Psychotherapy for Depression: A Meta-Analysis of Randomized Controlled Trials.

Introduction: The recent surge in telehealth service delivery represents a promising development in the field's ability to address access gaps in health care across underserved populations. Telehealth also carries the potential to help reduce the societal burden of mental illnesses such as major depression, which often go untreated. There is now a sufficiently large corpus of randomized controlled trials to examine the comparative effectiveness of teletherapy and in-person services meta-analytically. Methods: We searched the PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for articles from January 1, 2000 to February 1, 2021 to identify randomized head-to-head trials of video-based versus in-person delivery of psychotherapy to reduce depressive symptoms. We conducted a random-effects meta-analysis to evaluate potential differences in efficacy rates. We calculated and meta-analyzed odds ratios to examine differential attrition rates between video and in-person conditions. Finally, we conducted subgroup analyses based on the primary treatment focus (depression or another condition) of each trial. Results: Primary study analyses yielded evidence that video-based psychotherapy is roughly comparable in efficacy with in-person psychotherapy for reducing depressive symptoms (g = 0.04, 95% confidence interval [CI = -0.12 to 0.20], p = 0.60, I2 = 5%). Likewise, attrition rates between the two conditions were not significantly different (odds ratio = 1.07, 95% CI = [0.78 to 1.49], p = 0.63, I2 = 25%). Finally, we did not observe significant subgroup differences in either efficacy (p = 0.38) or attrition (p = 0.94). Conclusions: The present findings suggest that video-based teletherapy may be a feasible and effective alternative to in-person services for reducing depressive symptoms. Continued research on the effectiveness of telehealth in clinically depressed samples, and further elucidation of the access barriers entailed by each delivery modality, can help the field better determine which patients will derive the greatest benefit from each mode of intervention.

The Results of a Randomized Control Trial Evaluation of the SPARK Literacy Program: An Innovative Approach that Pairs One-on-One Tutoring with Family Engagement

This report presents the results of a two-year randomized control trial evaluation of the SPARK foundational literacy program. SPARK is an early grade literacy program developed by Boys & Girls Clubs of Greater Milwaukee that pairs one-on-one tutoring with parent engagement. In 2010, SPARK was awarded an Investing in Innovation (i3) U.S. Department of Education grant to test its impact in seven low-income and low-achieving Milwaukee Public Schools (MPS). In the fall of 2013, 286 students were randomly assigned to receive SPARK for two years and 290 assigned to the control condition. Overall attrition rates ranged from 34.4% to 38.7% and differential attrition rates between SPARK and control students ranged from 1.2% to 3.0%, depending on the outcome. Most participants received a high dosage of both tutoring and family engagement across their two years of participation. Although SPARK had statistically significant positive impacts on literacy development and regular school day attendance, most, if not all, of the impact was realized during the first year of participation. The impact of SPARK was also found to be greatest for students with the greatest need for additional literacy support.

TECHNOLOGY-BASED INTERVENTIONS TO IMPROVE CAREGIVER WELL-BEING

Informal or unpaid care is the most common form of long-term care. Despite clear benefits for the care recipient, caregiving can have unintended physical and emotional consequences for caregivers. Traditional caregiver interventions are limited in scope, as they often focus on the emotional consequences of caregiving; however, the physiological effects of caregiving are equally deleterious to caregiver health. Exercise improves physical health, yet the demands of caregiving can limit participation in physical activity. Traditional gym-based interventions may not be feasible for many caregivers. Advances in technology present an opportunity to address these limitations, specifically in the areas of accessibility and acceptability. The Combined Online Assistance for Caregiver Health (COACH) program combines evidence-based skills training with physical exercise in a tablet-based intervention. Preliminary evidence for the physical and psychological benefits are promising; however, differential attrition rates are informative as to the acceptability of technology-based interventions among some caregivers.

Sample size determination for multilevel hierarchical designs using generalized linear mixed models.

A unified statistical methodology of sample size determination is developed for hierarchical designs that are frequently used in many areas, particularly in medical and health research studies. The solid foundation of the proposed methodology opens a new horizon for power analysis in presence of various conditions. Important features such as joint significance testing, unequal allocations of clusters across intervention groups, and differential attrition rates over follow up time points are integrated to address some useful questions that investigators often encounter while conducting such studies. Proposed methodology is shown to perform well in terms of maintaining type I error rates and achieving the target power under various conditions. Proposed method is also shown to be robust with respect to violation of distributional assumptions of random-effects.

Attrition and health in ageing studies: evidence from ELSA and HRS

This paper investigates the characteristics associated with attrition in the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS), with a particular focus on whether attrition is systematically related to health outcomes and socioeconomic status. We have three main results. Firstly, raw attrition is greater in ELSA than in HRS but the potential survey-based explanations for this that we are able to consider do not, taken together, appear to explain the extent of this difference. Second, these differential attrition rates do not change the core conclusions regarding comparisons between the two countries of health and socioeconomic status. Finally, very few observable characteristics predict attrition in either study among those in their seventies. In the group aged 55-64, wealth appears to predict attrition in the U.S. (but not in England), and low education predicts attrition in England (but not the U.S.). Since the more serious attrition problem exists in ELSA, we conduct additional analysis of attrition in that survey. We find that respondents' level of numeracy strongly predicts attrition, but this does not account for the education gradient in attrition in ELSA.

Group-based Trajectory Modeling Extended to Account for Nonrandom Participant Attrition

This article reports on an extension of group-based trajectory modeling to address nonrandom participant attrition or truncation due to death that varies across trajectory groups. The effects of the model extension are explored in both simulated and real data. The analyses of simulated data establish that estimates of trajectory group size as measured by group membership probabilities can be badly biased by differential attrition rates across groups if the groups are initially not well separated. Differential attrition rates also imply that group sizes will change over time, which in turn has important implications for using the model parameter estimates to make population-level projections. Analyses of longitudinal data on disability levels in a sample of very elderly individuals support both of these conclusions.

Why Can’t a Student Be More Like an Average Person?: Sampling and Attrition Effects in Social Science Field and Laboratory Experiments

In the social sciences, the use of experimental research has expanded greatly in recent years. For various reasons, most experiments rely on convenience samples of undergraduate university students. This practice, however, might endanger the validity of experimental findings, as we can assume that students will react differently to experimental conditions than the general population. We therefore urge experimental researchers to broaden their pool of participants, despite the obvious practical difficulties this might entail with regard to recruitment and motivation of the participants. We report on an experiment comparing the reactions of student and non-student participants, showing clear and significant differences. A related problem is that differential attrition rates might endanger the effects found in long-term research. We argue that experimental researchers should pay more attention to the characteristics of participants in their experimental design.

Diversity, attrition and transition into nursing

This paper is a report of a study to explore the relationship between selected diversity variables (sex, country of birth, ethnicity, age, educational qualifications, and additionally visa status, application route, absence rates), and nursing students' progression and attrition. Debates on levels, forms and causation of nursing student attrition have been professional, academic and political concerns for some time on an international level. However, a more systematic approach to studying the topic is needed. We lack commonly operationalized national and international data on the relationship between attrition and diversity variables, and their implications for cost, social justice and demographic representativeness in nursing. A longitudinal cohort design was used. Data were collected from 2003 to 2005 from routinely collected data in student records. Males had lower odds of completing the programme than females, as did younger students. Compared with United Kingdom-born students, those born in Ireland, Zimbabwe, or other English-speaking countries were more likely to complete the programme. Students born overseas in non-English-speaking countries did not differ statistically significantly from United Kingdom-born students. Those at all qualification levels had similar odds of completion, except students already qualified at degree level, who were less likely to complete. Further national and international research is needed to understand better the causal variables underpinning differential attrition rates, with particular regard to understanding how different groups may experience the relationship between education and their broader circumstances and between the theoretical and the clinical elements of nurse education itself.

Sample size determination for hierarchical longitudinal designs with differential attrition rates.

We consider the problem of sample size determination for three-level mixed-effects linear regression models for the analysis of clustered longitudinal data. Three-level designs are used in many areas, but in particular, multicenter randomized longitudinal clinical trials in medical or health-related research. In this case, level 1 represents measurement occasion, level 2 represents subject, and level 3 represents center. The model we consider involves random effects of the time trends at both the subject level and the center level. In the most common case, we have two random effects (constant and a single trend), at both subject and center levels. The approach presented here is general with respect to sampling proportions, number of groups, and attrition rates over time. In addition, we also develop a cost model, as an aid in selecting the most parsimonious of several possible competing models (i.e., different combinations of centers, subjects within centers, and measurement occasions). We derive sample size requirements (i.e., power characteristics) for a test of treatment-by-time interaction(s) for designs based on either subject-level or cluster-level randomization. The general methodology is illustrated using two characteristic examples.

The effects of attrition on baseline comparability in randomized experiments in education: A meta-analysis.

Using meta-analysis, randomized experiments in education that either clearly did or clearly did not experience student attrition were examined for the baseline comparability of groups. Results from 35 studies suggested that after attrition, the observed measures of baseline comparability of groups did not differ more than would be expected given sampling error. The degree of either overall or differential attrition did not relate to baseline comparability, a finding that held under sensitivity analyses. Also, both overall and differential attrition rates were unrelated to posttest effect sizes. All of these analyses, however, lacked sufficient statistical power to detect small but potentially meaningful effects. Results suggest caution is warranted when applying quality scales and other blanket rules pertaining to attrition that are meant to either serve as inclusion-exclusion criteria or in scoring study quality. Much greater attention is needed to both the reporting of attrition in primary studies and to the development of conceptual and empirical models of the attrition process. These developments would aid further investigation of the relation between attrition and study outcomes.

Exploring differential attrition rates among system of care evaluation participants

AbstractThe purpose of the present study is to investigate differential attrition rates in terms of both demographic characteristics and initial levels of child functioning of participants in North Carolina's system of care evaluation. Participants included 303 families (78 dropped out of the study, a 26% attrition rate). Families dropped out of the evaluation for three main reasons: refusal to participate, moving, or inability to contact the family. The majority of families who dropped out of the study did so after completing only the baseline interview. Differential attrition did not exist in terms of demographic characteristics, but there was some support for possible differential attrition indicated by initial levels of child functioning in some cases. Additionally, higher parental education level predicted longer participation in longitudinal evaluation. Recommendations and implications for applied research are offered. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 167–176, 2004.

Differential attrition rates and active parental consent.

Active parental consent in survey research poses ethical and practical concerns. One common argument against the requirement of active consent procedures is its effect on participation rates. There is additional concern that higher risk groups may be underrepresented in the final sample. Empirical support of differential attrition, however, is lacking. In the current multisite longitudinal study, passive consent procedures were approved for the collection of pretest data. For subsequent years of data collection, active parental consent procedures were required. In this article, we use the pretest data to examine demographic, attitudinal, and behavioral differences between those students for whom active consent was provided and those for whom active consent was either denied or for whom no response was received. The results indicate that active consent procedures produce deleterious effects on participation rates and lead to an underrepresentation of at-risk youth in the sample.

HIV Sexual Risk—Reduction Interventions for African-American Women

In Reply. —We appreciate the thoughtful comments by Drs Winett and Kalichman and by Drs Branson, Moore, and Byers regarding methodological issues relevant to our article. One concern is the participation rate. Given that one recruitment strategy was distributing flyers throughout the target community, it is impossible to estimate how many eligible women saw flyers and chose not to participate. Another issue is that differential attrition rates may be attributable to frequency of contact associated with treatment conditions. This is likely. Moreover, as we pointed out, including a placebo-attention group may control for differential attention as a plausible explanation for treatment effects and reduce attrition. A third issue is the use of a single behavioral outcome, consistent condom use, to assess program efficacy. This measure was selected because of its public health significance in preventing HIV transmission. 1 Mathematical modeling suggests that, irrespective of the number of sexual partners and

Differential attrition rates in alcohol abusing and nonabusing schizophrenic inpatients: a methodological note.

This study investigates the impact of the screening process on the composition of the final sample of alcohol abusing and nonabusing hospitalized schizophrenics. The group of nonabusing schizophrenics had higher rates of study rejections by staff, refusals, inappropriate subjects, and a lower rate of study completers. The findings suggest that these differential attrition rates may have a significant impact on the interpretation of results of studies focusing on substance use in schizophrenic samples.