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Who is our cohort: recruitment, representativeness, baseline risk and retention in the "Watch Me Grow" study?
Susan Woolfenden1,2, Valsamma Eapen3,4,5, Emma Axelsson3,4,5
1Sydney Children's Hospitals Network, Sydney, Australia. susan.woolfenden@sesiahs.health.nsw.gov.au.
Insights
The "Watch Me Grow" study established a birth cohort in South West Sydney, finding it representative of a diverse population. Challenges in follow-up were noted, particularly for at-risk infants.
Area of Science:
- Child development research
- Public health surveillance systems
- Birth cohort studies
Background:
- The "Watch Me Grow" (WMG) study investigated the developmental surveillance system in South West Sydney.
- This paper details the establishment of the WMG birth cohort, including recruitment, representativeness, and baseline developmental risk assessments.
Purpose of the Study:
- To describe the establishment of the "Watch Me Grow" (WMG) study birth cohort.
- To assess the representativeness of the recruited cohort compared to the local population.
- To identify baseline risks for future developmental issues among participants.
Main Methods:
- Recruited newborn infants and parents from hospital postnatal wards and child health nurses (2011-2013).
- Collected data via questionnaires and linked electronic medical records (EMR).
- Assessed cohort representativeness using Chi-square analyses of EMR data and elicited reasons for non-participation.
Main Results:
- Recruited 2,025 infants; 50% participation rate, with reasons including disinterest, time constraints, language barriers, and privacy concerns.
- The WMG cohort represented the culturally diverse and socially disadvantaged local population.
- Follow-up data was available for 39% at 6 months, 32% at 12 months, and 28% at 18 months; higher psychosocial risk correlated with less follow-up data.
- Nearly 40% of infants had at least two known developmental risk factors at baseline.
Conclusions:
- The WMG birth cohort is a valuable resource for health services, particularly for including vulnerable populations.
- Challenges exist in actively following up this population, impacting data completeness over time.
Background:
The "Watch Me Grow" (WMG) study examines the current developmental surveillance system in South West Sydney. This paper describes the establishment of the study birth cohort, including the recruitment processes, representativeness, follow-up and participants' baseline risk for future developmental risk.
Methods:
Newborn infants and their parents were recruited from two public hospital postnatal wards and through child health nurses during the years 2011-2013. Data was obtained through a detailed participant questionnaire and linked with the participant's electronic medical record (EMR). Representativeness was determined by Chi-square analyses of the available clinical, psychosocial and sociodemographic EMR data, comparing the WMG participants to eligible non-participants. Reasons for non-participation were also elicited. Participant characteristics were examined in six, 12, and 18-month follow-ups.
Results:
The number of infants recruited totalled 2,025, with 50 % of those approached agreeing to participate. Reasons for parents not participating included: lack of interest, being too busy, having plans to relocate, language barriers, participation in other research projects, and privacy concerns. The WMG cohort was broadly representative of the culturally diverse and socially disadvantaged local population from which it was sampled. Of the original 2025 participants enrolled at birth, participants with PEDS outcome data available at follow-up were: 792 (39 %) at six months, 649 (32 %) at 12 months, and 565 (28 %) at 18 months. Participants with greater psychosocial risk were less likely to have follow-up outcome data. Almost 40 % of infants in the baseline cohort were exposed to at least two risk factors known to be associated with developmental risk.
Conclusions:
The WMG study birth cohort is a valuable resource for health services due to the inclusion of participants from vulnerable populations, despite there being challenges in being able to actively follow-up this population.
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