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Patient, Family, and Center-Based Factors Associated with Attrition in Neonatal Clinical Research: A Prospective

Sara B DeMauro1,2, Scarlett L Bellamy3,4, Melissa Fernando3

  • 1Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, demauro@email.chop.edu.

Neonatology
|March 6, 2019
PubMed

Insights

Lower maternal education and larger households predict attrition in neonatal research. Strategies to reduce study burden and reinforce goals are needed for families with lower educational levels to decrease attrition bias.

Area of Science:

  • Neonatal Research
  • Clinical Study Design

Background:

  • Attrition (loss to follow-up) threatens longitudinal clinical research validity.
  • Predictors of attrition in neonatal research are poorly understood.
  • The impact of family experiences on study compliance in infant research is unknown.

Purpose of the Study:

  • Identify factors associated with attrition in preterm infants over one year.
  • Examine predictors of attrition in the Prematurity and Respiratory Outcomes Program (PROP) study.

Main Methods:

  • Coordinators estimated attrition likelihood at discharge.
  • Parents completed surveys on study experience at discharge and 1-year corrected age.
  • Logistic models analyzed associations between infant, family, and site characteristics and attrition.

Main Results:

  • 89% of 318 infants completed the primary endpoint (4 PROP interviews).
  • Bivariate analysis: lower maternal education, more people in household, public insurance, and site associated with attrition.
  • Multivariable analysis: lower maternal education and more people in household most strongly predicted attrition.

Conclusions:

  • Lower maternal education and larger household size are key predictors of attrition.
  • Neonatal research should develop strategies to reduce study burden for at-risk families.
  • Reinforcing study goals can improve participation and decrease attrition bias in vulnerable populations.
Abstract

Keywords:
AttritionClinical researchFollow-upPrematurity

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