Adapting an evidence-based model to retain adolescent study participants in longitudinal research

Maintaining contact with and collecting outcome data from adolescent study participants can present a significant challenge for researchers conducting longitudinal studies. Establishing an organized and effective protocol for participant follow-up is crucial to reduce attrition and maintain high retention rates. This paper describes our methods in using and adapting the evidence-based Engagement, Verification, Maintenance, and Confirmation (EVMC) model to follow up with adolescents 6 and 12 months after implementation of a health program. It extends previous research by focusing on two key modifications to the model: (1) the central role of cell phones and texting to maintain contact with study participants throughout the EVMC process and, (2) use of responsive two-way communication between staff and participants and flexible administration modes and methods in the confirmation phase to ensure that busy teens not only respond to contacts, but also complete data collection. These strategies have resulted in high overall retention rates (87–91%) with adolescent study participants at each follow-up data collection point without the utilization of other, more involved tracking measures. The methods and findings presented may be valuable for other researchers with limited resources planning for or engaged in collecting follow-up outcome data from adolescents enrolled in longitudinal studies.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

Multimethod measurement of high-risk drinking locations: extending the portal survey method with follow-up telephone interviews

Portal survey techniques involve multimodal assessments (e.g., self-report, biologic, and observational) in high-risk drinking and drug-use settings. Our investigation expanded the portal survey methodology to include follow-up assessments of emerging adult women recruited at the border as they cross to and from Mexico south of San Diego, California. The feasibility of the follow-up procedure was established, and the limitations of the technique clarified. Follow-up participants and nonparticipants did not differ by age or reported victimization. Data indicated that 8% of women experience negative events on their return to the United States after a night of binge drinking. These experiences could only be captured in a follow-up survey, as they happened after participants left the border area.     

Factors influencing enrolment: A case study from Birth to Twenty, the 1990 birth cohort in Soweto–Johannesburg

Longitudinal studies offer significant advantages in rendering data commensurate with the complexity of human development. However, incomplete enrolment and attrition over time can introduce bias. Furthermore, there is a scarcity of evaluative information on cohorts in developing countries. This paper documents various strategies adopted to minimize loss to follow up and describes a retrospective analysis of a small group of families who were missed during initial enrolment and through several subsequent rounds of data collection of the Birth to Twenty (BT20) birth cohort in Soweto–Johannesburg, South Africa that began in 1990. A purposive case study approach was used, and 10 of the 119 families missed at enrolment were interviewed to investigate why these families were not enrolled into the study. The findings demonstrate that high mobility, both within urban areas and between urban and rural areas, are a major challenge for longitudinal studies in densely populated urban areas. In addition, enrolment was also affected by individuals changing their names, largely motivated to facilitate access to employment under Apartheid, as well as varying motivations for participating in research. Longitudinal studies in the developing country context must be mindful of the political, social and economic climate that influences enrolment and ongoing cohort maintenance.     

A Longitudinal Study: Casino Gambling Attitudes, Motivations, and Gambling Patterns Among Urban Elders

Guided by self-determination theory, the main purpose of this study was to explore demographic characteristics, attitudes toward casinos, and self-reported intrinsic and extrinsic reasons for casino gambling by urban elders. The study hypothesized that individuals would more frequently report intrinsic motivations for casino gambling (e.g., entertainment, enjoyment) rather than extrinsic motivation (e.g., financial gain). This longitudinal sample included 247 urban elders older who were 60 years and older and who had participated in surveys in 2002 and 2004. The initial survey consisted of (a) demographic items, (b) five items to measure attitudes toward casino gambling, (c) questions inquiring about motivations for casino gambling, and (d) questions about gambling frequency. The follow-up survey was an expanded questionnaire which still included these items. The sample consisted of the 247 participants, over 200 of whom were African-Americans, 188 were female, and 98 of the participants had a post graduate education. About half were widowed, and the sample generally reported a low income. The results supported the theoretical perspective underlying the project. The hypothesis that more participants would endorse intrinsic motivations for casino gambling rather than extrinsic motivations was supported. The implications of these findings represent for social workers, gambling counselors and health care services providers an important step toward understanding the attitudes, behaviors, and motivational factors involved in casino gambling among older adults.     

Strengths and coping strategies in the life narratives of sexual minority women

This study explored self-described strengths and strategies for coping with stress among sexual minority women (SMW), drawing on qualitative narratives of sexual minority and heterosexual women who were recruited from a population-based sample. In-depth follow-up qualitative telephone interviews were conducted with 48 women who had participated in the National Alcohol Survey, a U.S. population-based survey. Participants included 25 SMW and 16 matched exclusively heterosexual women. Narrative data were analyzed using inductive thematic analysis and constant comparison to explore the study aim, with an emphasis on themes that diverged or that were particularly salient for SMW relative to heterosexual women. Strengths and coping strategies that were especially meaningful in the narratives of sexual minority women emerged in two areas. First, participants described development of intrapersonal strengths through nurturing an authentic sense of self and embracing multifaceted identity. Second, participants described multiple strategies for cultivation of interpersonal resources: navigating distance and closeness with family of origin, cultivating supportive friends and chosen family, connecting to community, finding solace and joy with animals, and engaging in collective action. Findings underscore the importance of considering protective factors that are salient to SMW in developing or refining prevention and intervention efforts.     

The use of self-generated identification codes in longitudinal research

Longitudinal research designs involve data collection at multiple time points to measure change over time. Therefore, identification of the same respondents is essential at each time point so that data from the same respondents can be matched for comparison over time. Subject-generated identification codes permit an anonymous means to track respondents over multiple data collection points. This article describes the evolution of subject-generated identification codes, techniques to improve respondent match rates, and the authors' experience using this mechanism in a longitudinal study of staff registered nurses working in hospitals. Challenges, recommendations, and implications for using subject-generated identification codes are discussed.     

Ten years later: Locating and interviewing children of drug abusers

Longitudinal studies require high follow-up rates in order to maintain statistical power, reduce bias, and enhance the generalizability of results. This study reports on locating and survey completion for a 10-year follow-up of the Focus on Families project, an investigation of 130 families headed by parents who were enrolled in methadone treatment for opiate addiction. Despite having no contact with participants in the study for at least 10 years, the project successfully located nearly 99% of parent participants and 98% of their children. Twenty-four percent of the parents and one child had died before the follow-up. Of the surviving sample, 91% of parents and 86% of the children completed the follow-up interview. Multiple techniques were used to locate study participants, including internet searches, researching court and public records, collaborating with government and service agencies, and contacting family and social networks. For more than half of the sample, costly efforts were required to locate individual participants.     

Effects and Costs of Tracing Strategies on Nonresponse Bias in a Survey of Workers with Low-Back Injury

Declining rates of participation are an increasing challengefor studies that involve telephone surveys. This study examinedthe costs of a telephone survey methodology that used increasinglyintensive tracing methods to track a pool of claimants who hadsustained occupational back injuries. It also compared the respondentsample to people who refused the survey and/or were not locatedor contacted. 3,181 claimants were drawn from a database maintainedby the Missouri Division of Workers’ Compensation (DWC)and 1,475 completed a telephone interview. The DWC databaseprovided data reflecting monetary and disability outcomes forall potential participants; telephone interviews provided additionalself-reported data. More intensive tracing strategies improvedthe representativeness of the sample, yielding more women andminority participants. Relative to less intensive techniques,advanced tracing efforts located people whose DWC records weremore similar to claimants not located. While the hands-on tracingefforts reduced the apparent bias of the respondent sample,costs increased as tracing strategies intensified – over$98,000 was spent to trace 1,027 claimants who were never locatedor contacted. The results suggest some guidelines that may facilitatedecision-making for researchers and funders who must balancethe trade-off between costs and nonresponse bias when planningsurveys.     

A collaborative student affairs and faculty health assessment and intervention initiative

The authors describe a collaborative partnership forged between faculty and student affairs staff to improve student health at a large urban university. They examine skills and reward structures of each constituency and the stages of the collaboration in the context of 2 theoretical models. A comprehensive data collection and dissemination process in the campus community provided goals for the initial stage of the partnership, leading to implementation of campus initiatives that use the reciprocal skills of each stakeholder. Outcomes of the collaboration included (1) a working relationship between faculty and student affairs staff, (2) increased dialogue with high-level administrators, (3) more coordinated campus efforts to decrease high-risk drinking, (4) use of outcome measures for implementing and evaluating health programs, and (5) an opportunity for interdisciplinary research. The authors offer suggestions for implementing the process on other campuses.     

The Healthy Young Men's Study: Sampling Methods to Recruit a Random Cohort of Young Men Who Have Sex With Men

Recruiting a scientifically sound cohort of young men who have sex with men (YMSM) is an enduring research challenge. The few cohort studies that have been conducted to date on YMSM have relied on nonprobability sampling methods to construct their cohorts. While these studies have provided valuable information about HIV risk behaviors among YMSM, their generalizability to broader YMSM populations is limited. In this article, the authors describe a venue-based sampling methodology used to recruit a large and diverse cohort of YMSM from public venues in Los Angeles County, California. Venue-based sampling is a multistage probability sampling design that uses standard outreach techniques and standard survey methods to systematically enumerate, sample, and survey hard-to-reach populations. The study design allowed the authors to estimate individual, familial, and interpersonal psychosocial factors associated with HIV risk and health-seeking behaviors for a cohort of YMSM with known properties. Study participants completed an extensive baseline survey and over a 2-year period completed four follow-up surveys at 6-month intervals. The baseline survey was administered in both English and Spanish.     

Preliminary evaluation of contingent meals and telephone use to improve evidence-supported family therapy session attendance in mothers referred by Child Protective Services for substance abuse

Persons referred by Child Protective Services (CPS) for substance abuse evidence high rates of nonattendance to therapy sessions, taxing systems of care and exacerbating outcomes. This study examined the influence of two telephone-based incentive programs on therapy session attendance in mothers who were referred by CPS for substance abuse. After baseline therapy session attendance was established in an evidence-based clinic that incorporated a telephone engagement intervention (Phase I), participants were provided free cellular telephones with limited minutes and permitted to order free meals delivered by the therapist during upcoming sessions (Phase II). The third phase was similar to Phase II, but participants were provided unlimited minutes. Results indicated that participants’ attendance was significantly improved when meals and cellular telephone minutes were contingent on attendance. Although the percentage of sessions attended by participants during Phase III was higher than Phase II, unlimited minutes and meals did not significantly enhance attendance relative to limited minutes and meals. Session attendance for significant others of these participants was significantly higher during Phase III as compared with Phase I. Session attendance of significant others was statistically similar between Phase I and II and between Phase II and Phase III. Study implications and recommendations for future research and practice are discussed in light of the findings.     

Collecting experimental network data from interventions on critical links in workplace networks

This article describes and discusses challenges associated with interventionist network data gathering in organizational settings, with a special focus on dyadic interventions. While pointing out major risks of these approaches, we argue that collecting data in combination with dyadic network alteration methods can enable social network researchers to explore network mechanisms from a new angle and potentially benefit the members of the targeted social networks and the entire collectives, if certain research design and implementation principles are followed. We introduce a facilitated self-disclosure method for strengthening critical dyads in social networks in combination with longitudinal and retrospective network measurement. We assess the participants’ perceptions of the different stages of this process by qualitative interviews. The study illustrates that experimental network data collection includes some extra challenges in addition to the many challenges of observational network data collection but participants also reported practical benefits that would not be gained through observational network surveys alone. The results highlight the importance of early and continuous communication during the data collection process with all research participants, not just the management, and the benefits of sharing more of the preliminary results. The lessons learnt through this study can inform the design of experimental network data collection to prioritize the preferences of the participants and their benefits.     

A Collaborative Student Affairs and Faculty Health Assessment and Intervention Initiative

Abstract

The authors describe a collaborative partnership forged between faculty and student affairs staff to improve student health at a large urban university. They examine skills and reward structures of each constituency and the stages of the collaboration in the context of 2 theoretical models. A comprehensive data collection and dissemination process in the campus community provided goals for the initial stage of the partnership, leading to implementation of campus initiatives that use the reciprocal skills of each stakeholder. Outcomes of the collaboration included (1) a working relationship between faculty and student affairs staff, (2) increased dialogue with high-level administrators, (3) more coordinated campus efforts to decrease high-risk drinking, (4) use of outcome measures for implementing and evaluating health programs, and (5) an opportunity for interdisciplinary research. The authors offer suggestions for implementing the process on other campuses.     

The economic toll of intimate partner violence against women in the United States

This study provides estimates of the economic cost of intimate partner violence perpetrated against women in the US, including expenditures for medical care and mental health services, and lost productivity from injury and premature death. The analysis uses national survey data, including the National Violence Against Women Survey and the Medical Expenditure Panel Survey, to estimate costs for 1995. Intimate partner violence against women cost $5.8 billion dollars (95% confidence interval: $3.9 to $7.7 billion) in 1995, including $320 million ($136 to $503 million) for rapes, $4.2 billion ($2.4 to $6.1 billion) for physical assault, $342 million ($235 to $449 million) for stalking, and $893 million ($840 to $946 million) for murders. Updated to 2003 dollars, costs would total over $8.3 billion. Intimate partner violence is costly in the US. The potential savings from efforts to reduce this violence are substantial. More comprehensive data are needed to refine cost estimates and monitor costs over time.     

An evaluation of the Baltimore Community Lead Education and Reduction Corps (CLEAR Corps) program

This evaluation examines the effectiveness of the Baltimore Community Lead Education and Reduction Corps (CLEARCorps) program in reducing lead dust levels in low-income urban housing in Baltimore, Maryland, through minor lead-reduction activities and tenant lead-poisoning prevention education. Lead dust data collected before and after lead-reduction activities show statistically significant mean declines for floors, window sills, and window wells. Limited data using tests also show that follow-up lead dust levels collected 6 months after the CLEARCorps intervention were significantly lower than preintervention lead levels. Although there are many important of this analysis, the findings suggest that in-place management may be an effective method in reducing childhood lead poisoning in high-risk areas.     

CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a $3 million project supporting programs in various community agencies to develop, document, and evaluate programs for persons who are homeless with co-occurring disorders to be used as models in other communities. The program models include: Assertive Community Treatment, Psychosocial Rehabilitation, Therapeutic Community, and an integrated treatment model. The first phase of the two-phase project funded 16 programs in the U.S. to develop manuals within their primary treatment modalities for homeless people with co-occurring disorders. For Phase II of the project, six of the 16 model programs were competitively selected to demonstrate program impact through formal program evaluation efforts. The data derived from the various projects will be compiled into a compendium of information for state agencies and community service providers throughout the U.S.     

A process evaluation of an intervention to promote home smoking bans among low income households

Exposure to secondhand smoke occurs primarily in the home due to passage of smoke-free legislation. Creation of a total household smoking ban can reduce associated health conditions such as asthma, lung cancer, heart disease and stroke. This paper describes the results of a randomized control trial of a minimal intervention to create smoke-free homes. 2-1-1 callers were invited to participate in the trial and were randomized to an intervention (mailings and a coaching call) or a control group (no intervention). We assessed reach, dose, fidelity, and receptivity to the intervention through program records and a 3-month follow-up survey with intervention participants. For the intervention materials, materials were mailed to 244 participants (99.2%) and 227 participants (92.3%) received the coaching call intervention. 92.3% received all intervention components. Participants who had full household bans at 3 months were more likely to conduct behaviors leading to a smoke-free home (i.e., making a list of reasons, having a family talk, posting a pledge) than were those with no/partial ban. The intervention materials also were rated higher in relevance and usefulness by non-smokers than smokers. Results demonstrate that this minimal intervention had high fidelity to the delivery of components and relatively high receptivity.     

A preliminary study of group intervention along with basic canine training among traumatized teenagers: A 3-month longitudinal study

The current study aimed to reduce the psychological distress of teenage girls who were exposed to traumatic event (physical or sexual abused), through using dogs-assisted therapy. Two sets of designs conducted: 1) longitudinal design which aims to answer the question: does dog assisted therapy will reduce psychological distress (namely depressive symptoms, post-traumatic symptoms), improve self confidence and subjective well being among these teenage girls? 2) Cross-sectional design that aims to compare the treatment group (dogs-assisted therapy) with comparison group at baseline and after the last session. The groups (intervention vs. matching) were compared on socio-demographic variables (only for time 1), subjective well-being, coping with stressful life events, PTSD symptoms, and depressive symptoms at base line (time 1) and at the end of the intervention (time 2). Findings from the longitudinal perspective have shown a rapid decline at the level of PTSD symptoms in the intervention group, along with significant reduction in the proportion of participants with elevated risk for PTSD. The main significant findings from the cross-sectional design were: lower level of subjective well-being, higher level of PTSD symptoms and depressive symptoms among the intervention group compared to the matching group at base line. However, these differences became non-significant at the end of the intervention. Various explanations for these findings are discussed.     

Office ergonomics education: a comparison of traditional and participatory methods

Health and safety literature stresses the value of programs aimed at preventing musculoskeletal injuries. The concepts of empowerment learning are often recommended as guidelines for worker education yet these approaches are largely untested. The present study compares the traditional approach involving lecture and discussion with a participatory method. A sample of 102 participants employed at a centralized reservation facility was used. Participants were randomly assigned to either the traditional education group or the participatory education group. Data collection utilized surveys completed by study participants and observational checklists completed by a trained observer. Data were collected prior to intervention and at approximately 3, 6, and 12 months post intervention. Results of data analysis provide no evidence that participatory methods are more effective than traditional methods in encouraging workers to position their work equipment correctly or to maintain good working postures to prevent musculoskeletal injuries.