Strategies to maximise study retention and limit attrition bias in a prospective cohort study of men reporting a history of injecting drug use released from prison: the prison and transition health study
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Cossar, Reece
Walker, Shelley
Wilkinson, Anna Lee
Quinn, Brendan
Dietze, Paul
Winter, Rebecca
Kirwan, Amy
Curtis, Michael
Ogloff, James RP
Kinner, Stuart
Aitken, Campbell
Butler, Tony
Woods, Emma
Stoove, Mark
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Background: There are significant challenges associated with studies of people released from custodial settings, including loss to follow-up in the community. Interpretation of findings with consideration of differences between those followed up and those not followed up is critical in the development of evidence-informed policies and practices. We describe attrition bias in the Prison and Transition Health (PATH) prospective cohort study, and strategies employed to minimise attrition. Methods: PATH involves 400 men with a history of injecting drug use recruited from three prisons in Victoria, Australia. Four interviews were conducted: one pre-release (‘baseline’) and three interviews at approximately 3, 12, and 24 months post-release (‘follow-up’). We assessed differences in baseline characteristics between those retained and not retained in the study, reporting mean differences and 95% confidence intervals (95% CIs). Results: Most participants (85%) completed at least one follow-up interview and 162 (42%) completed all three follow-up interviews. Retained participants were younger than those lost to follow-up (mean diff − 3.1 years, 95% CI -5.3, − 0.9). There were no other statistically significant differences observed in baseline characteristics. Conclusion: The high proportion of participants retained in the PATH cohort study via comprehensive follow-up procedures, coupled with extensive record linkage to a range of administrative datasets, is a considerable strength of the study. Our findings highlight how strategic and comprehensive follow-up procedures, frequent contact with participants and secondary contacts, and established working relationships with the relevant government departments can improve study retention and potentially minimise attrition bias.
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BMC Medical Research Methodology
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21
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1
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© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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Public health
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Attrition bias
People in prison
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Stewart, AC; Cossar, R; Walker, S; Wilkinson, AL; Quinn, B; Dietze, P; Winter, R; Kirwan, A; Curtis, M; Ogloff, JRP; Kinner, S; Aitken, C; Butler, T; Woods, E; Stoove, M, Strategies to maximise study retention and limit attrition bias in a prospective cohort study of men reporting a history of injecting drug use released from prison: the prison and transition health study, BMC Medical Research Methodology, 2021, 21 (1), pp. 185