title: Sociodemographic, clinical, and psychological factors associated with attrition in a prospective study of cardiovascular prevention: the Heart Strategies Concentrating on Risk Evaluation study.
abstract: OBJECTIVE
  To identify factors associated with attrition in a longitudinal study of cardiovascular prevention.
  
  
  METHODS
  Demographic, clinical, and psychosocial variables potentially associated with attrition were investigated in 1841 subjects enrolled in the southwestern Pennsylvania Heart Strategies Concentrating on Risk Evaluation study. Attrition was defined as study withdrawal, loss to follow-up, or missing 50% or more of study visits.
  
  
  RESULTS
  Over 4 years of follow-up, 291 subjects (15.8%) met criteria for attrition. In multivariable regression models, factors that were independently associated with attrition were black race (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.55-3.16; P < .001), younger age (OR per 5-year increment, 0.88; 95% CI, 0.79-0.99; P < .05), male gender (OR, 1.79; 95% CI, 1.27-2.54; P < .05), no health insurance (OR, 2.04; 95% CI, 1.20-3.47; P < .05), obesity (OR, 1.80; 95% CI, 1.07-3.02; P < .05), CES-D depression score 16 or higher (OR, 2.02; 95% CI, 1.29-3.19; P < .05), and higher ongoing life events questionnaire score (OR, 1.09; 95% CI, 1.04-1.13; P < .001). Having a spouse/partner participating in the study was associated with lower odds of attrition (OR, 0.60; 95% CI, 0.37-0.97; P < .05). A synergistic interaction was identified between black race and depression.
  
  
  CONCLUSIONS
  Attrition over 4 years was influenced by sociodemographic, clinical, and psychological factors that can be readily identified at study entry. Recruitment and retention strategies targeting these factors may improve participant follow-up in longitudinal cardiovascular prevention studies.
authors.affiliation: School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Bambs
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Suresh R
authors.initials: SR
authors.lastname: Mulukutla
authors.forename: Aryan N
authors.initials: AN
authors.lastname: Aiyer
authors.forename: Cheryl
authors.initials: C
authors.lastname: Johnson
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: McDowell
authors.forename: Karen
authors.initials: K
authors.lastname: Matthews
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reis
mesh_terms: D000367:Age Factors; D000368:Aged; D044383:Black People; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016001:Confidence Intervals; D006801:Humans; D059012:Lost to Follow-Up; D008875:Middle Aged; D016017:Odds Ratio; D010352:Patient Dropouts / Q000523:psychology*; D010414:Pennsylvania; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D001741:Black or African American
references.citation: Rev Epidemiol Sante Publique. 2001 Oct;49(5):477-92
references.pmid: 11845097
references.citation: Am J Epidemiol. 2006 Feb 1;163(3):197-203
references.pmid: 16339049
references.citation: Circulation. 2011 Mar 1;123(8):850-7
references.pmid: 21321154
references.citation: Ann Epidemiol. 2007 Jan;17(1):9-18
references.pmid: 17140810
references.citation: Can J Nurs Res. 2004 Sep;36(3):82-98
references.pmid: 15551664
references.citation: Contemp Clin Trials. 2006 Dec;27(6):571-9
references.pmid: 16843069
references.citation: Ann Epidemiol. 2007 Sep;17(9):643-53
references.pmid: 17553702
references.citation: J Community Health. 2000 Dec;25(6):439-53
references.pmid: 11071226
references.citation: Ann Epidemiol. 2002 Apr;12(3):206-12
references.pmid: 11897179
references.citation: Clin Trials. 2010 Aug;7(4):400-10
references.pmid: 20571137
references.citation: Am J Epidemiol. 2001 Nov 1;154(9):845-53
references.pmid: 11682367
references.citation: J Pers Soc Psychol. 1994 Dec;67(6):1063-78
references.pmid: 7815302
references.citation: J Clin Epidemiol. 2002 Apr;55(4):319-28
references.pmid: 11927198
references.citation: J Clin Epidemiol. 2007 Aug;60(8):757-65
references.pmid: 17606170
references.citation: Am J Epidemiol. 2000 Dec 1;152(11):1039-47
references.pmid: 11117613
references.citation: Health Psychol. 2003 May;22(3):300-9
references.pmid: 12790258
references.citation: Epidemiology. 2006 May;17(3):252-4
references.pmid: 16617271
references.citation: J Clin Epidemiol. 2005 Jan;58(1):13-9
references.pmid: 15649666
references.citation: J Health Soc Behav. 1983 Dec;24(4):385-96
references.pmid: 6668417
references.citation: Ethn Dis. 1996 Winter-Spring;6(1-2):7-20
references.pmid: 8882832
references.citation: J Health Psychol. 1997 Jul;2(3):335-51
references.pmid: 22013026
references.citation: Psychol Aging. 1996 Jun;11(2):207-13
references.pmid: 8795049
references.citation: Eur J Epidemiol. 2005;20(7):575-9
references.pmid: 16119429
references.citation: JAMA. 1997 Jun 25;277(24):1940-4
references.pmid: 9200634
references.citation: J Behav Med. 2006 Jun;29(3):291-8
references.pmid: 16565785
references.citation: J Womens Health (Larchmt). 2007 Apr;16(3):423-8
references.pmid: 17439387
references.citation: Arch Intern Med. 2007 May 14;167(9):905-12
references.pmid: 17502531
references.citation: Ann Epidemiol. 2002 May;12(4):248-56
references.pmid: 11988413
references.citation: Eur J Epidemiol. 2004;19(8):751-60
references.pmid: 15469032
references.citation: Am J Epidemiol. 1980 Oct;112(4):467-70
references.pmid: 7424895
references.citation: Ann Epidemiol. 2000 Nov;10(8 Suppl):S13-21
references.pmid: 11189088