Objective-Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition. We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research.Study Design-We completed searches of PubMed, CINAHL, CENTRAL, Cochrane Methodology Register, and EMBASE (August 2005). We also examined reference lists of eligible articles and relevant reviews. A data-driven thematic analysis of the retention strategies identified common themes.Results-We retrieved 3,068 citations, 21 studies were eligible for inclusion. We abstracted 368 strategies and from these identified 12 themes. The studies reported a median of 17 strategies across a median of six themes. The most commonly reported strategies were systematic methods of participant contact and scheduling. Studies with retention rates lower than the mean rate (86%) reported fewer strategies. There was no difference in the number of themes used.Conclusion-Available evidence suggests that investigators should consider using a number of retention strategies across several themes to maximize the retention of participants. Further research, including explicit evaluation of the effectiveness of different strategies, is needed. Keywords patient participation; patient dropouts; in-person follow-up; follow-up studies; cohort studies; systematic review Loss to follow-up of research participants threatens the internal and external validity of a study [1;2]. The study results may be biased by differential dropout between comparison groups or Corresponding Author: Karen A. Robinson, Internal Medicine and Health Sciences Informatics, Medicine, Johns Hopkins University, 1830 East Monument Street, Room 8069, Baltimore, MD 21287, 410-502-9216 (voice), 410-955-0825 (fax), krobin@jhmi.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. . They elicited perceived barriers to participant retention and 61 retention strategies from the project staff and investigators from these trials. The retention strategies were categorized into eight themes which study personnel then ranked based on perceived effectiveness. The strategy category of flexibility followed by incentives, benefits and persistence were rated as most effective by the study personnel.
NIH Public AccessDavis et al (2002) completed a review of trials between 1990 and 1999 identifying 21 studies that included a description of retention strategies and retention rates [6]. The authors provided a table listing the trials rank-ordered based on the retention rate (specifics not pro...