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Abstract Details
Strategies To Maximize 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
Ashleigh Cara Stewart12, Reece Cossar34, Shelley Walker3, Anna Lee Wilkinson35, Brendan Quinn35, Paul Dietze356, Rebecca Winter37, Amy Kirwan3, Michael Curtis358, James R P Ogloff4, Stuart Kinner59101112, Campbell Aitken35, Tony Butler13, Emma Woods3, Mark Stoové35
Author information
1Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, 3004, Australia.
2School of Public Health and Preventive Medicine, Monash University, 85 Commercial Road, Melbourne, 3004, Australia.
3Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, 3004, Australia.
4Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Australia.
5School of Public Health and Preventive Medicine, Monash University, 85 Commercial Road, Melbourne, 3004, Australia.
6National Drug Research Institute, Curtin University, Perth, Australia.
7Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
8Monash Addiction Research Centre, Monash University, Melbourne, Australia.
9Justice Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
10Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
11Griffith Criminology Institute, Griffith University, Brisbane, Australia.
12Mater Research Institute-UQ, University of Queensland, Brisbane, Australia.
13School of Public Health and Community Medicine, University of Sydney, Sydney, Australia.
Abstract
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.