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Enrolment-latency in randomized behavior change trials: individual participant data meta-analysis showed association with attrition but not effect-size
Univ Newcastle, Australia.
Deakin Univ, Australia.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-0279-5903
Univ York, England.
2020 (English)In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 118, p. 55-59Article in journal (Refereed) Published
Abstract [en]

Objectives: Nonresponse can bias prevalence estimates in population surveys. Effects of selective participation in behavior change intervention trials have been little studied. We tested hypotheses that trial participants who are hard to recruit are (1) more likely to be lost-to-follow-up and (2) less responsive to intervention. Study Design and Setting: We undertook a two-stage individual participant data meta-analysis of four alcohol intervention trials involving 9,251 university students in Australia, New Zealand, and Sweden, comparing participants who enrolled "late" (after the final invitation to participate) vs. "early" (before that). Outcomes were whether participants completed assessments at each trials primary endpoint (late/early) and number of drinks consumed per week (intervention/control) among late enrolees vs. early enrolees. Results: Late enrolees were more likely to be lost-to-follow-up than early enrolees (OR 2.3, 95% CI: 1.7, 2.9). Intervention effect estimates were smaller for late vs. early enrolees, but not significantly so (RR = 0.93; 95% CI: 0.79, 1.08). Conclusion: Greater effort to recruit trial participants was associated with higher attrition, but there was no clear evidence of bias in effect estimation. The possibility that intervention effect estimates do not generalize beyond a relatively compliant minority of trial participants may warrant further study. (C) 2019 Published by Elsevier Inc.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 118, p. 55-59
Keywords [en]
Intervention trial; Bias; Nonresponse; Selection; External validity; Generalizability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-163658DOI: 10.1016/j.jclinepi.2019.09.019ISI: 000509782100007PubMedID: 31706962Scopus ID: 2-s2.0-85075803227OAI: oai:DiVA.org:liu-163658DiVA, id: diva2:1394185
Available from: 2020-02-18 Created: 2020-02-18 Last updated: 2020-03-03Bibliographically approved

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Karlsson, Nadine

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