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Advisory Committee Chair

Karen M Meneses

Advisory Committee Members

Andres Azuero

Michelle Y Martin

Linda D Moneyham

James M Shikany

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Participant retention in longitudinal research is gaining increasing attention. By identifying factors associated with participant retention, programs can be better designed to promote effective weight loss. This study examines factors associated with participant retention. The Anderson Behavioral Model provided the conceptual framework for the study. The sample consisted of secondary data abstracted from the research records of 316 participants in the University of Alabama at Birmingham cohort of the Look Action for Health in Diabetes (AHEAD) trial. The Look AHEAD trial is a randomized controlled trial designed to investigate the long-term effects of interventions aimed at producing weight loss in adult participants with type 2 diabetes. Variables measured at baseline and annually through follow-up year-five were abstracted and evaluated for association with participant retention using bivariate and multivariate statistics. Overall retention in the Look AHEAD trial was very high (89% - 93%) for a 5-year period. Bivariate testing showed individuals significantly more likely to be retained were greater than 60 years of age, possessed lower levels of depression, had lower body mass index (BMI), had hemoglobin A1c ranging from 7.0% to 8.9%, and had higher health status scores. There were no significant differences in retention by gender, race, education level, income, marital status, or treatment assignment. Multivariable models found age greater than 60 years, lower BMI, and hemoglobin A1c ranging from 4.0% to 8.9% to be significant predictors of greater retention. Retention in behavioral weight-loss programs is associated with greater efficacy. Study findings provide insight into subgroups of individuals who are at risk for attrition, and an exploration of changes in longitudinal research retention strategies.

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