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Factors Influencing Attrition in a Multisite, Randomized, Clinical Trial Following Traumatic Brain Injury in Adolescence

Blaha, Robert Z. MA; Arnett, Anne B. MA; Kirkwood, Michael W. PhD; Taylor, H. Gerry PhD; Stancin, Terry PhD; Brown, Tanya M. PhD; Wade, Shari L. PhD

The Journal of Head Trauma Rehabilitation: May/June 2015 - Volume 30 - Issue 3 - p E33–E40
doi: 10.1097/HTR.0000000000000059
Original Articles

Background: Attrition in longitudinal research negatively affects statistical power, disrupts statistical stability, and can produce unwanted bias.

Objective: To investigate factors associated with shorter length of study participation and lower rates of study completion (ie, attrition) in a large, multisite, longitudinal, randomized, clinical trial examining the efficacy of a Web-based family problem-solving treatment following traumatic brain injury (TBI) in adolescence.

Setting: Five major trauma centers in the central and western regions of the United States.

Participants: Children (N = 132) aged 12 to 17 years hospitalized for complicated mild to severe TBI within the previous 6 months.

Results: Completers had a higher primary caregiver education and higher family income than noncompleters, whereas ethnicity, latency to baseline assessment, and intervention group were not significantly associated with study completion.

Conclusion: This is the first study that has specifically examined factors of attrition in a pediatric TBI population. The results suggest that research on pediatric TBI populations may be biased toward higher-income families and highlights the importance of designing studies with increased awareness of the impact of participant demographic factors.

Children's Hospital Colorado, Aurora (Mr Blaha and Ms Arnett); Children's Hospital Colorado & University of Colorado Denver School of Medicine, Aurora (Dr Kirkwood); Rainbow Babies and Children's Hospital & Case Western Reserve University, Cleveland, Ohio (Dr Taylor); MetroHealth Medical Center & Case Western Reserve University, Cleveland, Ohio (Dr Stancin); Mayo Clinic, Rochester, Minnesota (Dr Brown); and Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Wade).

Corresponding Author: Robert Z. Blaha, MA, Department of Rehabilitation Medicine, Children's Hospital Colorado, 13123 E. 16th Ave, B285, Aurora, CO 80045 (

This work was supported in part by (1) NIH grant R01-MH073764 from the National Institute of Mental Health, (2) a grant from the Colorado Traumatic Brain Injury Trust Fund Research Program, Colorado Department of Human Services, Division of Vocational Rehabilitation, Traumatic Brain Injury Program, and (3) a grant from the Department of Education, NIDRR grant number H133B090010-01 (the contents do not necessarily represent the policy of the Department of Education, and endorsement by the Federal Government cannot be assumed).

The authors declare no conflicts of interest.

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