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Pretreatment dropouts: characteristics and outcomes.

The characteristics and outcome results of 123 cocaine dependent patients who dropped out following intake without returning for even one treatment visit were compared with those of 324 who did return and received at least one treatment service and 118 who remained on the program for two months or more. The pre-treatment dropouts were more often positive for cocaine on admission drug screens and less often employed. They reported fewer psychological symptoms on the scales of the SCL-90 and received lower scores on the medical problem severity scale of the ASI. At 9-month follow-up they were found to have less often attended self-help meetings or continued in outpatient treatment, more often to have been admitted for inpatient treatment or been in jail, less often returned to school and were more often using cocaine. Clearly, clinicians and researchers need a better understanding of these patients who account for significant attrition, have distinguishing characteristics, and do much more poorly than those who remain in treatment.

Adult↗

Characteristics of dropouts in longitudinal research on aging: a study of Mexican Americans and Anglos.

The characteristics of dropouts in a four-year longitudinal study of Mexican Americans and Anglos aged 60 years and over are investigated. Dropouts are found to be significantly older, to be less healthy, to view themselves as older, and to be less active than persons remaining in the study. Subgroups of dropouts differ from each other; deceased persons and those who could not be located were found to be generally less advantaged than restudied persons, while refusers were found to be advantaged. Implications for longitudinal studies on aging are discussed.

Aged↗

Evaluation and characteristics of "dropouts" in a longitudinal clinical study.

This paper attempts to identify characteristics of a longitudinal clinical study's "dropout" population (1974-1996) of patients using overdentures. This study included 395 subjects. Dropouts were identified as persons who did not respond to letters or telephone calls after participating in the study for up to 2 years, could not be located, or did not wish to return to the study. Participants (N=273) and Dropouts (N=84) were compared by evaluating a series of factors: sociodemographic, medical, health, and some oral health behaviors. The population was divided into two very similar cohorts for analysis based on years of recruitment: Group I (1974-1984) and Group II (1985-1993). Significant differences were found between them, including vision problems and risk of oral soft tissue problems related to medical diagnosis. Dropouts were significantly younger than Participants, had fewer hearing and vision problems, tended to brush their teeth more often and were more likely to use daily topical fluoride in their overdentures. The differences between the Dropouts and the Participants may be that younger persons are more mobile and have fewer vision and hearing problems, but this does not help predict their commitment to a study. Health behaviors such as brushing overdenture abutments or fluoride use may be more predictable but are harder to assess until persons have been study participants for some time.

Adolescent↗

[Characteristics of dropouts and participants in a twelve-year longitudinal research of Japanese elderly].

PURPOSES: The attrition of respondents in panel studies of the elderly can create bias in data analysis. The purposes of this study are two fold; 1) to examine characteristics of dropouts, from a particular panel lost except due to natural attrition (by death) by comparison with continuing participants in that wave, and 2) to assess representativeness of those actually continuing in a particular panel by comparison with those eligible for inclusion in that wave. Only those who died were excluded from the group of respondents at the baseline survey because they constituted natural attrition in this longitudinal survey. METHOD: At baseline (1987), 2,200 individuals age 60+ from 3,288 national representative sample were interviewed. Non-response status to three contacts (1990, 1993, 1996) with the panel was examined in relation to variables included in the baseline interview. A number of characteristics of demographic background, health, life-style, and social relations obtained in the baseline survey (1987) were compared between those re-interviewed in a particular panel and subjects lost through unnatural attrition until that wave. To study the influence of unnatural attrition on variable distributions and each related factors of two health indicators (self-rated health and depressive symptoms), baseline responses were compared between those re-interviewed in a particular panel and all who were eligible to respond in that wave. RESULTS: 1) Dropouts lost to each wave were significantly older and had a lower level of social participation than persons remaining in that wave. Significant differences in health and life-style variables appeared between dropouts lost and continuing participants until third or later waves. 2) Continuing participants in a particular panel were likely to be younger, to be more physically, mentally, or socially healthy than those eligible to respond in the wave. Each related factors of two health indicators were almost same between those re-interviewed in a particular panel and those eligible to respond in that wave. CONCLUSION: Dropouts in longitudinal research were found to appear nonrandomly. While distributions of age and health indicators in those re-interviewed were influenced by respondent attrition, related factors of health indicators may be free of bias that can be created by it.

Age Factors↗

Sociodemographic characteristics of dropouts from a child guidance clinic.

OBJECTIVE: This study examined the characteristics of families who dropped out and families who maintained contact with a children's psychiatric outpatient clinic through various phases of intake and treatment. METHODS: One year after intake, the authors examined the status of all patients (N = 555) who had sought treatment at an urban, university-affiliated children's psychiatric outpatient clinic over a two-year period and had completed the intake process. Factors associated with dropout were identified at four points in the clinic process: during intake, during evaluation, at completion of evaluation, and during treatment. RESULTS: Urban residence, minority status, single-parent status, and Medicaid status were related to dropout at intake and during evaluation but not at subsequent clinic phases. Nonminority, two-parent, suburban families of higher socioeconomic status were more likely to drop out at the completion of the evaluation. CONCLUSIONS: These results indicate that factors associated with attrition vary with the clinic phase. Further investigations of the clinical course of minority children and families involved with children's mental health services are necessary to understand the needs of this population and to design interventions such as increasing minority staff and providing training in multi-cultural competence.

Adolescent↗

Characteristics of dropouts, remainers, and refusers at a psychosocial rehabilitation program for the chronically mentally disabled.

Thirty-eight chronically mentally disabled patients who were invited to join a newly established, vocationally oriented, day treatment program in Raleigh, North Carolina, served as subjects. We attempted to determine whether demographic and psychosocial characteristics significantly differed among groups of clients who dropped out of, remained in, or refused membership in this community-support program. A variety of demographic, expectancy, psychological, and psychosocial measures were administered to each subject. Most significant was the finding that the subjects' perceived level of help and support from friends was a significant determinant of the level of program participation. Those subjects who refused to participate (refusers) perceived themselves as receiving proportionately less support than did members of the other two groups (dropouts and remainers).

Adult↗

Characteristics of dropouts from a child psychiatry clinic in Hong Kong.

There is, to date, no study on the pattern of dropping out from child and adolescent psychiatry clinics in a non-western setting. This study aims to investigate this phenomenon in Hong Kong. The database and medical charts of 235 new cases were reviewed 1 year after the initial assessments. The clinical, demographic and family data of the dropout and non-dropout groups were compared. An overall dropout rate of 27.2% was found. Boys and children with attention deficit hyperkinetic disorder and infantile autism were less likely to drop out. No interaction with gender was found. Compared with western literature, there are some important differences in the factors associated with dropping out of treatment. Our study highlights the importance of socio-cultural influences on the characteristics of clinic drop-outs.

Chi-Square Distribution↗

Abortion applicants: characteristics distinguishing dropouts remaining pregnant and those having abortion.

This study, of two groups of women who applied for induced hospital abortion, compares 100 women who had the abortion with 100 women who dropped out to carry to term. Dropout applicants who elected to carry to term had less education, had partners with less education, tended to be indecisive, and when they told their partners tended to receive negative responses toward abortion. In addition, these women expressed greater concern about the procedure and about the moral implications of abortion. Implications of this study for further research on women's and their partners' decision-making about abortion using the Janis-Mann model are discussed.

Abortion Applicants↗

Personality and demographic characteristics of dropouts and completers in a nonhospital residential alcohol treatment program.

This study investigated the relationship of scores on the Psychopathic Deviate, Denial, Dependency, and MacAndrew Scales of the MMPI; intelligence; age; income; and education to continuance in a residential alcohol treatment program. Dropouts scored higher on the Psychopathic Deviate Scale than completers did. For completers, Psychopathic Deviate scores were correlated with age and Denial scores were correlated with intelligence. These relationships did not occur for dropouts. Findings were compared to research done in hospital settings.

Adult↗

Dementia and disability outcomes in large hypertension trials: lessons learned from the systolic hypertension in the elderly program (SHEP) trial.

In the Systolic Hypertension in the Elderly Program (SHEP) trial (1985-1990), active treatment reduced the incidence of cardiovascular events, but not that of dementia and disability, as compared with placebo. This study aims to evaluate if assessment of cognitive and functional outcomes was biased by differential dropout. Characteristics of subjects who did or did not participate in follow-up cognitive and functional evaluations were compared. The relative risks of incident cognitive impairment and disability were assessed in the two treatment groups, with the use of the reported findings and under the assumption that the proportions of cognitive and functional impairment among dropouts increased. Assignment to the placebo group and the occurrence of cardiovascular events independently predicted missed assessments. From the reported findings, the risk of cognitive and functional impairment was similar between the two treatment groups. However, when 20-30% and 40-80% of the subjects who missed the assessment were assumed to be cognitively and, respectively, functionally impaired, assignment to active treatment reduced the risk of these outcomes. In the SHEP, the cognitive and functional evaluations were biased toward the null effect by differential dropout. This might have obscured the appraisal of a protective effect of treatment on the cognitive and functional decline of older hypertensive adults.

Aged↗

Factors related to autonomy and discontinuation of use of natural family planning for women in Liberia and Zambia.

From 1983 to 1988, natural family planning programs were conducted in Liberia and Zambia. In Liberia 1055 and in Zambia 2709 women used natural family planning to avoid pregnancy. These users could become pregnant, discontinue use of the method, or become autonomous users. Women who changed intention did not stop use of natural family planning and were not treated as discontinuations. In a multivariate analysis, client's age, breastfeeding status, employment, urban/rural residence, time of registration in the program, and visit intensity were significantly associated with the outcomes. The most consistent association was that women who entered the programs in the later time periods were more likely to become autonomous users and less likely to discontinue use of the method or to experience an accidental pregnancy.

Adolescent↗

Teenage conception and contraception in the English regions.

Nationally available data on teenage fertility, family planning care and mortality were analysed to determine the relationship between teenage conception, availability of abortion and family planning care, and an indicator of socioeconomic disadvantage--the Standardized Mortality Ratio (SMR). In the 14 regions of England the strongest correlate of teenage conception and of the proportion of teenage conceptions aborted was female all-causes SMR. High levels of provision of NHS abortion services and uptake of family planning clinic care did not significantly reduce teenage fertility. Provision of traditional family planning services obviously plays an important role in preventing teenage pregnancy, but innovation in this service coupled with a concerted effort to reduce social disadvantage might have a greater impact on teenage fertility in England.

Abortion, Induced↗

Assessing changes in vaginal bleeding patterns in contracepting women.

In clinical trials comparing alternative contraceptive methods, women often discontinue for disturbances in menstrual bleeding patterns. Vaginal bleeding diaries have been used to monitor these patterns, and this paper suggests two new methods of analysis of these data. One analysis measures trends over time in the occurrence of specific patterns and, a second analysis, the relation between a woman's current experience and the probability of continuing method use. Contrasts between these approaches and the reference period method of analysis are made. A randomised clinical trial of the relative efficacy of 100 and 150 mg doses of depot-medroxyprogesterone acetate (DMPA) is used for illustration.

Amenorrhea↗

A prospective treatment study of premenstrual symptoms using a triphasic oral contraceptive.

Eighty-two women with complaints of moderate to severe premenstrual symptoms were recruited for a double-blind, controlled trial of a triphasic oral contraceptive (o.c.). Subjects made daily ratings of symptoms for at least one baseline cycle and were then randomly assigned to receive either placebo or o.c. for three months. Twenty-three women dropped out of the study (18 o.c., 5 placebo), 13 failed to show prospective confirmation of moderate to severe premenstrual symptoms, and one placebo subject had an anovulatory cycle. Forty-five women with prospectively-confirmed premenstrual changes (20 o.c., 25 placebo) completed the study. Premenstrual breast pain and bloating were significantly reduced with active treatment compared to placebo (p less than 0.03) but there were no beneficial effects of the o.c. over placebo for any of the mood symptoms. Women who received o.c.s reported decreased sexual interest after starting treatment and this effect was independent of any adverse influence on mood.

Adult↗

The fate of women requesting reversal of tubal sterilization.

Although it was not possible to identify by simple demographic measurements those women who would elect not to pursue full investigation, this study has highlighted the high drop-out rate of women requesting reversal, and suggested that discussion with the couple at the first visit is a valid procedure, particularly if it allows as many as one-third of patients to elect not to proceed to invasive procedures. Finally, this study underscores that when gynecologists are counseling patients with respect to sterilization and the question of reversibility is opened, the success rate is not in excess of 50% when it is considered a function of the number of women regretting reversal rather than a function of women who undergo surgery.

Abortion, Spontaneous↗