Failing to retain an adequate number of study participants in behavioral intervention trials poses a threat to interpretation of study results and its external validity. This qualitative investigation describes the retention strategies promoted by the recruitment and retention committee of the Behavior Change Consortium, a group of 15 university-based sites funded by the National Institutes of Health to implement studies targeted toward disease prevention through behavior change. During biannual meetings, focus groups were conducted with all sites to determine barriers encountered in retaining study participants and strategies employed to address these barriers. All of the retention strategies reported were combined into 8 thematic retention categories. Those categories perceived to be most effective for retaining study participants were summarized and consistencies noted among site populations across the life course (e.g., older adults, adults, children, and adolescents). Further, possible discrepancies between site populations of varying health statuses are discussed, and an ecological framework is proposed for use in future investigations on retention.

The findings show that alcohol directly increases smoking urge in chipper smokers. Tobacco chippers may crave cigarettes more during heavier than during lighter drinking bouts, and this effect appears to be driven by heightened stimulation levels rather than as a means to offset alcohol's sedative effects.

Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses. What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness. Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise, nutrition and medication adherence. Ninety-three patients and their spouses/partners consented to participate (26% of those eligible) and were randomized into either the individual or couples conditon. However, only 80 couples, distributed across conditions, contributed data to the analyses, due to missing data and missing data points. For exercise, there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time. Additionally, there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment, while both distressed and non-distressed patients in the couples treatment exhibited accelerating gains throughout treatment. In terms of medication adherence, patients in the couples treatment exhibited virtually no change in medication adherence over time, while patients in the individuals treatment showed a 9% relative decrease across time. There were no condition or time effects for nutritional outcomes. Finally, there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction, while non- satisfied patients in the couples treatment showed improvement over time.

This study examined human immunodeficiency virus (HIV) as a traumatic stressor, intrusive and deliberate cognitive processing, psychological distress, and posttraumatic growth. One-hundred twelve participants completed interviews on posttraumatic stress disorder (PTSD) Criterion A, Rumination Scale-Revised, Impact of Event Scale, and the Posttraumatic Growth Inventory; relationships were modeled using path analysis. Model 1 attempted to replicate prior empirical research, Model 2 attempted to empirically replicate part of the posttraumatic growth theoretical model, and Model 3 attempted to empirically replicate an integrated model of posttraumatic growth and traumatic stress theories. Model 3 had good fit with study data. Results suggest shared and separate pathways from traumatic stressor to psychological distress and posttraumatic growth, with pathways mediated by cognitive processing. Implications of findings are discussed.