Characteristics of Women Lost to Follow-Up in Cardiovascular Community Health Interventions: Findings from the Sister to Sister Campaign

Abstract

Community-based interventions (CBI) have been targeted as a potential means of tackling cardiovascular disease in women. However, there have been mixed results in terms of their impact on health, with at least some of this being attributed to high attrition rates. This study explores factors that may be contributing to the low retention of women in cardiovascular CBIs. In 2009, Sister to Sister, a national organization that sponsors community health fairs, provided free cardiovascular health screenings for a total of 9,443 women nationwide. All participants were invited to enroll in a 1 year, survey-based observational study to assess the effectiveness of these community health screenings. Of these 9,443 women, 5.9 % actively participated in the follow-up study. Participants were more likely to have health insurance (75.5 vs. 65.3 %, p < 0.001), have an annual income above 75,000 dollars (26.7 vs. 19.7 %, p < 0.001), and identify themselves as white (50.0 vs. 31.5 %, p < 0.001). They were also more likely to have hypertension (32.1 vs. 27.4 %, p = 0.018) and metabolic syndrome (35.7 vs. 20.4 %, p < 0.001). Our results suggest that white, affluent women with health insurance and cardiovascular risk factors are more likely to engage in CBIs that require longitudinal assessment. This study gives insight into the demographics, socioeconomic status, and cardiovascular comorbidities of women who participate in cardiovascular CBIs. The results may prove to be useful in understanding the biopsychosocial barriers to participation in CBIs in order to develop more effective interventions in the future.

Factors Associated With Study Completion in Patients With Premature Acute Coronary Syndrome

“…Our age, smoking, and depression findings corroborate previous work in cardiovascular cohorts [9][10][11], suggesting that study completion may occur systematically depending on these patient characteristics. Younger individuals may feel less vulnerable to disease or less benefit from long-term involvement in research studies [10].…”

“…Based on previous research [7][8][9][10][11], several characteristics were identified as potential factors associated with study completion. Medication use at time of hospitalization (i.e., Calcium antagonists, ACE inhibitors, and statins), number of medications at time of discharge, previous diagnosis of dyslipidemia, hypertension, and diabetes were determined from chart review.…”

“…Moreover, few studies have examined whether completers and dropouts differ systematically in cohorts of cardiovascular patients or cardiovascular prevention [9][10][11]. In these studies, study completion was associated with several sociodemographic (i.e., higher income, lower body mass index (BMI), older age, female sex, and white ethnicity), access-to-care (i.e., attendance of health fairs and having health insurance), clinical (i.e., not smoking, having metabolic syndrome and hypertension, lower HDL cholesterol level, and adherence to cardiac medication), and psychosocial (i.e., lower levels of depression, anxiety, and general stress) characteristics [9][10][11]. These studies, however, had important limitations.…”

Factors associated with study completion in patients with premature acute coronary syndrome

“…However, only increasing age and cognitive impairment seem to be independently associated with not completing longitudinal studies [8]. Moreover, few studies have examined whether completers and dropouts differ systematically in cohorts of cardiovascular patients or cardiovascular prevention [9–11]. In these studies, study completion was associated with several sociodemographic (i.e., higher income, lower body mass index (BMI), older age, female sex, and white ethnicity), access-to-care (i.e., attendance of health fairs and having health insurance), clinical (i.e., not smoking, having metabolic syndrome and hypertension, lower HDL cholesterol level, and adherence to cardiac medication), and psychosocial (i.e., lower levels of depression, anxiety, and general stress) characteristics [9–11].…”

“…These studies, however, had important limitations. For instance, one study only reported unadjusted results [9] whereas another did not examine men or report their female participants’ age [11]. Moreover, the two studies that did report age [9, 10] only examined older adults (i.e., greater than 59 years).…”