Attrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issues

2.50
Hdl Handle:
http://hdl.handle.net/10755/166040
Category:
Abstract
Type:
Presentation
Title:
Attrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issues
Author(s):
McConnell, Eleanor
Author Details:
Eleanor McConnell, PhD, Duke University School of Nursing School of Nursing, Durham, North Carolina, USA, email: eleanor.mcconnell@duke.edu
Abstract:
Introduction:Attrition of subjects is an important potential threat to validity of exercise intervention trials. Reasons for attrition of subjects in nursing home-based exercise studies are likely to be different than reasons for attrition in community-based programs. This paper examines the experience from 13 exercise intervention studies lasting greater than 4 weeks, conducted in nursing home residents during the past decade, plus data from a intervention development study recently completed at the Duke Pepper Center. Methods:All exercise intervention trials in nursing home residents aged 60 years or older of at least 4 weeks duration, reported in journals indexed in Medline( from 1990 to 1996 were reviewed. Descriptive analysis from a 32 week randomized controlled cross-over trial of group strength and flexibility exercise program are also reported. Findings:The 14 studies reviewed had a total of 801 subjects, and represented a variety of approaches to exercise intervention, including strength, flexibility, and endurance exercise programs( Attrition rates raged from 0 to 48%. When subjects who did not complete baseline measures successfully were excluded from attrition calculations, attrition ranged from 0 to 35%. Reasons for attrition identified by investigators included death unrelated to exercise programs, exacerbation of chronic illness, transfer to another facility, loss of ability to follow study procedures, lack of interest in exercise, and minor injury associated with exercise. Conclusions:Measurable rates of attrition occur in nursing home-based exercise programs; investigators planning such intervention trials should anticipate rates as high as 20%, and plan specific approaches to reduce attrition. Although the majority of reasons for attrition from these studies were due to factors beyond investigator control, such as declines due to changing chronic disease status, a small amount of attrition may be due to factors related to the design of the exercise program itself. Advantages and disadvantages of several experimental design approaches to decrease biasing effects of attrition will be discussed, including targeting exercise interventions to more homogeneous groups of nursing home residents, using a "run-in" period to examine ability of subjects to comply with study procedures, and incentive programs to maintain interest in the study.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAttrition In Nursing Home Based Exercise Intervention Studies: Experimental Design Issuesen_GB
dc.contributor.authorMcConnell, Eleanoren_US
dc.author.detailsEleanor McConnell, PhD, Duke University School of Nursing School of Nursing, Durham, North Carolina, USA, email: eleanor.mcconnell@duke.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166040-
dc.description.abstractIntroduction:Attrition of subjects is an important potential threat to validity of exercise intervention trials. Reasons for attrition of subjects in nursing home-based exercise studies are likely to be different than reasons for attrition in community-based programs. This paper examines the experience from 13 exercise intervention studies lasting greater than 4 weeks, conducted in nursing home residents during the past decade, plus data from a intervention development study recently completed at the Duke Pepper Center. Methods:All exercise intervention trials in nursing home residents aged 60 years or older of at least 4 weeks duration, reported in journals indexed in Medline( from 1990 to 1996 were reviewed. Descriptive analysis from a 32 week randomized controlled cross-over trial of group strength and flexibility exercise program are also reported. Findings:The 14 studies reviewed had a total of 801 subjects, and represented a variety of approaches to exercise intervention, including strength, flexibility, and endurance exercise programs( Attrition rates raged from 0 to 48%. When subjects who did not complete baseline measures successfully were excluded from attrition calculations, attrition ranged from 0 to 35%. Reasons for attrition identified by investigators included death unrelated to exercise programs, exacerbation of chronic illness, transfer to another facility, loss of ability to follow study procedures, lack of interest in exercise, and minor injury associated with exercise. Conclusions:Measurable rates of attrition occur in nursing home-based exercise programs; investigators planning such intervention trials should anticipate rates as high as 20%, and plan specific approaches to reduce attrition. Although the majority of reasons for attrition from these studies were due to factors beyond investigator control, such as declines due to changing chronic disease status, a small amount of attrition may be due to factors related to the design of the exercise program itself. Advantages and disadvantages of several experimental design approaches to decrease biasing effects of attrition will be discussed, including targeting exercise interventions to more homogeneous groups of nursing home residents, using a "run-in" period to examine ability of subjects to comply with study procedures, and incentive programs to maintain interest in the study.en_GB
dc.date.available2011-10-27T14:38:59Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:38:59Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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