scholarly journals Why do participants drop-out: findings from a prospective pediatric cohort for fever surveillance established at Vellore, southern India

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kulandaipalayam Natarajan Sindhu ◽  
Manikandan Srinivasan ◽  
Sathyapriya Subramaniam ◽  
Anita Shirley David ◽  
Venkata Raghava Mohan ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Large Scale ◽  
Economic Status ◽  
Field Research ◽  
Drop Out ◽  
Background Characteristics ◽  
Group Discussions ◽  
Community Based ◽  
Drop Out Rate ◽  
Drop Outs

Abstract Background Cohort studies are pivotal in understanding the natural history, and to thereby determine the incidence of a disease. The conduct of large-scale community-based cohort studies is challenging with reference to money, manpower and time. Further, attrition inherent to cohort studies can affect the power, and thereby the study’s validity. Our objective was to estimate the percentage of participant withdrawal and to subsequently understand reasons for the same in the Vellore Typhoid Surveillance (VTS) cohort. Methods VTS study, a prospective community-based pediatric cohort, was established in a semi-urban settlement of Vellore to estimate the incidence rate of typhoid fever. An active weekly surveillance identified children with fever, and blood cultures were performed for fevers of ≥3 days. Reasons for participant drop-out in the cohort were documented. Nine focus group discussions (FGD), each with 5 to 7 parents/primary caregivers of former as well current participants were conducted separately, to understand reasons for consent withdrawal as well as the good aspects of the study that the current participants perceived. A descriptive, as well as an interpretative account of the themes that emerged from the FGDs were done. Results Of the 5639 children in the VTS cohort, 404 (7.2%) withdrew consent during the 12-month surveillance. Of these, 50% dropped out due to migration from study area; 18.1% as their parents were unhappy with the blood draws for blood culture; and 14.4% did not clearly put forth the reason for consent withdrawal. Being from an orthodox background, high socio-economic status and joint family were associated with a decision to drop-out. Frequent and voluminous blood draws, male field research assistants (FRA) making weekly home-visits, the perception that inquiring about fever made their child fall sick, and that the study clinic did not initiate antibiotics immediately, were the important themes that emerged from the FGDs conducted among drop-outs. Conclusion Our study showed that specific beliefs and behaviours within the community influenced the drop-out rate of the VTS cohort. Background characteristics and perceptions that exist, along with attrition data from previous cohort studies in the specific community are important to be considered while implementing large-scale cohort studies.

COMPARISON OF EFFECTIVENESS OF LARGE SCALE STRESS WORKSHOPS WITH SMALL STRESS/ANXIETY MANAGEMENT TRAINING GROUPS

1998 ◽  
Vol 26 (3) ◽  
pp. 219-235 ◽  
Author(s):  
June S. L. Brown ◽  
Ray Cochrane ◽  
Carol Mack ◽  
Newman Leung ◽  
Teresa Hancox
Keyword(s):  
Large Scale ◽  
Management Training ◽  
Drop Out ◽  
Anxiety Management ◽  
Client Group ◽  
Traditional Health ◽  
Drop Out Rate ◽  
Anxiety Management Training ◽  
Comparison Of Effectiveness ◽  
Stress Workshops

This study investigates whether large-scale, day-long stress management workshops open to the general public can work as well as small, weekly groups run for referred clients. It is suggested that the self-referral route may enable some people who might otherwise have been ‘‘filtered out’’ from the traditional health services to get help for their stress-related problems. Analysis showed that the large-scale format was just as effective with a more distressed subgroup as was the small weekly format for formally referred clients, which suggests that the effectiveness of this approach is not only related to a restricted client group. It would appear that the low drop-out rate, the effectiveness of the workshops and the severity of problem handled within this format indicates potential value in this type of approach.

Socio-Demographic Determinants of Antenatal Care

1998 ◽  
Vol 28 (4) ◽  
pp. 206-209 ◽  
Author(s):  
Shalini Chandrashekar ◽  
R S Phaneendra Rao ◽  
N Sreekumaran Nair ◽  
P Raman Kutty
Keyword(s):  
Antenatal Care ◽  
Large Scale ◽  
Economic Status ◽  
Poor Quality ◽  
Infant Mortality Rate ◽  
High Risk Population ◽  
Medical Facility ◽  
Community Based ◽  
Karnataka State

A large scale community-based study in South Kanara district of Karnataka state, India has revealed that, despite a low infant mortality rate (IMR), there is a clear association between IMR and lack of antenatal care (ANC) as well as IMR and poor quality ANC. We analyse the factors which determine the utilization of ANC and show the association between quality of ANC and maternal literacy, occupation, age and parity. Factors which are also significantly associated are socio-economic status, religion and matriarchal system. Characteristically, those who do not receive any ANC are poor, illiterate, multiparous unskilled mothers over 30 years of age and who live far away from a medical facility. This study conclusively demonstrates that even in regions where IMR is low there is enough scope to reduce it further by concentrating our efforts on the high risk population.

scholarly journals Dropping out of care: inappropriate terminations of contact with community-based psychiatric services

2002 ◽  
Vol 181 (4) ◽  
pp. 331-338 ◽  
Author(s):  
Alberto Rossi ◽  
Francesco Amaddeo ◽  
Giulia Bisoffi ◽  
Mirella Ruggeri ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Global Assessment ◽  
Mental Illnesses ◽  
Psychiatric Services ◽  
Drop Out ◽  
Dropping Out ◽  
Global Assessment Of Functioning ◽  
Community Based ◽  
Satisfaction Scale ◽  
Younger Patients ◽  
Drop Outs

BackgroundFew studies have investigated factors which predict inappropriate terminations (drop-out) of clinical contact with mental health services.AimsTo identify patient and treatment characteristics associated with dropping out of contact with community-based psychiatric services (CPS).MethodA 3-month cohort of patients attending the CPS was followed up for 2 years, to identify drop-outs.ResultsWe identified 495 patients who had had at least one psychiatric contact of whom 261 had complete ratings for the Global Assessment of Functioning and the Verona Service Satisfaction Scale. In the year after the index contact, 70 terminated contact with the CPS; of these, 44 were rated as having inappropriate terminations (the ‘drop-out’ group) and 26 had appropriate terminations of contact. Drop-outs were younger, less likely to be married and their previous length of contact with services was shorter. No drop-outs had a diagnosis of schizophrenia. Multivariate analysis revealed predictors of dropping out.ConclusionsIn a CPS targeted to patients with severe mental illnesses, those who drop out of care are younger patients without psychoses who are generally satisfied with their treatment.

scholarly journals Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation

2021 ◽  
Vol 11 ◽  
Author(s):  
Anael Barberan-Garcia ◽  
Isaac Cano ◽  
Bart C. Bongers ◽  
Steffen Seyfried ◽  
Thomas Ganslandt ◽  
...  
Keyword(s):  
Large Scale ◽  
Patient Adherence ◽  
Hospital Setting ◽  
Service Selection ◽  
Chronic Patients ◽  
Community Based ◽  
Patient Reported ◽  
Integrated Care Pathways ◽  
Drop Outs

Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.

scholarly journals Evaluating the Development Potentials of Agri Sites for Tourism: The Case of Tigaon, Province of Camarines Sur, Philippines

2020 ◽  
pp. 1-9
Author(s):  
Jossie B. Romero
Keyword(s):  
Economic Status ◽  
Descriptive Statistics ◽  
Assessment Process ◽  
Research Approach ◽  
Participatory Action ◽  
Group Discussions ◽  
Community Based ◽  
Action Research Approach ◽  
Baseline Information ◽  
Mode Of Transportation

The study aims to evaluate the potential and prospects of agritourism sites in Barangays Tinawagan and Libod, Tigaon, Camarines Sur through Community-Based Participatory Action Research approach. The result of the study will serve as baseline information to develop community-managed agritourism trek in the area to help the community uplift the socio-economic status. The study focuses on classifying the potential agritourism sites from the point of origin, accessibility, mode of transportation and side attractions, evaluating the environment and surroundings of the locality and other services. The Tourism Assessment Process (Linking Communities Tourism and Conversation) model was utilized through focused group discussions, ocular and site visit, and oral interview were considered in gathering the data. The gathered data were treated using descriptive statistics.

scholarly journals Effect of Mobile Phone Reminders and Recalls on Pentavalent Vaccines Drop-out Rate among Caregivers Accessing Childhood Immunisation Services in a Developing City, Southeast Nigeria

2018 ◽  
Author(s):  
N. C. Eze ◽  
C. N. Onwasigwe
Keyword(s):  
Mobile Phone ◽  
Health Facility ◽  
Intervention Group ◽  
Immunisation Programme ◽  
Cost Effective ◽  
Drop Out ◽  
Control Group ◽  
Post Intervention ◽  
Drop Out Rate ◽  
Drop Outs

Background: Immunisation drop-out rate measures the effectiveness of the immunisation programme. When drop-outs exceed 10 percent it indicates a problem of utilisation of services. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing pentavalent vaccination drop-outs in Abakaliki. Materials and Methods: This is a quasi-experimental study among caregivers of infants in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Izzi and Ebonyi Local Government Areas (LGA) of Ebonyi State were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire forms, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria.            Results: The mean age of respondents were 26.6 ±4.9 years and 27.1±4.2 years in the intervention and control groups respectively. Thirty five point seven percent (35.7%) of infants dropped out of pentavalent vaccinnation 3 in pre-intervention phase when compared with 5.5% post-intervention. This difference in their proportions was found statistically significant (p<0.01).  In the control group, 47.7% dropped out of pentavalent vaccination 3 at the beginning of the study when compared with 22.1% at the end of the study, a difference that was statistically significant (p=0.02). Out of 145 infants who received pentavalent vaccines 1 in both groups, 137 (94.5%) infants received pentavalent vaccines 3 in the intervention group while 113 (77.9%) infants received pentavalent vaccines 3 in the control group. Far distance to health facility predicted immunisation drop-out in the control group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility. No predictor was found in the intervention group. Conclusion: Mobile phone reminders and recall has proven very effective in reducing pentavalent vaccines drop-out rate in Abakaliki. Implementation of immunisation reminders and recall systems are therefore recommended in immunisation clinics in developing countries especially in Nigeria for improved immunisation coverage in order to achieve Sustainable Developmental Goal 3 (SDG 3).

scholarly journals A survey of abandonment of student nurses at Greys Hospital

Curationis ◽  
1982 ◽  
Vol 5 (1) ◽  
Author(s):  
S.F. Fry ◽  
A. Karani ◽  
G.M. Tuckell
Keyword(s):  
South African ◽  
Tertiary Education ◽  
Student Nurses ◽  
Drop Out ◽  
South African Context ◽  
The Past ◽  
Drop Out Rate ◽  
African Context ◽  
Active Research ◽  
Drop Outs

In all tertiary education, a certain percentage of drop-outs can be expected. In this instance, the authors were interested in the abandonment or withdrawal of students from the Diploma in General Nursing at Greys Hospital, Pietermaritzburg. Over the past few years the drop out rate at Greys Hospital was sufficiently high to cause concern - particularly at a time when there is a widely reported shortage of White nursing personnel. Also, in the South African context, very little active research has been reported in this regard.

scholarly journals Vaccination coverage of children in tribal Narmada district of Gujarat: a cross sectional study

2020 ◽  
Vol 7 (2) ◽  
pp. 609
Author(s):  
Rahul Parmar ◽  
Nirmal Prajapati ◽  
Kalpita Shringarpure
Keyword(s):  
Vaccination Coverage ◽  
Cross Sectional Study ◽  
Drop Out ◽  
Cluster Sampling ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Drop Out Rate ◽  
Study Population ◽  
Set Up

Background: Vaccination being one of the cheapest and safest methods of primary prevention, indicators of maternal and child healthcare are crucial. Multi-indicator cluster survey was planned to check these objectives as set up in reproductive child health (RCH)-II and National Rural Health Mission (NRHM) plan. This study was initiated to determine the vaccination coverage among the children in tribal district in Gujarat and to determine factors associated with partial immunization and non-immunization.Methods: A community based cross-sectional study was done in tribal district Narmada in Gujarat for a period of four months from May 2011 to August 2011. The study population consisted of all children aged between 12-23 months. After using cluster sampling method, assessment of vaccination programme was obtained from 346 out of total 352 children scattered across 30 clusters. A pre-tested semi-structured questionnaire was administered by interview technique.Results: Highest coverage was seen in the first dose of diphtheria, pertussis, and tetanus (DPT) 95.7% (CI 92.3-99) followed by Bacillus Calmette-Guérin (BCG) 95.4% (CI 92-98.7) and first dose of oral poliovirus vaccines (OPV) 95.4% (CI 92-98.7). The proportion of fully immunized children was 77.7% (CI 69.4-86.1), whereas 2.9% (CI 0.0-6.1) children were not vaccinated at all. The drop-out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles.Conclusions: Vaccination   coverage   was highest for DPT first dose followed by BCG. The drop- out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles. Non-awareness regarding subsequent doses of vaccines was most common reason for partial or non-vaccination.

Entwicklung und Evaluation einer internetbasierten begleiteten Selbsthilfe-Intervention zur Bewältigung von Albträumen

2015 ◽  
Vol 63 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Max Böckermann ◽  
Annika Gieselmann ◽  
Marjolijn Sorbi ◽  
Reinhard Pietrowsky
Keyword(s):  
Drop Out ◽  
Drop Out Rate

Hintergrund: Dieser Artikel beschreibt die Entwicklung eines internetbasierten begleiteten Selbsthilfetrainings (Albtraumcoach) zur Bewältigung von Albträumen, das innerhalb zweier Pilotstudien auf seine Durchführbarkeit und Anwendbarkeit getestet wurde. Methoden: Innerhalb eines neunstufigen Modells wird die Entwicklung der Intervention beschrieben. Dabei wird neben der wissenschaftlichen Evidenz, die die Basis für die Intervention bildet, auf technische, ethische, datenschutzrechtliche und weitere spezifische Maßnahmen innerhalb der Interventionsentwicklung eingegangen. In zwei Pilotstudien evaluierten zudem 10 Personen mit schlechten Träumen in der Vergangenheit die Durchführbarkeit (Studie 1) und 12 Personen mit wiederkehrenden Albträumen die Anwendbarkeit sowie den Nutzen der Intervention (Studie 2). Abhängige Variablen waren die Qualität der einzelnen Sitzungen, die Zufriedenheit mit der Intervention sowie Albtraumfrequenz, Albtraumbelastung, Schlafqualität und Depressivität. Ergebnisse und Diskussion: Die Durchführbarkeit und Anwendbarkeit des Trainings wurden positiv beurteilt. Während die Drop-out-Rate verhältnismäßig hoch war, ergaben sich erste, zurückhaltend zu beurteilende, Hinweise für einen Nutzen der Intervention.

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