Engaging Adolescents in Contemporary Longitudinal Health Research: Strategies for Promoting Participation and Retention
Aja Louise Murray, Tong Xie
Abstract
PurposeHigh (and nonselective) recruitment and retention rates in longitudinal studies of adolescence are essential for illuminating health trajectories and determinants during this critical period. Knowledge of optimal recruitment and retention strategies must keep pace with emerging challenges and opportunities, such as the shifts towards digitally-based data collection.MethodsWe used a narrative review approach to synthesize research on promising recruitment and retention strategies for optimizing engagement in the next generation of longitudinal adolescent health studies.ResultsWe identified a small number of well-evidenced strategies, emerging challenges and opportunities for recruitment and retention in contemporary studies, and key evidence gaps. Core recommendations include the use of well-evidenced strategies (e.g., incentivizing participation, reducing barriers and burden, and investing in building positive relationships with participants) and coproducing recruitment and retention strategies with adolescents and parents of adolescents.DiscussionMore research is needed into successful recruitment/retention strategies for digital/remote data collection methods, but initial evidence suggests that adopting principles and adapting well-evidenced strategies from traditional longitudinal studies is promising. High (and nonselective) recruitment and retention rates in longitudinal studies of adolescence are essential for illuminating health trajectories and determinants during this critical period. Knowledge of optimal recruitment and retention strategies must keep pace with emerging challenges and opportunities, such as the shifts towards digitally-based data collection. We used a narrative review approach to synthesize research on promising recruitment and retention strategies for optimizing engagement in the next generation of longitudinal adolescent health studies. We identified a small number of well-evidenced strategies, emerging challenges and opportunities for recruitment and retention in contemporary studies, and key evidence gaps. Core recommendations include the use of well-evidenced strategies (e.g., incentivizing participation, reducing barriers and burden, and investing in building positive relationships with participants) and coproducing recruitment and retention strategies with adolescents and parents of adolescents. More research is needed into successful recruitment/retention strategies for digital/remote data collection methods, but initial evidence suggests that adopting principles and adapting well-evidenced strategies from traditional longitudinal studies is promising. Implications and ContributionOptimizing recruitment and retention of adolescents in longitudinal health research is crucial. This narrative review synthesizes evidence on promising strategies (e.g., incentive use, barrier reduction, building relationships, and coproducing strategies with adolescents and parents), discusses emerging challenges and opportunities for recruitment and retention in the digital age, highlights evidence gaps, and provides recommendations. Optimizing recruitment and retention of adolescents in longitudinal health research is crucial. This narrative review synthesizes evidence on promising strategies (e.g., incentive use, barrier reduction, building relationships, and coproducing strategies with adolescents and parents), discusses emerging challenges and opportunities for recruitment and retention in the digital age, highlights evidence gaps, and provides recommendations. Longitudinal research in adolescent populations is essential for illuminating the trajectories and determinants of health in and beyond this critical period [[1]Karcher N.R. Barch D.M. The ABCD study: Understanding the development of risk for mental and physical health outcomes.Neuropsychopharmacology. 2021; 46: 131-142Google Scholar,[2]Niarchou M. Zammit S. Lewis G. The Avon longitudinal study of parents and children (ALSPAC) birth cohort as a resource for studying psychopathology in childhood and adolescence: A summary of findings for depression and psychosis.Soc Psychiatr Psychiatr Epidemiol. 2015; 50: 1017-1027Google Scholar]. Sustaining participant engagement over years and decades is challenging and relies on recruitment and retention strategies that consider the unique challenges of research in adolescence. To inform such strategies, especially considering the increasing shift towards remote and digitally-based methods, we review the evidence on optimizing recruitment and retention of adolescents in contemporary longitudinal health studies. There are numerous unique challenges for engagement in longitudinal adolescent health studies. Adolescence is a transitional period of considerable physical, cognitive, and social change [[3]Dahl R.E. Allen N.B. Wilbrecht L. Suleiman A.B. Importance of investing in adolescence from a developmental science perspective.Nature. 2018; 554: 441-450Google Scholar]. Research participation must compete with the developmental tasks and busy schedules that occupy young people during this period and studies must implement engagement strategies that are responsive to relevant developmental changes, such as increasing autonomy [4Tercyak K.P. Donze J.R. Prahlad S. et al.Identifying, recruiting, and enrolling adolescent survivors of childhood Cancer into a randomized controlled trial of health promotion: Preliminary experiences in the survivor health and Resilience education (SHARE) Program.J Pediatr Psychol. 2006; 31: 252-261Google Scholar, 5Villarruel A.M. Jemmott L.S. Jemmott J.B. Eakin B.L. Recruitment and retention of Latino adolescents to a research study: Lessons learned from a randomized clinical trial.J Spec Pediatr Nurs (JSPN). 2006; 11: 244-250Google Scholar, 6Calderwood L. Smith K. Gilbert E. et al.Securing participation and getting accurate answers from teenage children in surveys: Lessons from the UK Millennium cohort study.Social Res Practice. 2015; 1: 27-32Google Scholar]. The presence of multiple stakeholders also creates challenges. As well as adolescents themselves, caregivers must often be convinced of the value of a study to provide consent [[7]Ewing S.W.F. Dash G.F. Thompson W.K. et al.Measuring retention within the adolescent brain cognitive development (ABCD) SM study.Dev Cogn Neurosci. 2022; 54101081Google Scholar] and in dyadic or multi-informant studies, it is additionally necessary to implement strategies for engaging them as participants [[8]Eisner N.L. Murray A.L. Eisner M. Ribeaud D. A practical guide to the analysis of non-response and attrition in longitudinal research using a real data example.IJBD (Int J Behav Dev). 2019; 43: 24-34Google Scholar]. Given the importance of schools in shaping health and the opportunities offered for recruiting representative samples through them, school-based data collection is common [[9]Clary K.L. Reinhart C.A. Kim H.J. Smith D.C. Improving recruitment procedures for school-based surveys: Through the lens of the Illinois youth survey.J Sch Health. 2021; 91: 250-257Google Scholar,[10]Schilpzand E.J. Sciberras E. Efron D. et al.Improving survey response rates from parents in school-based research using a multi-level approach.PLoS One. 2015; 10e0126950Google Scholar]. This makes school communities further stakeholders to be considered in engagement strategies. School transitions can also create retention challenges [[11]Aldridge J. Parker H. Measham F. Drug trying and drug use across adolescence: A longitudinal study of young people’s drug taking in two regions of northern England. Home Office Drugs Prevention Advisory Service, Home Office, 1999Google Scholar], with adolescents surveyed near the end of middle school or secondary school being especially prone to attrition due to higher rates of absenteeism, dropout [[12]Epstein J.A. Botvin G.J. Methods to decrease attrition in longitudinal studies with adolescents.Psychol Rep. 2000; 87: 139-140Google Scholar], and leaving school [[13]Hanna K.M. 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