Differential attrition in health behaviour change trials: a systematic review and meta-analysis

Crutzen, Rik; Viechtbauer, Wolfgang; Spigt, Mark; Kotz, Daniel

doi:10.1080/08870446.2014.953526

Cited by 132Meta-analysis and systematic reviewsBehavioral Health and InterventionsStatistical Methods in Clinical Trials

Differential attrition in health behaviour change trials: a systematic review and meta-analysis

Open access

Crutzen, Rik, Viechtbauer, Wolfgang, Spigt, Mark, Kotz, Daniel·2015·Psychology & Health

DOI 10.1080/08870446.2014.953526

Open this paper in CoChat — free account

Abstract

OBJECTIVE: Attrition is a common problem in health behaviour change (HBC) trials. When the degree of attrition differs between treatment conditions, then this is called differential attrition and is regarded as a major threat to internal validity. The primary research question of this study was: how often and to what degree does differential attrition occur in HBC trials? DESIGN: A systematic review and meta-analysis of a random selection of HBC trials (k = 60). We meta-analysed the relative attrition rates using a random-effects model and examined the relationship between the relative attrition rates and the potential moderators: the amount of human contact in delivery and the intensity of the intervention/control condition, the type of control condition, and the follow-up intensity and duration. MAIN OUTCOME MEASURES: Relative attrition rates. RESULTS: The average attrition rate was 18% (SD = .15; M = .15) in the intervention and 17% (SD = .13; M = .13) in the control conditions. The estimated average relative attrition rate was 1.10 (95% CI: 1.01-1.20, p = .02), suggesting an overall higher attrition rate of 10% in the intervention conditions. This relative attrition rate was not related to any of the potential moderators. CONCLUSION: There is indication of a slightly higher amount of attrition on average in the intervention conditions of HBC trials.

Integrity signals

Registry

Crossref · 10.1080/08870446.2014.953526

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

The text we found for this paper looks like another document, so its claims and self-check weren’t run. The registry and citation checks still apply.

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The text we found for this paper looks like another document, so the self-check wasn’t run.

R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
Conducting Meta-Analyses in <i>R</i> with the <b>metafor</b> Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464 · see citing works
Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099 · see citing works
Untitled work
(2002) · Cited by 13,211 · see citing works
Journal of The American Statistical Association
Fienberg, S. E. (2004) · Encyclopedia of Statistical Sciences · doi:10.1002/0471667196.ess1317 · Cited by 6,289 · see citing works
The Handbook of Research Synthesis and Meta-Analysis
(2019) · doi:10.7758/9781610448864 · Cited by 4,553 · see citing works
A Nonparametric “Trim and Fill” Method of Accounting for Publication Bias in Meta-Analysis
Duval, S., & Tweedie, R. (2000) · Journal of the American Statistical Association · doi:10.1080/01621459.2000.10473905 · Cited by 2,955 · see citing works
Outlier and influence diagnostics for meta-analysis
Viechtbauer, W., & Cheung, M. W.-L. (2010) · Research Synthesis Methods · doi:10.1002/jrsm.11 · Cited by 2,949 · see citing works
Self-citation
Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry
Peters, J. L., Sutton, A. J., Jones, D. R., Abrams, K. R., & Rushton, L. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.11.010 · Cited by 2,053 · see citing works
Cochrane Database of Systematic Reviews
Lyons, R. (2006) · Progress in Neurology and Psychiatry · doi:10.1002/pnp.208 · Cited by 1,907 · see citing works
Missing Data in Clinical Studies
Molenberghs, G., & Kenward, M. G. (2007) · Wiley eBooks · doi:10.1002/9780470510445 · Cited by 969 · see citing works
Experimental and Quasi‐Experimental Designs for Generalized Causal Inference , by William R. Shadish, Thomas D. Cook, and Donald T. Campbell. Boston: Houghton Mifflin, 2001, 623 pp., $65.56.
MacCoun, R. J. (2003) · Journal of Policy Analysis and Management · doi:10.1002/pam.10129 · Cited by 828 · see citing works
Regression Methods to Detect Publication and Other Bias in Meta‐Analysis
Sterne, J. A. C., & Egger, M. (2005) · Publication Bias in Meta‐Analysis · doi:10.1002/0470870168.ch6 · Cited by 826 · see citing works
The European Health Psychologist
Todorova, I. L. G., Araújo‐Soares, V., & Sniehotta, F. F. (2005) · European Health Psychologist · Cited by 777 · see citing works
Sample size slippages in randomised trials: exclusions and the lost and wayward.
Schulz, K. F., & Grimes, D. A. (2002) · The Lancet · doi:10.1016/s0140-6736(02)07882-0 · Cited by 642 · see citing works
Reporting attrition in randomised controlled trials
Dumville, J. C., Torgerson, D. J., & Hewitt, C. E. (2006) · BMJ · doi:10.1136/bmj.332.7547.969 · Cited by 443 · see citing works
Analyzing effect sizes: Random-effects models.
Raudenbush, S. W. (2009) · Cited by 418 · see citing works
Reporting methods of blinding in randomized trials assessing nonpharmacological treatments
Boutron, I., Guittet, L., Estellat, C., Moher, D., Hróbjartsson, A., & Ravaud, P. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040061 · Cited by 389 · see citing works
Online Prevention Aimed at Lifestyle Behaviors: A Systematic Review of Reviews
Kohl, L. F., Crutzen, R., & de Vries, N. K. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2665 · Cited by 388 · see citing works
Self-citation
Blinding was judged more difficult to achieve and maintain in nonpharmacologic than pharmacologic trials
Boutron, I., Tubach, F., Giraudeau, B., & Ravaud, P. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2003.12.010 · Cited by 300 · see citing works
Multiple Risk Expert Systems Interventions: Impact of Simultaneous Stage-Matched Expert System Interventions for Smoking, High-Fat Diet, and Sun Exposure in a Population of Parents.
Prochaska, J. O., Velicer, W. F., Rossi, J. S., Redding, C. A., Greene, G. W., Rossi, S. R., Sun, X., Fava, J. L., Laforge, R. G., & Plummer, B. A. (2004) · Health Psychology · doi:10.1037/0278-6133.23.5.503 · Cited by 190 · see citing works
Methodological Differences in Clinical Trials Evaluating Nonpharmacological and Pharmacological Treatments of Hip and Knee Osteoarthritis
Boutron, I. (2003) · JAMA · doi:10.1001/jama.290.8.1062 · Cited by 155 · see citing works
Assessing the impact of attrition in randomized controlled trials
Hewitt, C. E., Kumaravel, B., Dumville, J. C., & Torgerson, D. J. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.01.010 · Cited by 139 · see citing works
Effects of the mediterranean lifestyle program on multiple risk behaviors and psychosocial outcomes among women at risk for heart disease
Toobert, D. J., Strycker, L. A., Glasgow, R. E., Barrera, M., & Angell, K. L. (2005) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2902_7 · Cited by 92 · see citing works
Assessment of Risk of Bias Among Pediatric Randomized Controlled Trials
Crocetti, M. T., Amin, D. D., & Scherer, R. W. (2010) · PEDIATRICS · doi:10.1542/peds.2009-3121 · Cited by 73 · see citing works
Who participates in which health promotion programs? A meta-analysis of motivations underlying enrollment and retention in HIV-prevention interventions.
Noguchi, K., Albarracín, D., Durantini, M. R., & Glasman, L. R. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.6.955 · Cited by 67 · see citing works
Dropout Rates in Randomized Clinical Trials of Antipsychotics: A Meta-analysis Comparing First- and Second-Generation Drugs and an Examination of the Role of Trial Design Features
Rabinowitz, J., Levine, S. Z., Barkai, O., & Davidov, O. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn005 · Cited by 64 · see citing works
Full Disclosure: Doing behavioural science necessitates sharingPreprint
Peters, G.-J., Abraham, C., & Crutzen, R. (2018) · doi:10.31234/osf.io/n7p5m · Cited by 55 · see citing works
How standard is standard care? Exploring control group outcomes in behaviour change interventions for young people with type 1 diabetes
Ayling, K., Brierley, S., Johnson, B., Heller, S. R., & Eiser, C. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953528 · Cited by 55 · see citing works
Reducing the risk of bias in health behaviour change trials: Improving trial design, reporting or bias assessment criteria? A review and case study
de Bruin, M., McCambridge, J., & Prins, J. M. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953531 · Cited by 53 · see citing works
Attrition in a longitudinal study with hard-to-reach participants was reduced by ongoing contact
David, M., Alati, R., Ware, R. S., & Kinner, S. A. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.12.002 · Cited by 43 · see citing works
What about trialists sharing other study materials?
Crutzen, R., Peters, G.-J., & Abraham, C. (2012) · BMJ · doi:10.1136/bmj.e8352 · Cited by 33 · see citing works
No differential attrition was found in randomized controlled trials published in general medical journals: a meta-analysis
Crutzen, R., Viechtbauer, W., Kotz, D., & Spigt, M. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.03.019 · Cited by 32 · see citing works
Self-citation
Assessing differential attrition in clinical trials: self-monitoring of oral anticoagulation and type II diabetes
Heneghan, C. J., Perera, R., Ward, A., Fitzmaurice, D. A., Meats, E., & Glasziou, P. (2007) · BMC Medical Research Methodology · doi:10.1186/1471-2288-7-18 · Cited by 31 · see citing works
Meta-Analysis of Dropout Rates in SSRIs Versus Placebo in Randomized Clinical Trials of PTSD
Lurie, I., & Levine, S. Z. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181cc41b6 · Cited by 31 · see citing works
Evaluating initial reach and robustness of a practical randomized trial of smoking reduction.
Glasgow, R. E., Estabrooks, P. A., Marcus, A. C., Smith, T. L., Gaglio, B., Levinson, A. H., & Tong, S. (2008) · Health Psychology · doi:10.1037/0278-6133.27.6.780 · Cited by 27 · see citing works
Daily Stress and Social Support among Women with CAD: Results from a 1-year Randomized Controlled Stress Management Intervention Study
Blom, M., Georgiades, A., Janszky, I., Alinaghizadeh, H., Lindvall, B., & Ahnve, S. (2009) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9031-y · Cited by 24 · see citing works
Differential attrition: Another hazard of follow-up research.
Wortman, P. M. (1978) · American Psychologist · doi:10.1037//0003-066x.33.12.1145 · Cited by 24 · see citing works
Differential attrition: Another hazard of follow-up research.
Wortman, P. M. (1978) · American Psychologist · doi:10.1037/0003-066x.33.12.1145 · Cited by 7 · see citing works

Flagged first, then by citations

1 of the 41 references couldn’t be matched to a known paper.

Sorted by citations

Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews
Captieux, M., Pearce, G., Parke, H. L., Epiphaniou, E., Wild, S., Taylor, S. J. C., & Pinnock, H. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-024262 · Cited by 132 · see citing works
“62 The recognised benefit of achieving early control in reducing longer term micro-vascular outcomes supports provision of self-management support despite this attenuation.”
Background
Context effects and behaviour change techniques in randomised trials: A systematic review using the example of trials to increase adherence to physical activity in musculoskeletal pain
Bishop, F. L., Fenge-Davies, A. L., Kirby, S., & Geraghty, A. W. A. (2015) · Psychology & Health · doi:10.1080/08870446.2014.953529 · Cited by 121 · see citing works
Methods for Evaluating Respondent Attrition in Web-Based Surveys
Hochheimer, C. J., Sabo, R. T., Krist, A. H., Day, T., Cyrus, J. W. W., & Woolf, S. H. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.6342 · Cited by 94 · see citing works
“Prior research in this area has investigated both the degree to which attrition from clinical trials occurs and methods for retaining participants [8-12].”
Long-term effectiveness and moderators of a web-based tailored intervention for cancer survivors on social and emotional functioning, depression, and fatigue: randomized controlled trial
Willems, R. A., Mesters, I., Lechner, L., Kanera, I. M., & Bolman, C. A. W. (2017) · Journal of Cancer Survivorship · doi:10.1007/s11764-017-0625-0 · Cited by 80 · see citing works
Waste watchers: A food waste reduction intervention among households in Arizona
Wharton, C., Vizcaino, M., Berardy, A., & Opejin, A. (2021) · Resources, Conservation and Recycling · doi:10.1016/j.resconrec.2020.105109 · Cited by 79 · see citing works
Data Missing Not at Random in Mobile Health Research: Assessment of the Problem and a Case for Sensitivity Analyses
Goldberg, S. B., Bolt, D. M., & Davidson, R. J. (2021) · Journal of Medical Internet Research · doi:10.2196/26749 · Cited by 72 · see citing works
“Although MNAR cannot be assessed directly, we might speculate that participants in the active condition who did not benefit as much from the smartphone-based intervention may be more likely to drop out of the study (refer to Crutzen et al [13] for similar possibilities offered to explain higher attrition in treatment…”
Background
Why and how we should care about the General Data Protection Regulation
Crutzen, R., Peters, G.-J., & Mondschein, C. F. (2019) · Psychology and Health · doi:10.1080/08870446.2019.1606222 · Cited by 75 · see citing works
Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial
Friederichs, S. A. H., Oenema, A., Bolman, C. A. W., & Lechner, L. (2015) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-015-0262-9 · Cited by 74 · see citing works
“This is in line with the findings from a recent review on differential attrition in health behavior change interventions [77].”
Result
A Systematic Review of the Effect of PTSD and Trauma on Treatment Outcomes for Eating Disorders
Day, S., Hay, P., Tannous, K., Fatt, S. J., & Mitchison, D. (2023) · Trauma Violence & Abuse · doi:10.1177/15248380231167399 · Cited by 75 · see citing works
“However, attrition can reduce the internal and external validity of studies by skewing the characteristics of the sample so that they may lose representativeness of the population being studied (Crutzen et al., 2015; Nam & Toneatto, 2016).”
Background
A Mobile Phone App Intervention Targeting Fruit and Vegetable Consumption: The Efficacy of Textual and Auditory Tailored Health Information Tested in a Randomized Controlled Trial
Elbert, S., Dijkstra, A., & Oenema, A. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5056 · Cited by 69 · see citing works
“Although it was not a significant result in this study, more respondents dropped out in one of the intervention conditions, which is a common finding in health intervention research [60].”
Tailored Therapist-Guided Internet-Based Cognitive Behavioral Treatment for Psoriasis: A Randomized Controlled Trial
van Beugen, S., Ferwerda, M., Koulil, S. S., Smit, J. V., Zeeuwen-Franssen, M. E. J., Kroft, E. B. M., de Jong, E. M. G. J., Otero, M. E., Donders, A. R. T., van de Kerkhof, P. C. M., et al. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447267 · Cited by 68 · see citing works
Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use – A Randomized Controlled Pilot Trial
Sundström, C., Gajecki, M., Johansson, M., Blankers, M., Sinadinovic, K., Stenlund-Gens, E., & Berman, A. H. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157817 · Cited by 65 · see citing works
The Missing=Smoking Assumption: A Fallacy in Internet-Based Smoking Cessation Trials?
Blankers, M., Smit, E. S., van der Pol, P., de Vries, H., Hoving, C., & van Laar, M. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv055 · Cited by 61 · see citing works
Panning for the gold in health research: Incorporating studies’ methodological quality in meta-analysis
Johnson, B. T., Low, R. E., & MacDonald, H. V. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953533 · Cited by 58 · see citing works
Reducing the risk of bias in health behaviour change trials: Improving trial design, reporting or bias assessment criteria? A review and case study
de Bruin, M., McCambridge, J., & Prins, J. M. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953531 · Cited by 53 · see citing works
Missing data in randomized controlled trials testing palliative interventions pose a significant risk of bias and loss of power: a systematic review and meta-analyses
Hussain, J. A., White, I. R., Langan, D., Johnson, M. J., Currow, D. C., Torgerson, D. J., & Bland, M. (2015) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2015.12.003 · Cited by 52 · see citing works
“[35] in their review of health behavior change trials also did not find any explanatory variables to be significantly associated with the rate of differential attrition.”
Background
Web-Based Alcohol Intervention: Study of Systematic Attrition of Heavy Drinkers
Radtke, T., Ostergaard, M., Cooke, R. W. I., & Scholz, U. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6780 · Cited by 50 · see citing works
“The Study Few studies to date have provided detailed analyses of attrition rates and possible reasons [36,37], and to the best of our knowledge, there are only a few studies investigating systematic attrition in Web-based alcohol interventions (eg, [15,38]) despite a high need [39].”
Background
Strategies for research participant engagement: A synthetic review and conceptual framework
Wong, C. A., Song, W. B., Jiao, M. G., O'Brien, E. C., Ubel, P. A., Wang, G., & Scales, C. D. (2021) · Clinical Trials · doi:10.1177/17407745211011068 · Cited by 51 · see citing works
“Participant drop-out rates vary widely; estimates include 48% in a review of general medicine trials,(10) 24%–64% in a review of psychopharmacology trials,(11) and 17%–18% in a review of health behavior change trials.(12) Researchers have used different interventions to increase research participant recruitment and re…”
Background
Occurrence of and Reasons for “Missing Events” in Mobile Dietary Assessments: Results From Three Event-Based Ecological Momentary Assessment Studies
Ziesemer, K., König, L. M., Boushey, C. J., Villinger, K., Wahl, D. R., Butscher, S., Müller, J., Reiterer, H., Schupp, H. T., & Renner, B. (2020) · JMIR mhealth and uhealth · doi:10.2196/15430 · Cited by 47 · see citing works
“This is highly comparable to the average attrition rate of 18% found by Crutzen et al [51] for health JMIR Mhealth Uhealth 2020 | vol. 8 | iss.”
Result
Mindfulness and self-compassion as tools in health behavior change: An evaluation of a workplace intervention pilot study
Horan, K. A., & Taylor, M. B. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.02.003 · Cited by 50 · see citing works
Cognitive-behavioural therapy for the management of inflammatory bowel disease-fatigue: a feasibility randomised controlled trial
Artom, M., Czuber-Dochan, W., Sturt, J., Proudfoot, H., Roberts, D., & Norton, C. (2019) · Pilot and Feasibility Studies · doi:10.1186/s40814-019-0538-y · Cited by 48 · see citing works
Efficacy of a Web-Based Self-Management Enhancing Program for Patients with Rheumatoid Arthritis: Explorative Randomized Controlled Trial
Zuidema, R., van Dulmen, S., der Sanden, M. W. G. N., Meek, I., van den Ende, C. H. M., Fransen, J., & van Gaal, B. G. I. (2018) · Journal of Medical Internet Research · doi:10.2196/12463 · Cited by 46 · see citing works
“A high dropout rate is a common finding in Web-based programs [40,41].”
Self-compassion in weight management: A systematic review
Brenton-Peters, J., Consedine, N. S., Boggiss, A., Wallace-Boyd, K., Roy, R., & Serlachius, A. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110617 · Cited by 44 · see citing works
Overall and differential attrition in mindfulness-based interventions: A meta-analysis
Lam, S. U., Kirvin-Quamme, A., & Goldberg, S. B. (2022) · Mindfulness · doi:10.1007/s12671-022-01970-z · Cited by 39 · see citing works
From question-behaviour effects in trials to the social psychology of research participation
McCambridge, J. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953527 · Cited by 40 · see citing works
A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents
van der Wurff, I. S. M., Meyer, B. J., & de Groot, R. H. M. (2017) · Nutrients · doi:10.3390/nu9050474 · Cited by 37 · see citing works
Risk of bias in randomised controlled trials of health behaviour change interventions: Evidence, practices and challenges
de Bruin, M. (2015) · Psychology & Health · doi:10.1080/08870446.2014.960653 · Cited by 36 · see citing works
Effectiveness of interventions to maintain physical activity behavior (device‐measured): Systematic review and meta‐analysis of randomized controlled trials
Madigan, C. D., Fong, M., Howick, J., Kettle, V. E., Rouse, P. C., Hamilton, L., Roberts, N. W., Gomersall, S. R., & Daley, A. (2021) · Obesity Reviews · doi:10.1111/obr.13304 · Cited by 36 · see citing works
Attrition rates in trials for adolescents and young adults at clinical high‐risk for psychosis: A systematic review and meta‐analysis
Farris, M. S., Devoe, D. J. A., & Addington, J. (2019) · Early Intervention in Psychiatry · doi:10.1111/eip.12864 · Cited by 33 · see citing works
Internet health information education for older adults: A pilot study
Chang, S. J., Yang, E., Lee, K., & Ryu, H. (2020) · Geriatric Nursing · doi:10.1016/j.gerinurse.2020.10.002 · Cited by 32 · see citing works
Targeting Next Generations to Change the Common Practice of Underpowered Research
Crutzen, R., & Peters, G.-J. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01184 · Cited by 32 · see citing works
“…besides neglect to perform realistic power analyses [e.g., unanticipated difficulties with recruitment (Crutzen et al., 2014) and loss to followup (Crutzen et al., 2015), of which students should also be made aware], at the same time, psychological curricula promote continuous conducting of…”
Background
Manager-driven intervention for improved psychosocial safety climate and psychosocial work environment
Berglund, R. T., Kombeiz, O., & Dollard, M. F. (2024) · Safety Science · doi:10.1016/j.ssci.2024.106552 · Cited by 41 · see citing works
Increasing response rates to follow-up questionnaires in health intervention research: Randomized controlled trial of a gift card prize incentive
Morgan, A. J., Rapee, R. M., & Bayer, J. K. (2017) · Clinical Trials · doi:10.1177/1740774517703320 · Cited by 31 · see citing works
Effects of Mental Strength Training for Police Officers: a Three-Wave Quasi-experimental Study
van der Meulen, E., Bosmans, M. W. G., Lens, K. M. E., Lahlah, E., & van der Velden, P. G. (2017) · Journal of Police and Criminal Psychology · doi:10.1007/s11896-017-9247-8 · Cited by 30 · see citing works
“Higher attrition rates among experimental groups are not uncommon in health behavior change (HBC) trials (Crutzen et al. 2015).”
Background
Efficacy of a Transdiagnostic Self-Help Internet Intervention for Reducing Depression, Anxiety, and Suicidal Ideation in Adults: Randomized Controlled Trial
Batterham, P. J., Calear, A. L., Farrer, L. M., Gulliver, A., & Kurz, E. (2020) · Journal of Medical Internet Research · doi:10.2196/22698 · Cited by 25 · see citing works
“A previous review has also emphasized that attrition is typically higher for active interventions than control conditions because of factors such as higher expectations for change and greater cognitive demands [41].”
COPE for asthma: Outcomes of a cognitive behavioral intervention for children with asthma and anxiety.
McGovern, C. M., Arcoleo, K. J., & Melnyk, B. M. (2019) · School Psychology · doi:10.1037/spq0000310 · Cited by 25 · see citing works
Cost-effectiveness of a mindfulness-based mental health promotion program: economic evaluation of a nonrandomized controlled trial with propensity score matching
Müller, G., Pfinder, M., Schmahl, C. G., Bohus, M., & Lyssenko, L. (2019) · BMC Public Health · doi:10.1186/s12889-019-7585-4 · Cited by 25 · see citing works
Visceral Origin: An Underestimated Source of Neck Pain. A Systematic Scoping Review
Oliva‐Pascual‐Vaca, Á., González-González, C., Oliva-Pascual-Vaca, J., Piña-Pozo, F., Ferragut‐Garcías, A., Fernández‐Domínguez, J. C., & Heredia‐Rizo, A. M. (2019) · Diagnostics · doi:10.3390/diagnostics9040186 · Cited by 25 · see citing works
Working mechanisms of a web-based self-management intervention for cancer survivors: a randomised controlled trial
Willems, R. A., Lechner, L., Verboon, P., Mesters, I., Kanera, I. M., & Bolman, C. A. W. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1293054 · Cited by 23 · see citing works
Can interest and enjoyment help to increase use of Internet-delivered interventions?
Crutzen, R., Ruiter, R. A. C., & de Vries, N. K. (2014) · Psychology and Health · doi:10.1080/08870446.2014.921300 · Cited by 22 · see citing works
Life Balance – a mindfulness-based mental health promotion program: conceptualization, implementation, compliance and user satisfaction in a field setting
Lyssenko, L., Müller, G., Kleindienst, N., Schmahl, C. G., Berger, T., Eifert, G. H., Kölle, A., Nesch, S., Ommer-Hohl, J., Wenner, M., et al. (2015) · BMC Public Health · doi:10.1186/s12889-015-2100-z · Cited by 21 · see citing works
“interventions presents a mean attrition rate of 18 % in the intervention groups [61].”
Background
A person‐centred, theory‐based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study
Dimenäs, S. L., Jönsson, B., Andersson, J. S., Lundgren, J., Petzold, M., Abrahamsson, I., & Abrahamsson, K. H. (2022) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13601 · Cited by 19 · see citing works
“A systematic review (Crutzen et al., 2015) on differential attrition in health behaviour change trials indicated a slightly higher attrition in the test intervention groups in comparison with control, but found no relationship between attrition rate and potential moderators, for example, the amount…”
Background
Recruitment and adherence of randomized controlled trials for mild cognitive impairment: A systematic review and meta‐analysis
Xu, Z., Sun, W. J., Zhang, D., & Wong, S. Y. S. (2020) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5336 · Cited by 19 · see citing works
A Mixed-Method Assessment of a Pilot Peer Advocate Intervention for Rural Gender and Sexual Minorities
Willging, C. E., Harkness, A., Israel, T., Ley, D. J., Hokanson, P. S., DeMaria, C., Joplin, A., & Smiley, V. (2017) · Community Mental Health Journal · doi:10.1007/s10597-017-0168-x · Cited by 18 · see citing works
Adherence and barriers in e‐health self‐control training for enhancing childhood multidisciplinary obesity treatment
Naets, T., Vervoort, L., Tanghe, A., & Braet, C. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2405 · Cited by 18 · see citing works
Interactive group-based orientation sessions: A method to improve adherence and retention in pragmatic clinical trials
Mayhew, M., Leo, M. C., Vollmer, W. M., DeBar, L., & Kiernan, M. (2020) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2020.100527 · Cited by 16 · see citing works
Clinician Use of HIV-Related Infographics During Clinic Visits in the Dominican Republic is Associated with Lower Viral Load and Other Improvements in Health Outcomes
Stonbraker, S., Liu, J., Sanabria, G., George, M., Amesty, S. C., Alcántara, C., Abraído‐Lanza, A. F., Halpern, M., Rowell‐Cunsolo, T. L., Henry, S. B., et al. (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03331-8 · Cited by 15 · see citing works
Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program
Nieto, I., & Vázquez, C. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102459 · Cited by 14 · see citing works
Coach to cope: feasibility of a life coaching program for young adults with cystic fibrosis
Knudsen, K. B., Pressler, T., Mortensen, L. H., Jarden, M., Boisen, K. A., Skov, M., Quittner, A. L., & Katzenstein, T. L. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s141267 · Cited by 15 · see citing works
“Attrition rates as high as 18%–26% are not unusual in studies of counseling interventions.(34,35) Dropout rates in previous studies have been associated with symptoms of depression, e-therapy (mental health services over the Internet), outpatient settings, and interventions that include a large number of sessions.”
Accuracy and precision of fixed and random effects in meta‐analyses of randomized control trials for continuous outcomes
Gnambs, T., & Schroeders, U. (2023) · Research Synthesis Methods · doi:10.1002/jrsm.1673 · Cited by 13 · see citing works
“61,63 Importantly, attrition is primarily a concern if it introduces bias because the likelihood of non-participation is associated with pre-and posttest scores.”
Background
Systematic review and meta analysis of differential attrition between active and control arms in randomized controlled trials of lifestyle interventions in chronic disease
Bevens, W., Shoushtari, A. N., Jelı́nek, P., Jelinek, G., & Weiland, T. J. (2021) · BMC Medical Research Methodology · doi:10.1186/s12874-021-01313-x · Cited by 13 · see citing works
“They found slightly higher attrition in the intervention arm, however concluded that the differences were likely the result of sampling error [8].”
Background
The Effectiveness of Internet-Based Cognitive Behavioral Therapy for the Treatment of Depression in a Large Real-World Primary Care Practice: A Randomized Trial
Stuart, R., Fischer, H. J., Leitzke, A., Becker, D., Saheba, N., & Coleman, K. J. (2022) · The Permanente Journal · doi:10.7812/tpp/21.183 · Cited by 13 · see citing works
Peer-mentor support for older vulnerable myocardial infarction patients referred to cardiac rehabilitation: single-arm feasibility study
Pedersen, M. K., Bennich, B. B., Boateng, T., Beck, A. M., Sibilitz, K. L., Andersen, I., & Overgaard, D. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01141-w · Cited by 13 · see citing works
“from a meta-analysis of attrition rates [16].”
Feasibility and Pilot Studies
Powell, L. H., Kaufmann, P. G., & Freedland, K. E. (2021) · Springer eBooks · doi:10.1007/978-3-030-39330-4_7 · Cited by 12 · see citing works
Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
Rowland, S. A., Ramos, A. K., Trinidad, N., Quintero, S. A., Johnson-Beller, R., Struwe, L. A., & Pozehl, B. (2022) · JMIR Formative Research · doi:10.2196/40379 · Cited by 12 · see citing works
“While the COVID-19 pandemic likely contributed to the high attrition rate at 24 weeks (n=38, 54%), the attrition rate at 12 weeks (n=19, 28%) was higher than the average rate of 18% observed in health behavior trials [30] but less than the 40% observed in app-based interventions targeting chronic disease management [3…”
Result
Effects of Heating Therapy on Pain, Anxiety, Physiologic Measures, and Satisfaction in Patients Undergoing Cystoscopy
Kwon, O. S., Kwon, B., Kim, J., & Kim, B.-H. (2022) · Asian Nursing Research · doi:10.1016/j.anr.2022.02.002 · Cited by 12 · see citing works
The marketing plan and outcome indicators for recruiting and retaining parents in the HomeStyles randomized controlled trial
Byrd‐Bredbenner, C., Delaney, C., Martin‐Biggers, J. T., Koenings, M., & Quick, V. (2017) · Trials · doi:10.1186/s13063-017-2262-3 · Cited by 12 · see citing works
Computer-delivered intervention for individuals with obesity and elevated anxiety sensitivity: feasibility, acceptability, and initial test
Kauffman, B. Y., Gallagher, M. W., Viana, A. G., Schmidt, N. B., & Zvolensky, M. J. (2022) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.2018487 · Cited by 11 · see citing works
“These rates compare to studies that have suggested 18% of attrition is to be expected for health behavior trials in the active condition and 17% in control conditions (Crutzen et al., 2015).”
BackgroundResult
A Simulation Study of Threats to Validity in Quasi-Experimental Designs: Interrelationship between Design, Measurement, and Analysis
Tello, F. P. H., Moscoso, S. C., Sanduvete‐Chaves, S., & Pérez-Gil, J. A. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00897 · Cited by 11 · see citing works
“In this regard, Crutzen et al. (2015) used meta-analysis in order to study the relationship between differential attrition and several moderator variables; nevertheless, they could not study the relationship between the differential attrition and the effect size owing to technical problems.”
Method
Measuring the Impact of MyLupusGuide in Canada: Results of a Randomized Controlled Study
Fortin, P. R., Neville, C., Julien, A., Rahme, E., Haroun, V. A., Nimigon‐Young, J., Morrison, A., Eng, D., PESCHKEN, C. A., Vinet, É., et al. (2022) · Arthritis Care & Research · doi:10.1002/acr.24871 · Cited by 11 · see citing works
“grams have been found in other studies (37,38).”
Result
Mitigating Gambling-Related Harms in Children and Young People: A Scoping Review of Interventions
Davis, C., Davidson, K., Arden-Close, E. J., Bolat, E., & Panourgia, C. (2025) · Journal of Gambling Studies · doi:10.1007/s10899-025-10387-x · Cited by 14 · see citing works
Dropout rate in randomised controlled trials of balance and gait rehabilitation in multiple sclerosis: is it expected to be different for virtual reality-based interventions? A systematic review with meta-analysis and meta-regression
Casuso-Holgado, M. J., García‐Muñoz, C., Martín‐Valero, R., Lucena-Antón, D., Moral-Muñoz, J. A., & Cortés-Vega, M.-D. (2022) · Virtual Reality · doi:10.1007/s10055-022-00733-4 · Cited by 10 · see citing works
“Furthermore, this could influence the differential dropout rate, which is how the degree of dropout differs between the intervention and comparator conditions after randomisation (Crutzen et al. 2015).”
Background
Virtual Behavioral Intervention to Promote Healthy Lifestyle Behaviors: A Feasibility RCT during COVID-19 Pandemic
Alothman, S., Alshehri, M. M., Al-Masud, A. A., Aljubairi, M. S., Alrashed, I., Shaphe, M. A., & Alghannam, A. F. (2022) · Healthcare · doi:10.3390/healthcare11010091 · Cited by 10 · see citing works
“In addition, a meta-analysis study showed a slight increase in the attrition rate of health behavior change trials compared to control groups, which might have been because of the demands to change behaviors and blindness problems [45].”
Background
Can Brief Email Guidance Enhance the Effects of an Internet Intervention for People with Problematic Alcohol Use? A Randomized Controlled Trial
Sundström, C., Schell, C., Wardell, J. D., Godinho, A., & Cunningham, J. A. (2020) · Substance Use & Misuse · doi:10.1080/10826084.2020.1788087 · Cited by 10 · see citing works
“Although attrition was high in the trial, it did not differ between the two groups, which under the circumstances can be seen as a strength, since differential attrition is considered a major threat to internal validity (Crutzen et al., 2015).”
How Education and Metacognitive Training May Ameliorate Religious Prejudices: A Randomized Controlled Trial
Moritz, S., Ahmed, K., Krott, N., Ohls, I., & Reininger, K. (2020) · International Journal for the Psychology of Religion · doi:10.1080/10508619.2020.1815994 · Cited by 10 · see citing works
“Better adherence in the intervention conditions (here: metacognitive conditions) is an unusual finding and speaks for the feasibility of the approach (Crutzen et al., 2015).”
Background
Missing, Presumed different: Quantifying the risk of Attrition Bias in Education Evaluations
Weidmann, B., & Miratrix, L. W. (2021) · Journal of the Royal Statistical Society Series A (Statistics in Society) · doi:10.1111/rssa.12677 · Cited by 10 · see citing works
“%) and is only marginally higher than samples of RCTs in public health interventions (Crutzen et al., 2015, n = 60 studies, median attrition = 14%), and economics (Hirshleifer et al., 2019, n = 90 studies, mean attrition = 15%).”
Background
Evaluation of the effectiveness of a 7-week minimal guided and unguided cognitive behavioral therapy-based stress-management APP for students
Weiss, E. M., Harder, M., Staggl, S., Holzner, B., Dresen, V., & Canazei, M. (2025) · BMC Public Health · doi:10.1186/s12889-025-23399-4 · Cited by 9 · see citing works
Adolescents' self‐reported experiences following a person‐centred, theory‐based educational intervention versus conventional education for improved oral hygiene: Analysis of secondary outcomes of a randomized field study
Dimenäs, S. L., Andersson, J. S., Jönsson, B., Lundgren, J., Petzold, M., Östberg, A., & Abrahamsson, K. H. (2023) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13883 · Cited by 9 · see citing works
Personalized feedback intervention for individuals with low distress tolerance who smoke cigarettes: A randomized controlled trial of a digital intervention
Redmond, B. Y., Salwa, A., Bricker, J. B., Buckner, J. D., Garey, L., & Zvolensky, M. J. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.209163 · Cited by 8 · see citing works
PRIORITY Trial: Results from a feasibility randomised controlled trial of a psychoeducational intervention for parents to prevent disordered eating in children and young people with type 1 diabetes
Jones, C. J., Read, R. K., O’Donnell, N., Wakelin, K., John, M., Skene, S. S., Stewart, R., Hale, L. S., Cooke, D. D., Kanumakala, S., et al. (2023) · Diabetic Medicine · doi:10.1111/dme.15263 · Cited by 8 · see citing works
Differential attrition and engagement in randomized controlled trials of occupational mental health interventions in person and online: A systematic review and meta-analysis
de Miquel, C., Haro, J. M., Feltz-Cornelis, C. M. V. D., Ortiz-Tallo, A., Chen, T., Sinokki, M., Naumanen, P., Olaya, B., & Lima, R. A. (2024) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.4173 · Cited by 8 · see citing works
“These results line up with previous meta-analysis on differential attrition in behavioral and clinical interventions (18, 19).”
Influential
Why and how we should care about the General Data Protection RegulationPreprint
Crutzen, R., Peters, G.-J., & Mondschein, C. F. (2018) · doi:10.31234/osf.io/5gybt · Cited by 8 · see citing works
Attrition and discontinuation in amyotrophic lateral sclerosis clinical trials: a meta-analysis
van Eijk, R. P. A., van Loon, F. T., van Unnik, J. W. J., Weemering, D. N., Seitidis, G., Mavridis, D., van den Berg, L. H., & Nikolakopoulos, S. (2024) · Journal of Neurology · doi:10.1007/s00415-024-12813-3 · Cited by 7 · see citing works
“Studies with no discontinuations in either the intervention or the placebo arm were handled by adding 0.50 to each cell in the 2 by 2 table [4, 5].”
Influential
Interventions to promote home radon testing: A randomized clinical trial of a smartphone app vs. printed brochures
Kim, S., Chiu, T. H., Klug, M. G., Schmitz, D. F., & Schwartz, G. G. (2022) · Cancer Medicine · doi:10.1002/cam4.4988 · Cited by 7 · see citing works
Comparing Communication Methods to Increase Radon Knowledge and Home Testing: A Randomized Controlled Trial in a High-Radon City
Kim, S. G., Scheffer-Wentz, H., Klug, M. G., & Schwartz, G. G. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20095634 · Cited by 7 · see citing works
A feasibility randomised controlled trial of a Fibromyalgia Self-management Programme for adults in a community setting with a nested qualitative study (FALCON)
Pearson, J., Coggins, J., Derham, S., Russell, J., Walsh, N. E., Lenguerrand, E., Palmer, S., & Cramp, F. L. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05529-w · Cited by 7 · see citing works
“A systematic literature review and meta-analysis showed there was, on average, slightly higher attrition in intervention arms of health behaviour change trials [62].”
Background
Effect of Eyeglasses on Student Academic Performance: What Matters? Evidence from a Randomized Controlled Trial in China
Du, K., Wang, H., Ma, Y., Guan, H., & Rozelle, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710923 · Cited by 7 · see citing works
“The attrition rate of our study was low, according to relevant RCT literature [23].”
Background
Twelve Month Efficacy of Computer-Tailored Communication in Boosting Fruit and Vegetable Consumption Among Adults Aged Forty and over: A Three-Level Meta-Analysis and Systematic Review of Randomized Controlled Trials
Misir, A., Viechtbauer, W., de Vries, H., & Mesters, I. (2023) · Advances in Nutrition · doi:10.1016/j.advnut.2023.100150 · Cited by 6 · see citing works
“In addition, Crutzen et al. (2013) [80] claim that there is an indication that slightly higher attrition rates are often seen in intervention groups compared with control, which attenuates the observed effect.”
Result
The Self-as-Doer Identity and Physical Activity: The Mediating Effect of Self-Efficacy for Managing Physical Activity Barriers
Brouwer, A. M. (2019) · Identity · doi:10.1080/15283488.2019.1697272 · Cited by 6 · see citing works
Participant and trial characteristics reported in predictive analyses of trial attrition: an umbrella review of systematic reviews of randomised controlled trials across multiple conditions
McChrystal, R., Lees, J. S., Gillies, K., McAllister, D., & Hanlon, P. (2025) · Trials · doi:10.1186/s13063-025-08794-x · Cited by 5 · see citing works
Impact of trial attrition rates on treatment effect estimates in chronic inflammatory diseases: A meta‐epidemiological study
Overgaard, S. H., Moos, C. M., Ioannidis, J. P. A., Luta, G., Berg, J., Nielsen, S. M., Andersen, V. C., & Christensen, R. (2024) · Research Synthesis Methods · doi:10.1002/jrsm.1708 · Cited by 5 · see citing works
“For example, studies with anti-depressant drug interventions 17 or health behaviour change interventions 18 observed more attrition in the experimental intervention groups than in the con-trol comparator groups.”
Effectiveness of an LGBTQ+ E-Learning Module for Social Workers: A Randomized Controlled Trial
Schaub, J., Keemink, J. R., Stander, W. J., & Montgomery, P. (2023) · Research on Social Work Practice · doi:10.1177/10497315231208199 · Cited by 4 · see citing works
“%) as is typical in trials such as this one (Crutzen et al., 2015).”
Development and assessment of a self-management intervention for urinary incontinence among patients with prostate cancer: protocol for a randomized feasibility study
Chien, C., Liu, K., Wu, C., Chuang, C., Yu, K., Lin, P., Huang, X., & Pang, S. (2023) · BMC Urology · doi:10.1186/s12894-023-01367-7 · Cited by 4 · see citing works
“Based on this information and considering a study discontinuation rate of 17–18% [67], we plan to include a total of 86 patients (43 per group) in this study.”
Method
Family structure and delinquency: Antisocial cognition as a mediating mechanism
Walters, G. D., Runell, L., & Kremser, J. (2022) · Journal of Adolescence · doi:10.1002/jad.12063 · Cited by 4 · see citing works
‘Relearning how to think’: A brief online intervention to modify biased interpretations in emotional disorders—study protocol for a randomised controlled trial
Nieto, I., & Vázquez, C. (2021) · Trials · doi:10.1186/s13063-021-05459-3 · Cited by 4 · see citing works
Adherence to Behavioral Weight Management: A Scoping Review of Definitions, Measurement, and Components
Wang, D., Rojo‐Tirado, M. Á., Benito, P. J., Rubio‐Arias, J. Á., Ramos‐Campo, D. J., & Marques, M. M. (2025) · Obesity Reviews · doi:10.1111/obr.70066 · Cited by 3 · see citing works
Randomized Trial of Self-Guided, Internet-Based, Cognitive Behavior Therapies for Migraine
Huguet, A., Rozario, S., Chaplin, W., McDonald, M., Wozney, L., Lagman‐Bartolome, A. M., Kronish, I. M., Purdy, A., Stinson, J., & McGrath, P. J. (2024) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2024.287 · Cited by 3 · see citing works
“44 Differential attrition could be because of the greater effort required to participate in the treatment arms.”
Feasibility, acceptability and preliminary effectiveness of a manualized lay-led food literacy intervention for women in a community setting
Greenberg, K. L., Bar‐Zeev, Y., Donchin, M., Karjawally, M., Sneineh, S. A., Husseini, M. N., & Zwas, D. R. (2025) · Appetite · doi:10.1016/j.appet.2025.107885 · Cited by 3 · see citing works
Efficacy of Occupation-Based Intervention in Promoting Well-Being Among Occupational Therapy Graduate Students
Espiritu, E., Chang, P.-F., Evetts, C., & Adams, J. (2024) · OTJR: Occupation, Participation and Health · doi:10.1177/15394492241287712 · Cited by 4 · see citing works
Submitting the original participant information letter as supplementary material of a trial report is useful and can be easily implemented
Kotz, D., Viechtbauer, W., Spigt, M., & Crutzen, R. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.09.013 · Cited by 3 · see citing works
“This differential attrition is a common problem in, for example, health behavior change trials [4].”
Background
Palliative Care Interventions Among Adolescents and Young Adults With Serious Illness: A Scoping Review
Newman, A. R., Kenney, A. E., Witkowski, E., Karst, J. S., Lerret, S. M., Davies, W. H., & Rothschild, C. B. (2023) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000486 · Cited by 3 · see citing works
“Attrition from behavioral health interventions is common (Crutzen et al., 2015).”
Revitalizing wellbeing: App design for stress reduction through artificial intelligence and persuasive technology
Orji, J., Chan, G., & Orji, R. (2025) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2025.103600 · Cited by 2 · see citing works
Dietary E‐Health Interventions for Adults With Severe Mental Illness: A Systematic Review
Holmes, K., Heaney, S. E., Smith, A., Skinner, J. A., & Burrows, T. L. (2025) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.70112 · Cited by 2 · see citing works
The great live and move challenge and the promotion of physical activity in children: results from a two-school-year cluster-randomized trial
Gourlan, M., Lambert, C., Fregeac, B., Mora, L., Jeanleboeuf, F., Minotte, A., Coste, O., Pereira, B., & Cousson‐Gélie, F. (2025) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-025-01849-x · Cited by 2 · see citing works
“…had a significantly higher attrition rate than the control group, and attrition was associated with older age, which, while common in health trials [100, 101], may have reduced the representativeness of the retained sample and thereby threatened the study’s internal validity [102] and limited the…”
Study Design Complexity and Participant Completion in Dietary Trials for Inflammatory Bowel Disease: A Systematic Review and Metaresearch Study
Gregersen, L., Moos, C. M., Hikmat, Z., Rasmussen, N. F., Petersen, S. R., Heitmann, B. L., Halldorsson, T. I., Andersen, V. C., & Christensen, R. (2026) · Advances in Nutrition · doi:10.1016/j.advnut.2026.100614 · Cited by 2 · see citing works
“…collect information on the number of outcomes reported by the trials, the intensity of intervention delivery, the motivation incentives, or the degree of control over energy intake, which could have provided more nuanced perspectives on trial completion as also indicated by previous reviews [1,96].”
Influential
Recruitment and Retention of Social Workers as Research Participants: Lessons from a Randomized Controlled Trial
Keemink, J. R., Stander, W. J., Montgomery, P., & Schaub, J. (2025) · Social Work Research · doi:10.1093/swr/svaf002 · Cited by 2 · see citing works
From Trials to Practice: Implementing a Clinical Intervention in Community Settings
Vaughan, E. M., Yu, X., Cardenas, V. J., Johnston, C. A., Virani, S. S., Balasubramanyam, A., Ballantyne, C. M., & Naik, A. D. (2025) · Journal of Primary Care & Community Health · doi:10.1177/21501319251339190 · Cited by 2 · see citing works
Combination Therapy of Resilience Intervention with Biologics in Crohn's Disease (CATHARSIS): Study protocol for a randomized controlled trial
Keefer, L., Ungaro, R. C., Lewis, A. E., Lee, J., de Amorrortu, C., Lores, T. J., Siganporia, T., Mehandru, S., Petralia, F., & Colombel, J. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.108151 · Cited by 2 · see citing works
5-Year Follow-Up of a Telephone Intervention to Increase Fruit and Vegetable Consumption in Preschoolers: The ‘Healthy Habits’ Cluster Randomised Trial
Wyse, R., Stacey, F. G., Campbell, L., Yoong, S. L., Lecathelinais, C., Wiggers, J. H., Campbell, K. J., & Wolfenden, L. (2020) · Nutrients · doi:10.3390/nu12123702 · Cited by 2 · see citing works
“effectiveness, and if their expectations are not met they drop out of follow-up [44].”
BackgroundResult
Development of a Mobile App to Monitor the Effectiveness of a Hydrolyzed Cartilage Matrix Supplement on Joint Discomfort: Real-World Study
Newman, C., Adriaens, E., Virgilio, N., Vleminckx, S., Pelsmaeker, S. D., Prawitt, J., & Silva, C. I. F. (2023) · JMIR Formative Research · doi:10.2196/42967 · Cited by 2 · see citing works
“Although dropouts are a common issue in controlled trials [42-44], the dropout rates in this study were relatively low (3% for the HCM group, 19% for the placebo group), especially given the fact that this study was run at distance.”
Result

No differential attrition was found in randomized controlled trials published in general medical journals: a meta-analysis
Crutzen, R., Viechtbauer, W., Kotz, D., & Spigt, M. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.03.019 · Cited by 32 · see citing works
Role and methods of the clinical centers
Berge, K. G., Laubach, C. A., & Hutchinson, R. G. (1983) · Controlled Clinical Trials · doi:10.1016/0197-2456(83)90026-0 · Cited by 1 · see citing works
Risk of Bias in Health Behaviour Change Trials: Evidence, Practices and Challenges
Johnston, M., & de Bruin, M. (2014) · European Health Psychologist
Systematic review and meta analysis of differential attrition between active and control arms in randomized controlled trials of lifestyle interventions in chronic disease
Bevens, W., Shoushtari, A. N., Jelı́nek, P., Jelinek, G., & Weiland, T. J. (2021) · BMC Medical Research Methodology · doi:10.1186/s12874-021-01313-x · Cited by 13 · see citing works
Enrolment-latency in randomised behaviour change trials : IPD meta-analysis showed association with attrition but not effect-size
Kypri, K., Bowe, S. J., Karlsson, N. E., & McCambridge, J. (2020) · White Rose Research Online (University of Leeds, The University of Sheffield, University of York)

Authors: Crutzen, R., Viechtbauer, W., Spigt, M., & Kotz, D.
Affiliations: Maastricht University (NL)
Cancer Research UK (GB)
Corresponding author: Crutzen, Rik
ORCID: Crutzen, Rik
Viechtbauer, Wolfgang
Spigt, Mark
Kotz, Daniel
Venue: Psychology & Health
Publisher: Informa UK Limited
Published: 2014-12-09
Volume: 30
Issue: 1
Pages: 122-134
ISSN: 0887-0446 (ISSN-L)
1476-8321
DOI: 10.1080/08870446.2014.953526
OpenAlex: W2160645377
Cited by: 132
References: 41
Citations by year: 2026: 8 · 2025: 20 · 2024: 8 · 2023: 13 · 2022: 16 · 2021: 13 · 2020: 11 · 2019: 10 · 2018: 5 · 2017: 10 · 2016: 7 · 2015: 5 · 2014: 6
FWCI: 2.56
Type: journal article
Language: en
Open access: green
cris.maastrichtuniversity.nl
Licence: other-oa
Locations: Psychology and Health (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, other-oa)
Lirias (submittedVersion)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics: Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Keywords: differential attrition, health behavior change interventions, attrition rates, internal validity, control conditions, intervention intensity, follow-up intensity
MeSH terms: Humans, Patient Dropouts, Health Behavior, Bias, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Differential attrition in health behaviour change trials: a systematic review and meta-analysis

Abstract

Integrity signals

Claims the paper makes

Self-check

Cites

Cited by

Related

Record

About these checks