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Differential attrition in health behaviour change trials: A systematic review and meta-analysis
Open accessAbstract
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.
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Metadata
- Authors
- Crutzen, R., Viechtbauer, W., Spigt, M., & Kotz, D.
- Affiliations
- Maastricht University (NL)
- Cancer Research UK (GB)
- Corresponding author
- Crutzen, Rik
- 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
- 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
- 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
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