Retention

Adolescent-focused research can suffer from a paradox of participation, as adolescents may be temperamental about their involvement in research, even if the potential benefits of research are personally high for them.

Adolescents may exhibit high interest at the outset of a research study, but may then let the research process drift by without actively committing or involving themselves, even if they have signed documents agreeing to do so. This may be due to any combination of factors, including misunderstanding the time commitments, not feeling capable of providing adequate data to researchers, not feeling comfortable in the research environment or not agreeing in the possible benefits of the research outcomes.

Researchers studying teenagers with chronic illnesses or other special healthcare needs may find their target audience even harder to reach, as these potential participants may reject participation if even the title of the study provides yet another reminder of how they are “different” from others around them

Careful attention is needed to present the study in ways that are acceptable to eligible adolescents.

• Financial incentives (if approved by the ethics committee)
• Recruit a friend
• Improve adherence by providing ongoing reminders to participants – phone call, SMS, WhatsApp – before and after visits.
• Visit homes if necessary to encourage retention.
• Milestone certificates.
• Study specific interventions – to improve the experience.
• Where relevant, strategies to put adolescents at ease during pelvic examinations

Visual approaches to explaining procedures or the research study 

• Schedule visits to accommodate the adolescent schedule.
• Peer support – can assist with navigation through study clinic visits; explanations of the study; encouraging retention