Sample selection and reasons for non-participation in the PRedictors and Outcomes of incident FRACtures (PROFRAC) study

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  • Amanda L. Stuart
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Australia.
  • Julie A. Pasco
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University; Department of Medicine – Western Health, University of Melbourne; Department of Epidemiology and Preventive Medicine, Monash University, Australia.
  • Sharon L. Brennan-Olsen
    Department of Medicine – Western Health, University of Melbourne; Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia.
  • Michael Berk
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University; Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, University of Melbourne; Orygen the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.
  • Amelia G. Betson
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Australia.
  • Katherine E. Bennett
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Australia.
  • Elizabeth N. Timney
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Australia.
  • Lana J. Williams
    IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Australia.

ABSTRACT

Background. Fragility fractures, associated with osteoporosis, are an escalating public health problem. We aim to describe sample selection, recruitment methods and reasons for non-participation in The PRedictors and Outcomes of incident FRACtures (PROFRAC) study.

Design and Methods.
 Barwon Statistical Division residents aged 20+ years, with a radiologically-confirmed fracture between June 1st 2012 and May 31st 2013, were eligible. Individuals identified as fracture cases were invited by mail to complete a questionnaire. Reasons for non-participation were documented. Logistic regression techniques were used to determine odds ratios for participation and non-participation reasons.

Results.
 A total of 1,458 of 2,155 (67.7%) adults with fracture (48.7% men) participated. Individuals were excluded due to inability to give informed consent, death, no knowledge of fracture, or inability to be contacted. The odds of participation decreased with age (OR 0.99, 95%CI 0.99-0.99, P=0.011) and increased among specific fracture groups [clavicle/scapula (OR 2.50, 1.30-4.68, P=0.006), forearm/humerus (OR 2.00, 1.22-3.27, P=0.006), wrist (OR 2.08, 1.31-0.32, P=0.002), hip (OR 2.12, 1.20-3.75, P=0.009), ankle (OR 1.85, 1.20-2.87, P=0.001), compared to face/skull fractures]. The odds of reporting disinterest, time constraints or personal reasons as the reason for non-participation decreased with age, whereas the odds of reporting frailty, language-related issues or illness as the reason for non-participation increased with of age [disinterest (OR 0.98, 0.97-0.98, P<0.001), time constraints (OR 0.97, 0.96-0.98, P<0.001), personal reasons (OR 0.98, 0.97-0.99, P=0.007), frailty (OR 1.12, 1.09- 1.15, P<0.001), language-related issues (OR 1.02, 1.01-1.04, P<0.001), illness (OR 1.03, 1.02-1.05, P<0.001)].

Conclusions.
 Understanding drivers of research participation can inform study design to achieve optimal participation in health research.

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