Development of a structured tracking system to improve retention in a birth cohort in rural Ecuador.

Retention in birth cohort studies varies globally, with rates of over 80% in high-income countries and 30%–75% in low- and middle-income settings due to socioeconomic vulnerability, geographic dispersion, and infrastructural barriers. Despite the importance of participant retention, evidence on stru...

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Publicado en:Global Health Action Vol. 18; no. 1; pp. 1 - 12
Autores principales: Montenegro, Stephanie, Handal, Alexis J., Orozco, Fadya
Formato: algorithm statistics tables/charts Journal Article
Publicado: Taylor & Francis Ltd Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
      vid: 18
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/16549716.2025.2569207
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        atl: Development of a structured tracking system to improve retention in a birth cohort in rural Ecuador.
      aug:
        au:
          Montenegro, Stephanie
          Handal, Alexis J.
          Orozco, Fadya
        affil: Centro de Transferencias y Desarrollo de Tecnologías CTT-USFQ, Universidad San Francisco de Quito USFQ, Quito, Ecuador
      sug:
        subj:
          Systems Development
          Research Subject Retention Evaluation
          Prospective Studies
          Rural Areas Ecuador
          Expectant Mothers Psychosocial Factors
          Postnatal Period
          Research Subjects Psychosocial Factors
          Ecuador
          Employment
          Telephone
          Office Visits
          Home Visits
          Protocols
          COVID-19 Pandemic
          Work
          Workload
          Residential Mobility
          Agriculture
          Data Quality
          Communities
          Medically Underserved Area
          Research Subject Recruitment
          Childbearing Age
          Telecommunications
          Role
          Research Dropouts
          Special Populations
          Adaptation, Psychological
      ab: Retention in birth cohort studies varies globally, with rates of over 80% in high-income countries and 30%–75% in low- and middle-income settings due to socioeconomic vulnerability, geographic dispersion, and infrastructural barriers. Despite the importance of participant retention, evidence on structured tracking systems contextualized to these settings remains limited. This paper describes the design, adaptations, and outcomes of a participant tracking system developed for the Study of Environmental Exposure of Mothers and Infants Impacted by Large-Scale Agriculture, a community-based birth cohort that enrolled 409 pregnant participants in a floriculture-intensive rural area of Ecuador. In this setting, retention was challenged by informal employment, variable phone access, and high mobility. The tracking system was implemented from pregnancy through 18 months postpartum, including two final follow-up waves conducted at 12 and 18 months. It comprised a predefined follow-up schedule, a team with defined roles, a real-time digital planner for recording contact attempts, participation status, and activity completion, and a five-tier participation classification. Tracking was conducted through office visits, phone calls, and home visits. Flexible protocols and targeted outreach addressed pandemic-related disruptions and irregular work schedules. Overall retention was 77%, with 84% and 75% at 12 and 18 months, respectively. Partial refusals (27%) were primarily linked to mobility and work demands, while 94 participants fully discontinued. Home visits enabled completion for 154 participants, with an 88% success rate. This experience illustrates how context-adapted tracking systems can sustain high retention in rural settings, offering a scalable model to inform global health research in underserved populations. Paper Context: Main Findings: A context-adapted tracking system enabled high participant retention in a rural birth cohort, overcoming logistical, social, and contextual barriers in a low-resource setting. Added Knowledge: This study contributes new knowledge by documenting the design and field implementation of a context-adapted tracking system, offering an operational model beyond isolated retention strategies. Global health impact for policy and action: It supports global health efforts to strengthen long-term data quality through practical, scalable retention strategies in community-based research.
      pubtype: Academic Journal
      doctype:
        algorithm
        statistics
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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