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...
| Publicado en: | Global Health Action Vol. 18; no. 1; pp. 1 - 12 |
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| Autores principales: | , , |
| Formato: | algorithm statistics tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190437302&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190437302 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16549716 829W jtl: Global Health Action issn: 16549716 maglogo: N pubinfo: dt: Dec2025 vid: 18 iid: 1 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 190437302 190437302 190437302 10.1080/16549716.2025.2569207 190437302 ppf: 1 ppct: 11 formats: tig: 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 refInfo: holdings: @attributes: islocal: N |
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