Predictors of participation and attrition in a health promotion study involving psychiatric outpatients.

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Abstract
Participant selection biases can reduce the generalizability of research findings and lead to overestimates of intervention effectiveness. We examined factors associated with study participation and attrition among psychiatric outpatients recruited for the initial phase of a health promotion trial. Medical records were reviewed to obtain HIV risk and substance abuse data, as well as psychiatric and demographic characteristics of potential participants. Out of 895 eligible outpatients, 67% (n = 601) consented to participate, among whom 69% (n = 415) completed all baseline appointments. Compared to non-consenters, consenters were more likely to be at risk for drug problems, and to receive care from clinics serving more impaired patients. Study completion was associated with older age, a psychiatric diagnosis other than adjustment disorder, and a recent STD diagnosis. These findings suggest that patients who could most benefit from risk reduction interventions are more likely to participate.