Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Biomedical Informatics, University of Cincinnati, Cincinnati, Ohio, USA.
Sleep Health. 2024 Jun;10(3):291-294. doi: 10.1016/j.sleh.2024.01.010. Epub 2024 Mar 27.
Attrition and nonadherence are common concerns that can distort findings in clinical trials. This study examines the potential for systematic attrition in the largest sample to date of adolescents undergoing sleep manipulation.
Using pooled data across two trials involving 242 adolescents, a cumulative logistic regression tested whether demographics and baseline sleep predicted study completion/adherence.
Race, a composite measure of socioeconomic status, and its elements (e.g., income, education) individually predicted completion/adherence. When entered concurrently into a multivariate predictive model, only socioeconomic status and study (trial A vs. B) were significant. Adolescents from households with higher socioeconomic status were more likely to complete or adhere to the protocol than those from households with lower socioeconomic status, p < .001.
Systematic attrition in sleep manipulation research could distort conclusions about under-resourced groups. Future sleep trials should intentionally measure systemic/structural factors and adopt strategies to recruit and retain participants from various backgrounds.
损耗和不依从是临床试验中常见的关注点，可能会扭曲研究结果。本研究考察了迄今为止对接受睡眠干预的最大青少年样本中是否存在系统性损耗的可能性。
使用涉及 242 名青少年的两项试验的汇总数据，累积逻辑回归检验了人口统计学和基线睡眠是否预测研究完成/依从。
种族、社会经济地位的综合衡量指标及其元素（如收入、教育）个体预测完成/依从。当同时输入到多变量预测模型中时，只有社会经济地位和研究（试验 A 与 B）是显著的。来自社会经济地位较高家庭的青少年比来自社会经济地位较低家庭的青少年更有可能完成或遵守方案，p<0.001。
睡眠干预研究中的系统性损耗可能会扭曲对资源不足群体的结论。未来的睡眠试验应有意测量系统性/结构性因素，并采取策略招募和保留来自不同背景的参与者。
