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Spatial cluster analyses are commonly used in epidemiologic studies of case-control data to detect whether certain areas in a study region have an excess of disease risk. Case-control studies are susceptible to potential biases including selection bias, which can result from non-participation of eligible subjects in the study. However, there has been no systematic evaluation of the effects of non-participation on the findings of spatial cluster analyses. In this paper, we perform a simulation study assessing the effect of non-participation on spatial cluster analysis using the local spatial scan statistic under a variety of scenarios that vary the location and rates of study non-participation and the presence and intensity of a zone of elevated risk for disease for simulated case-control studies. We find that geographic areas of lower participation among controls than cases can greatly inflate false-positive rates for identification of artificial spatial clusters. Additionally, we find that even modest non-participation outside of a true zone of elevated risk can decrease spatial power to identify the true zone. We propose a spatial algorithm to correct for potentially spatially structured non-participation that compares the spatial distributions of the observed sample and underlying population. We demonstrate its ability to markedly decrease false positive rates in the absence of elevated risk and resist decreasing spatial sensitivity to detect true zones of elevated risk. We apply our method to a case-control study of non-Hodgkin lymphoma. Our findings suggest that greater attention should be paid to the potential effects of non-participation in spatial cluster studies. [ABSTRACT FROM AUTHOR]

This article uses the case New York City to examine why certain immigrant groups participated in the 2006 protest wave more than others and why the city mobilized less compared with other major immigrant metropolises. The findings indicate that certain immigrant groups participated more than others because of how the issue of “illegal immigration” was racialized and framed by the media, and because of the disproportionate impact the proposed legislation would have had on them. The data presented illustrate how the city’s heterogeneous population served to diminish its capacity to produce the magnitude of mobilization found in other large immigrant cities.

Sara Badre-Esfahani,1,2 Mette Bach Larsen,1 Lene Seibæk,2 Lone Kjeld Petersen,3 Jan Blaakær,3 Henrik Støvring,4 Berit Andersen1 1Department of Clinical Medicine, Aarhus University, Aarhus C DK-8000, Denmark; 2Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus N DK-8200, Denmark; 3Department of Gynaecology and Obstetrics, Odense University Hospital, Odense C DK-5000, Denmark; 4Department of Public Health, Aarhus University, Aarhus C DK-8000, DenmarkCorrespondence: Sara Badre-EsfahaniDepartment of Public Health Programmes, Randers Regional Hospital, Skovlyvej 15, Randers DK-8930, DenmarkTel +45 8 78 42 01 72Fax +45 8 78 42 43 45Email sarbad@rm.dkBackground: The combination of organized cervical cancer screening and childhood HPV vaccination programs has the potential to eliminate cervical cancer in the future. However, only women participating in both programs gain the full protection, and combined non-attenders remain at high risk of developing cervical cancer. Our aim was to analyze the association between non-adherence to HPV vaccination and non-participation in cervical cancer screening for the total population and stratified by native background and parental education.Participants: Women born in 1993 eligible for both childhood HPV vaccination and first cervical cancer screening.Analysis: Logistic regression models were used to estimate the odds ratio (OR) of non-participation in cervical cancer screening with 95% confidence intervals (CI). Stratified and adjusted logistic regression models were used along with the Wald test in order to test for interaction.Results: 24,828 women were included in the study. Among vaccinated women, 61.4% participated in cervical cancer screening; only 39.0% of unvaccinated women participated in cervical cancer screening. Unvaccinated and unscreened women were often non-native and had the lowest socio-economic status, whereas vaccinated and screened women were often native and had the highest socio-economic status. The adjusted OR for non-participation in cervical cancer screening was 2.07 [95% CI: 1.88–2.28] for unvaccinated compared to vaccinated women. After stratifying by country of origin, unvaccinated natives had the highest adjusted OR of not participating in cervical cancer screening compared to non-native women from both western and non-western countries (adjusted ORs of 2.2 [95% CI: 2.0–2.4], 1.3 [95% CI: 0.6–2.8], and 1.5 [95% CI: 1.1–2.0], respectively) (Wald test p=0.019).Conclusion: Among natives, non-adherence to HPV vaccination and non-participation in screening seem to be signs of generally poor health-preventive behavior, whereas among non-natives from non-western countries, non-attendance in HPV vaccination and cervical cancer screening seem to be influenced by unrelated factors. Therefore, a differentiated and culturally sensitive approach is needed to enhance overall cervical cancer preventive behavior across different nativities.Keywords: human papilloma virus, vaccination, screening, non-participation, socio-economic status, nationality

This work aims to propose reflections on the implications of habits related to technology, especially the use of cell phones, in Physical Education (PE) classes. The cell phone has become an "almost" indispensable tool in our lives. Depending on the device, it has modified the coexistence and interactions of people of all ages. As our methodological procedure, we developed a mainly qualitative bibliographic research, aiming at a discussion with empirical observations. We considered that the cell phone is an obstacle for PE classes, which are aimed at promoting a healthy lifestyle. This topic is a recent issue for Education and PE, and it is necessary to address behaviors related to the modern life that hinder the school environment. [ABSTRACT FROM AUTHOR]

This article reviews existing theory and research on political non‐participation. Spanning the electoral, civic and social movement spheres, it critically compares the different conceptual tools that have been employed to explain why individuals might not participate in politics. This includes the study of rational choice, political socialisation, social networks and political emotions. In doing, this article identifies opportunities for a more holistic approach to studying non‐participation across multiple fields and contexts in the social sciences. [ABSTRACT FROM AUTHOR]

Background: Despite the high participation rates in the Basque Country, colorectal cancer screening programme (Spain), there is still a part of the population that has never participated. Since it is essential to ensure equal access to health services, it is necessary to identify the determinants of health and socio-economic factors related to non-participation in the screening programme.Methods: Cross sectional descriptive study including all invited population in a complete round between 2015 and the first trimester of 2017. Health risk factors available in medical records and their control have been analyzed using univariate and multivariate analyses.Results: 515,388 people were invited at the programme with a 71.9% of fecal immunochemical test participation rate. Factors that increase the risk of non-participation are: being men (OR = 1.10, 95% CI 1.09–1.12); younger than 60 (OR = 1.18, 95% CI 1.17–1.20); smoker (OR = 1.20, 95% CI 1.18–1.22); hypertensive (OR = 1.14, 95% CI 1.12–1.15) and diabetic (OR = 1.40, 95% CI 1.36–1.43); having severe comorbidity (OR = 2.09, 95% CI 2.00–2.19) and very high deprivation (OR = 1.15, 95% CI 1.12–1.17), as well as making

Background: Cervical cancer is preventable through human papillomavirus vaccination and cervical cancer screening. However, possibly due to systemic, individual (e.g. low socio-economic staus) and socio-cultural barriers, it is likely that non-natives, especially non-westerns, are more prone to attend neither vaccination nor screening (combined non-attendance). This is disturbing as the non-native population in Denmark is predicted to rise to 21% by 2060. We aimed to investigate differences in combined non-attendance by nativity and region of origin, and to analyse the association between country of origin and combined non-attendance adjusted for socio-economic status. Setting: 1.6.2007–31.12.2016 Denmark. Methods: Logistic regression was performed to estimate crude and adjusted odds ratios with 95% confidence intervals for combined non-attendance. Results: 170,158 women were included. Overall combined non-attendance was 11.8% [11.7–12.0]; 10.0% [9.8–10.1] for native women and 27.1% [26.4–27.7] for non-native women, with highest degrees among Middle-Eastern and North-Africans (30.1% [29.2–30.9]). Even when adjusted for socio-economics, women from Middle-East and North-Africa had substantially higher odds of combined non-attendance than natives (adj. OR = 7.5 [6.3–8.9] for Somali women). Conclusion: Denmark has a relatively low degree of combined non-attendance. However, cervical cancer preventive programmes seem to be better tailored to the needs of native women and do not appear to cater sufficiently to the needs of the fast-growing non-native populations, particularly not to the needs of Middle-Eastern and North African women. In order to secure more just cervical cancer prevention, future studies are recommended to develop tailored intervention sensitive to the need of non-native women.

Abstract Background With declining rates of participation in epidemiological studies there is an important need to attempt to understand what factors might affect response. This study examines the pattern of response at different adult ages within a contemporary cross-sectional population-based cohort, the Cambridge Centre for Ageing and Neuroscience (Cam-CAN). Methods Using logistic regression, we investigated associations between age, gender and Townsend deprivation level for both participants and non-participants. Weighted estimates of the odds ratios with confidence intervals for each demographic characteristic were calculated. Reasons given for refusal were grouped into three broad categories: ‘active’, ‘passive’ and illness preventing interview. Results An association of age and participation was found, with individuals in middle age groups more likely to participate (age group 48–57 OR: 1.8, 95% CI: 1.5–2.2 and age group 58–67 OR: 2.1, 95% CI: 1.7–2.4). Overall, there was no difference in participation between men and women. An association with deprivation was found, with those living in the most deprived areas being the least willing to participate (fifth quintile OR: 0.6, 95% CI: 0.5–0.7). An interaction between age and gender was found whereby younger women and older men were more likely to agree to participate (p = 0.01). Conclusion Our findings highlight some of the factors affecting recruitment into epidemiological studies in the UK and suggest that targeted age-specific recruitment strategies might be needed to increase participation rates in future cohort investigations.

Abstract Background The aim of the study was to estimate the proportion of women giving birth in two hospitals in the Region of Southern Denmark who did not attend the malformation scan and to elucidate the reasons for not participating. Methods In this register-based descriptive study, we used patient administration systems to identify women who had given birth at two Danish hospitals between March 2013 and January 2015. We then linked this information with the hospital database for fetal medicine (Astraia) to identify women who did not attend the malformation scan at week 18–20. We reviewed the medical records of these women to validate the data and to identify the reason for non-participation. Results Of 7690 births, 153 (2%) women did not attend the malformation scan. The main reason for non-participation was a passive deselection (81%). Most of these women were not present in Denmark at the time of the malformation scan (61%) and few women declined (8%). Conclusions Less than 2% of a birth cohort in two major hospitals in Denmark did not attend the free offer of a malformation scan. Most of these women (81%) did not actively decide against the malformation scan. Very few (0.2%) declined the malformation scan. Non-attendance is not always due to an active decision made by the pregnant woman.

Abstract Background Research has shown that recruitment to trials is a process that stretches from identifying potentially eligible patients, through eligibility assessment, to obtaining informed consent. The length and complexity of this pathway means that many patients do not have the opportunity to consider participation. This article presents the development of a simple framework to document, understand and improve the process of trial recruitment. Methods Eight RCTs integrated a QuinteT Recruitment Intervention (QRI) into the main trial, feasibility or pilot study. Part of the QRI required mapping the patient recruitment pathway using trial-specific screening and recruitment logs. A content analysis compared the logs to identify aspects of the recruitment pathway and process that were useful in monitoring and improving recruitment. Findings were synthesised to develop an optimised simple framework that can be used in a wide range of RCTs. Results The eight trials recorded basic information about patients screened for trial participation and randomisation outcome. Three trials systematically recorded reasons why an individual was not enrolled in the trial, and further details why they were not eligible or approached, or declined randomisation. A framework to facilitate clearer recording of the recruitment process and reasons for non-participation was developed: SEAR – Screening, to identify potentially eligible trial participants; Eligibility, assessed against the trial protocol inclusion/exclusion criteria; Approach, the provision of oral and written information and invitation to participate in the trial, and Randomised or not, with the outcome of randomisation or treatment received. Conclusions The SEAR framework encourages the collection of information to identify recruitment obstacles and facilitate improvements to the recruitment process. SEAR can be adapted to monitor recruitment to most RCTs, but is likely to add most value in trials where recruitment problems are anticipated or evident. Further work to test it more widely is recommended.

Abstract Background Failure to include socio-economically deprived or ethnic minority groups in physical activity (PA) trials may limit representativeness and could lead to implementation of interventions that then increase health inequalities. Randomised intervention trials often have low recruitment rates and rarely assess recruitment bias. A previous trial by the same team using similar methods recruited 30% of the eligible population but was in an affluent setting with few non-white residents and was limited to those over 60 years of age. Methods PACE-UP is a large, effective, population-based walking trial in inactive 45-75 year-olds that recruited through seven London general practices. Anonymised practice demographic data were available for all those invited, enabling investigation of inequalities in trial recruitment. Non-participants were invited to complete a questionnaire. Results From 10,927 postal invitations, 1150 (10.5%) completed baseline assessment. Participation rate ratios (95% CI), adjusted for age and gender as appropriate, were lower in men 0.59 (0.52, 0.67) than women, in those under 55 compared with those ≥65, 0.60 (0.51, 0.71), in the most deprived quintile compared with the least deprived 0.52 (0.39, 0.70) and in Asian individuals compared with whites 0.62 (0.50, 0.76). Black individuals were equally likely to participate as white individuals. Participation was also associated with having a co-morbidity or some degree of health limitation. The most common reasons for non-participation were considering themselves as being too active or lack of time. Conclusions Conducting the trial in this diverse setting reduced overall response, with lower response in socio-economically deprived and Asian sub-groups. Trials with greater reach are likely to be more expensive in terms of recruitment and gains in generalizability need to be balanced with greater costs. Differential uptake of successful trial interventions may increase inequalities in PA levels and should be monitored. Trial registration ISRCTN.com ISRCTN98538934 . Registered 2nd March 2012.

We can observe a well-documented decline of trust levels in Western societies: from the reputation of political representatives as being 'not trustworthy' to the rise of anti-system-oriented populist parties. Yet the implications of different forms of distrust for a society and democratic institutions have been theorized in conflicting ways so far. In order to illuminate existing inconsistencies in social and democratic theory, this article addresses two research questions: What are the implications of different manifestations of distrust for the acceptance of democracy and democratic institutions? How do different forms of distrust affect the motivation to become engaged in democratic decision-making and in civil society institutions? Taking empirical evidence from 25 focus groups in Germany, our findings show that growing social divisions affect the role distrust plays for political interest representation of social groups and for the acceptance of liberal representative democracy. [ABSTRACT FROM AUTHOR]

Introduction and background: Cervical cancer is one of the leading responsible condition for causing high death rate among women after breast cancer. It is preventable and curable disorder, but the prevalence of cervical cancer remaining too high in India. Majority of women do not aware of cervical screening procedures. Maharashtra is standing in second position in possessing more number of cervical cancer cases. Methodology: A quasi-experimental pretest and post research design was used to execute the study. This study was conducted in selected hospitals of PCMC. The samples were the women age group between 30-60 years attending Gynec OPD. The systemic random sampling techniques was used to select the samples. Total sample size was 501. A self-administered tool was administered to find the reasons for participation and nonparticipation in cervical screening. Tool and content validity was done. The reliability of the tool was done r value is = 0.88. The study proposal has been approved by the Ethical Committee, MGM Institute of Health Sciences, Kamothe, Navi Mumbai. Permission has been taken from the concerned authority of the selected urban health care centers for data collection. The content was prepared on prevention and early detection of cervical screening in the form of video and modules in their regional languages. Results: Majority of participants among three experimental groups, about 38.32 % in verbal group, 41.91% in written group and 40.71 % in video group have responded that they could not take part in the cervical screening programme as they are very embarrassed with cervical screening procedure. While others had responded that, I am healthy I do not have to go for this test, some women said, I have only one sexual partner so I don't require this test. A few women have assumed that the test is very expensive, thinking that not required the Pap test as no symptoms of cancer observed and other have stated that don't know the frequency of test. Conclusion: A key strategy to improve the attendance of the women for cervical screening is to spread the awareness on prevention and early detection of cervical cancer by using various educational methods. [ABSTRACT FROM AUTHOR]

Background: Large-scale, centralized data repositories are playing a critical and unprecedented role in fostering innovative health research, leading to new opportunities as well as dilemmas for the medical sciences. Uncovering the reasons as to why citizens do or do not contribute to such repositories, for example, to population-based biobanks, is therefore crucial. We investigated and compared the views of existing participants and non-participants on contributing to large-scale, centralized health research data repositories with those of ex-participants regarding the decision to end their participation. This comparison could yield new insights into motives of participation and non-participation, in particular the behavioural change of withdrawal.Methods: We conducted 36 in-depth interviews with ex-participants, participants, and non-participants of a three-generation, population-based biobank in the Netherlands. The interviews focused on the respondents' decision-making processes relating to their participation in a large-scale, centralized repository for health research data.Results: The decision of participants and non-participants to contribute to the biobank was motivated by a desire to help others. Whereas participants perceived only benefits relating to their participation and were unconcerned about potential risks, non-participants and ex-participants raised concerns about the threat of large-scale, centralized public data repositories and public institutes, such as social exclusion or commercialization. Our analysis of ex-participants' perceptions suggests that intrapersonal characteristics, such as levels of trust in society, participation conceived as a social norm, and basic societal values account for differences between participants and non-participants.Conclusions: Our findings indicate the fluidity of motives centring on helping others in decisions to participate in large-scale, centralized health research data repositories. Efforts to improve participation should focus on enhancing the trustworthiness of such data repositories and developing layered strategies for communication with participants and with the public. Accordingly, personalized approaches for recruiting participants and transmitting information along with appropriate regulatory frameworks are required, which have important implications for current data management and informed consent procedures. [ABSTRACT FROM AUTHOR]

The idea that there might be democratic forms of non-participation has been largely overlooked in the theoretical and empirical literature on democracy. Non-participation has variously been seen as a threat to the proper functioning of democracy, as a rational choice, or (more rarely) as potentially beneficial at the systems level. We argue that there are forms of non-participation that may be justified on democratic grounds. Our main theoretical move is to distinguish between reflectivity (or thoughtfulness) and participation. We argue that the normative value of both participation and non-participation is conditioned by reflectivity, such that there may be democratically desirable forms of reflective non-participation. To support our claims, we provide examples of how non-participation can help support democratic goods—such as inclusion, influence, and legitimacy—that are normally associated only with democratic participation. [ABSTRACT FROM AUTHOR]

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Background: In the context of declining levels of participation, understanding differences between participants and non-participants in health surveys is increasingly important for reliable measurement of health-related behaviors and their social differentials. This study compared participants and non-participants of the Finnish Health 2000 survey, and participants and a representative sample of the target population, in terms of alcohol-related harms (hospitalizations and deaths) and all-cause mortality.Methods: We individually linked 6,127 survey participants and 1,040 non-participants, aged 30-79, and a register-based population sample (n = 496,079) to 12 years of subsequent administrative hospital discharge and mortality data. We estimated age-standardized rates and rate ratios for each outcome for non-participants and the population sample relative to participants with and without sampling weights by sex and educational attainment.Results: Harms and mortality were higher in non-participants, relative to participants for both men (rate ratios = 1.5 [95% confidence interval = 1.2, 1.9] for harms; 1.6 [1.3, 2.0] for mortality) and women (2.7 [1.6, 4.4] harms; 1.7 [1.4, 2.0] mortality). Non-participation bias in harms estimates in women increased with education and in all-cause mortality overall. Age-adjusted comparisons between the population sample and sampling weighted participants were inconclusive for differences by sex; however, there were some large differences by educational attainment level.Conclusions: Rates of harms and mortality in non-participants exceed those in participants. Weighted participants' rates reflected those in the population well by age and sex, but insufficiently by educational attainment. Despite relatively high participation levels (85%), social differentiating factors and levels of harm and mortality were underestimated in the participants. [ABSTRACT FROM AUTHOR]

Background: Screening programmes for cervical cancer, breast cancer and colorectal cancer have been implemented in many Western countries to reduce cancer incidence and mortality. Ethnic minority women are less likely to participate in cancer screening than the majority population. In worst case this can result in higher incidence rates, later diagnosis and treatment and ultimately inferior survival. In this paper we explored the perceptions about cancer and perceived barriers towards cancer screening participation among ethnic minority women in a deprived area in Denmark.Methods: Interview study with ethnic minority women in a deprived area in Denmark. The interviews were transcribed verbatim followed by an inductive content analysis.Results: Cancer was perceived as a deadly disease that could not be treated. Cancer screening was perceived as only relevant if the women had symptoms. Knowledge about cancer screening was fragmented, often due to inadequate Danish language skills and there was a general mistrust in the Danish healthcare system due to perceived low medical competences in Danish doctors. There was, however, a very positive and curious attitude regarding information about the Danish cancer screening programmes and a want for more information.Conclusion: Ethnic minority women did not have sufficient knowledge about cancer and the purpose of cancer screening. Perceptions about cancer screening were characterised by openness and the study showed positive and curious attitudes towards screening participation. The findings emphasise the importance of culturally adapted interventions for ethnic minority women in attempts to reduce inequality in screening participation. [ABSTRACT FROM AUTHOR]

We document that declining hours worked are the primary driver of widening inequality in the bottom half of the male labor earnings distribution in the United States over the past 52 years. This decline in hours is heavily concentrated in recessions: hours and earnings at the bottom fall sharply in recessions and do not fully recover in subsequent expansions. Motivated by this evidence, we build a structural model to explore the possibility that recessions cause persistent increases in inequality; that is, that the cycle drives the trend. The model features skill-biased technical change, which implies a trend decline in low-skill wages relative to the value of non-market activities. With this adverse trend in the background, recessions imply a potential double-whammy for low skilled men. This group is disproportionately likely to experience unemployment, which further reduces skills and potential earnings via a scarring effect. As unemployed low skilled men give up job search, recessions generate surges in non-participation. Because non-participation is highly persistent, earnings inequality remains elevated long after the recession ends. [ABSTRACT FROM AUTHOR]

Surveys are key means of obtaining policy-relevant information not available from routine sources. Bias arising from non-participation is typically handled by applying weights derived from limited socio-demographic characteristics. This approach neither captures nor adjusts for differences in health and related behaviours between participants and non-participants within categories. We addressed non-participation bias in alcohol consumption estimates using novel methodology applied to 2003 Scottish Health Survey responses record-linked to prospective administrative data. Differences were identified in socio-demographic characteristics, alcohol-related harm (hospitalisation or mortality) and all-cause mortality between survey participants and, from unlinked administrative sources, the contemporaneous general population of Scotland. These were used to infer the number of non-participants within each subgroup defined by socio-demographics and health outcomes. Synthetic observations for non-participants were then generated, missing only alcohol consumption. Weekly alcohol consumption values among synthetic non-participants were multiply imputed under missing at random and missing not at random assumptions. Relative to estimates adjusted using previously derived weights, the obtained mean weekly alcohol intake estimates were up to 59% higher among men and 16% higher among women, depending on the assumptions imposed. This work demonstrates the universal value of multiple imputation-based methodological advancement incorporating administrative health data over routine weighting procedures. [ABSTRACT FROM AUTHOR]

One of the greatest challenges facing international courts and tribunals today is a State's decision not to participate in a proceeding. Ever since China refused to take part in the South China Sea arbitration in 2013, there have been no fewer than nine additional inter-State cases of non-participation. The existing literature views this growing phenomenon as a problem. This article, however, takes the perspective of the non-participating State, and thus views non-participation as a strategy. After examining the law and practice of non-participation, the article discusses a series of strategic considerations that States should take into account when deciding whether to participate in a proceeding. In doing so, the article hopes not only to advise States considering non-participation, but also to help others understand the reasons behind a State's decision of non-participation. [ABSTRACT FROM AUTHOR]

Common typologies frame youth participation as something that exists at different hierarchical, or linear, levels or stages. In these models, non-participation is positioned as something negative or not addressed at all. Scholars have critiqued these typologies for ignoring contextual specificities and complexities, nuances, and power dynamics inherent in participatory processes. In this article, I draw from narratives of young people to productively theorize what non-participation might engender for thinking about and enacting participatory processes. In this study, I asked stakeholders at a youth-led HIV prevention and harm reduction peer-education program to take and discuss photographs that reflected their ideas about youth engagement. I provide a thematic analysis of how young people understood and navigated their participation in complex and self-determined ways. I put their narratives in dialogue with critical scholars' writing on settler-colonialism, neoliberalism, and willfulness to tease apart why and how young people's comments on non-participation offer a sophisticated counter-hegemonic understanding of the "call to participation" and its discursive and material effects. Last, drawing on the work of Indigenous theorists who advocate for a politics of refusal, I argue that young people's refusal to participate (or to participate on their own terms) may be an act of resistance – especially for young people whose bodies are regulated on a daily basis. I conclude by making a case for non-participation as a conceptual tool to disrupt and refuse hegemonic, linear theories of change and invite practitioners working with young people to do the same. [ABSTRACT FROM AUTHOR]

Background: Understanding women's life conditions regarding their non-participation in different health-promoting and disease-preventing activities is important as it may draw attention to potential areas for improvement in the healthcare sector. Mammographic screening, a disease-preventing service, facilitates early detection of any potential malignancies and consequently prompts initiation of treatment. The reasons for non-participation in mammographic screening can be understood from different perspectives, such as socioeconomic and lifestyle-related determinants of health. This study aims to gain a deeper understanding of women's experiences and perceptions about non-participation in mammographic screening in a Swedish region with a single mammographic facility.Methods: Data from individual semi-structured interviews, conducted in 2018 with eleven women between the ages of 48 and 73, were analysed by a qualitative content analysis.Results: The findings reveal three main categories: 1) doubts regarding mammographic screening and its organisation, 2) sense and sensibility in the decision to refrain from mammographic screening, and 3) dependency and options. These three categories indicate aspects, such as the individual's life situation, accessibility to the offered service, and the flexibility of the healthcare system, that need to be considered to improve the organisation of mammographic screening.Conclusion: Listening to the women's voices regarding their experiences and perceptions about mammographic screening is important as individual characteristics and social circumstances interact with healthcare and affect the degree of participation. [ABSTRACT FROM AUTHOR]

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

Background: Non-participation in mental health studies is an under-explored but very important topic. Investigating reasons for non-participation holds promise for the planning of future study designs and recruitment strategies. This study aimed at investigating reasons for children and adolescents (C&A) not participating in a school-based mental health research project., Methods: Data collection took place within the school-based recruitment of a large-scale multi-site project ("ProHEAD-Promoting Help-seeking using E-technology for Adolescents") in Germany. Participants were N = 534 C&A aged ≥ 12 years attending secondary schools. The present cross-sectional study analyzed anonymous survey data of C&A who themselves or whose parents, respectively, did not provide written consent to participate in the mental health research project. The questionnaire consisted of 14 items covering potential reasons for non-participation, and four free text fields. Besides descriptive statistics, free text field answers were analyzed using qualitative content analysis., Results: Students indicated an average of M = 2.94 ( SD = 1.75) reasons for their non-participation in the project. In the descriptive analysis of indicated items, the three most frequently reported reasons for non-participation included students reporting to not be concerned by the topic "mental health" ( n = 290, 54.3%), not having returned the consent form to the teacher ( n = 175, 32.8%), and not having time for participation ( n = 149, 27.9%). In the qualitative content analysis, the most frequently assigned categories were organizational reasons ( n = 216, 57.1%), general disinterest in study participation ( n = 139, 36.8%), and personal attitudes toward the topic "mental health" ( n = 84, 22.2%), such as not being concerned with the topic "mental health" ( n = 23, 6.1%) or being too concerned with the topic "mental health" ( n = 16, 4.2%)., Conclusion: The study provides unique insights into reasons for C&A and their caregivers not participating in a large federally funded mental health research project. The results suggest that in order to increase participation rates, stigma should be reduced, parents as well as teachers should be involved where possible, and the use of incentives might be helpful. The study highlights the importance of assessing reasons for non-participation, especially in online intervention studies on mental health., Competing Interests: KB has received honorary from Georg Thieme Publisher during the last 5 years outside and independent of the submitted work. CR-K received lecture honoraria from Recordati and Servier outside and independent of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Baldofski, Klemm, Kohls, Mueller, Bauer, Becker, Diestelkamp, Eschenbeck, Hiery, Kaess, Koenig, Lehner, Moessner, Thomasius and Rummel-Kluge.)

This study examined factors influencing rural caregivers' decision to decline participation in a healthy lifestyle intervention. Eligible caregivers of rural children who declined participation in a healthy lifestyle intervention were interviewed regarding reasons for declining. Inductive thematic analyses were conducted for responses. Caregiver interviews (n=16) resulted in 5 saturated themes: (1) rural families' household schedules prohibit participation, (2) preference for diverse treatment approaches, (3) desire for information across multimedia platforms, and more communication with a point-of-contact, (4) support for an inclusive approach integrated with existing school practices, and (5) caregivers had an understanding of behaviors that promote health., Competing Interests: Declaration of Interest Statement The authors report there are no competing interests to declare.

Aim: Despite efforts toward health promotion and preventive care for older adults, including health checkups and postal Kihon Checklist survey, one fifth of community‐dwelling older adults do not participate in them. The aim of the present study was to examine the relationship between this non‐participation and the end of certification‐free survival in older adults. Methods: In a cohort of 4120 older adults with no prior history of Long‐Term Care Insurance certification, the associations of non‐participation with risk of later death without certification and support/care‐need certification for 72 months were evaluated using Cox proportional hazards analysis. Results: Of them, 4022 (mean age 72.7 years, 54.7% women) were followed up (97.6%). At baseline, 1072 received health checkups, 2085 replied to the Kihon Checklist alone and 865 did not participate. During 72 months, 310 deaths without certification and 701 certifications occurred. After adjustment, non‐participating individuals had significantly higher hazard ratios for death up to 72 months and for certification up to 36 months, compared with the other two groups. The Kruskal–Wallis test showed associations of increasing incidence of certification due to stroke in pre‐old (aged 65–74 years) men for 72 months, and due to arthralgia/fracture and dementia in old (aged ≥75 years) women for 24 months, with non‐participation in health promotions. Certified non‐participating individuals incurred higher estimated Long‐Term Care Insurance expenditure per person for 72 months, especially in pre‐old men and old women. Conclusions: Health promotion by health checkup and even Kihon Checklist survey increases certification‐free survival in older residents, and decreases Long‐Term Care Insurance expenditure. Geriatr Gerontol Int 2019; 19: 1206–1214. [ABSTRACT FROM AUTHOR]

Background: Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research - deriving from the processes of non-recruitment of targeted individuals and self-selection - can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection.Methods: Based on a review of the relevant literature, we designed an instrument - the NPART survey questionnaire - for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study.Results: Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature.Conclusions: The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures. [ABSTRACT FROM AUTHOR]

Transitional justice scholarship has increasingly focused on participation to critically reflect upon the legitimacy and transformative potential of transitional justice. This article addresses these issues yet through a different vantage point: that of non-participation. It focuses on the case study of the Khmer Rouge Tribunal and a particular set of actors: those who continue to face political violence in Cambodia today. Thereby, it engages with the perspectives of those often overlooked in transitional justice for having opted out of the process, but also for putting forward justice claims that exceed the mandate of established transitional justice institutions. This article draws from qualitative fieldwork conducted in Cambodia between 2013 and 2016. It demonstrates the epistemic value of engaging with non-participation in transitional justice. It argues that non-participation in judicial transitional justice processes is inherently linked to the ways in which ordinary citizens experience and understand the law in their everyday life. It further highlights continuities in subjective experiences of political violence, which question discourses that political violence is a time that is past in Cambodia. [ABSTRACT FROM AUTHOR]

Playing a digital game is considered to be a leisure activity; therefore playing or not playing is typically viewed as an autonomous choice motivated by individual preferences for how one spends their time not occupied by other obligations. While a growing body of interventionist literature documents new entry points for girls and women into playing or making games, investigations are primarily focused on joining rather than why someone might ultimately leave. To address this gap whereby the study of former and non-players remains under explored, I bring together two disparate areas of academic investigation: leisure studies, specifically the study of barriers and access to leisure spaces, and critical feminist games scholarship. Taken together, these two areas of investigation provide a framework to account for why women might leave a game or never begin playing in the first place. Rather than assuming that playing or not playing is exclusively about choice or interest, I argue that there is much to be learned by asking women about what games they do not play and their reasons for quitting or never purchasing or downloading a particular game in the first place. [ABSTRACT FROM AUTHOR]

In this nationwide register-based cohort study, we examined cervical cancer screening participation among immigrants in Denmark by country and region of origin. Furthermore, we assessed whether differences in screening participation between immigrants and Danish-born women were explained by sociodemographic or health-related characteristics, and examined predictors of participation among immigrants. Using high-quality registries, we identified women invited for cervical cancer screening during 2008-2009 and retrieved individual-level data on sociodemographic-, health- and immigration-related characteristics. A total of 610,907 women were followed for up to 2.9 years after screening invitation. We estimated the probability of participation using the Aalen-Johansen estimator and the hazard ratios (HRs) of participation using Cox regression. The probability of participation within follow-up was 74.5% (95% CI, 74.4%-74.6%) in Danish-born women; 61.2% (95% CI, 60.4%-62.1%) in Western immigrants; and 61.3% (95% CI, 60.9%-61.8%) in non-Western immigrants. Participation in immigrants varied by region of origin from 44.3% (95% CI, 41.4%-47.4%) in immigrants from North America, New Zealand and Australia to 67.8% (95% CI, 65.4%-70.3%) in immigrants from South- and Central America. Substantial variation was seen between specific countries of origin. Differences in participation between immigrants and Danish-born women were not explained by sociodemographic or health-related characteristics. Predictors of low participation in immigrants included lower income, unemployment, being unmarried, having a history of schizophrenia or other psychoses, and ≤5 years' stay in Denmark. In conclusion, cervical cancer screening participation in immigrants varied by region and country of origin, but all immigrant groups had lower participation than Danish-born women. [ABSTRACT FROM AUTHOR]

Abstract There is limited research on travel behaviors using longitudinal cohorts. Longitudinal studies on people who do not travel overseas as latent tourists have also rarely been attempted. This study investigated whether latent tourists substitute overseas travel with other leisure activities, such as domestic travel or day trips. Data from the National Survey of Tourism, collected between 2004 and 2016, were used. Twenty-one subgroups of tourists were identified based on birth cohort and household income level. The Bayesian logit model, which is suitable for longitudinal data, was used. The results of the analysis show that 1) domestic travel tends to be a complement to, rather than a substitute for, overseas travel, 2) day trips are substitutes for overseas travel for the younger generations, and 3) day trips were complements to overseas travel for older generations. This study allows tourism policymakers and marketers to establish new policies and strategies to improve the tourism industry. Highlights • Domestic travel was considered a complement to overseas travel. • Day trips were considered substitutes for overseas travel in younger generations. • Day trips were considered complementary to overseas trips by older generations. • Family size, income, and residents' city size influenced overseas travel. • Bayesian logit model can predict travel behaviour using longitudinal data. [ABSTRACT FROM AUTHOR]

Copyright of Al-Adab / Al-ādāb is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article presents results from a study of online presence in activist milieus associated with the radical left in Sweden discussed from a perspective of non-participation. With the aim to further the understanding of digital non-participation as communicative strategy in activism, it builds upon empirical findings and argues that the online practices and use of social media, as could be observed in milieus associated with the radical left, indicates active non-participation and that this, in turn, is related to the ambition to claim autonomy. The article draws from existing scholarship on critical perspectives on protest movements and social media as well as empirical examples of online content published by radical leftist groups. Furthermore, it analyses how these activities could be understood in terms of active and passive non-participation, abstention or adaptation to social media affordances, as well as implosion of the social in digital media. The findings suggest that much of the activities in the material could be described as active non-participation and that this media practice relates to ideological positioning and values in the milieu.

The purpose of this descriptive-correlation study was to investigate effective factors on rural people’s non-participation of Mahabad’s dam catchment in Watershed Management Projects. The research instrument was structural questionnaire with close-ended questions, which its validity confirmed by panel of academic staff and reliability of questionnaire was confirmed. The target population of this study consisted of all householders who lived in Mahabad’s dam catchment (N=2458) out of them, according to Cochran's formula 175 people were selected by using cluster sampling in a simple randomization method (n=175). The descriptive results showed lack of financial ability for participating in watershed management, lack of awareness about watershed management efficiency, the longterm rate of return on the investment attracted in watershed management were the main variables related to rural people’s non participation in watershed management. By applying Factor Analysis Explanatory Technique, effective factors on rural people’s non-participation in watershed management were reduced to five factors namely weakness of agricultural extension services, getting watershed management out of governmental control, no achieving success to implement another rural projects by government, and no considering local individuals or organization by government. These five factors expressed 84% of the total variance of the non-participation people on Mahabad’s dam catchment in watershed management projects. Therefore points to these factors could solve the barriers of non-participation people on Mahabad’s dam catchment in watershed management projects.

Purpose: The 'Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship' (PROFILES) registry collects patient-reported outcomes (PROs) from short- and long-term cancer survivors in the Netherlands, in a population-based setting. The aim of this analysis is to assess the generalizability of observational PRO research among cancer survivors by comparing socio-demographic and clinical characteristics, and survival of participants and non-participants in cancer survivors invited for questionnaire research through the PROFILES registry.Methods: Between 2008 and 2015, cancer survivors with different cancer diagnoses (N = 14,011) were invited to participate in PROFILES registry studies, of whom 69% (N = 9684) participated. Socio-demographic and clinical characteristics and survival data, collected through the Netherlands Cancer Registry, were associated with participation versus non-participation in multivariable logistic regression analyses and cox proportional hazard regression models, respectively.Results: Participants had a significantly better survival compared to non-participants (HR = 1.47, P < .01). Participation was associated with male gender, being 60-70 years old, high socio-economic status, receiving any treatment, receiving radiotherapy, having no comorbidities, and a cancer diagnosis 2-3 years before invitation. Sensitivity analysis demonstrates that the health-related quality of life (HRQoL) might be up to 1.3 points lower (scale 0-100) using hot deck imputation compared to non-imputed participant data.Conclusions: Cancer survivors not participating in observational PROs research significantly differ from participants, with respect to socio-demographic and clinical characteristics, and survival. Their HRQoL scores may be systematically lower compared to participants. Therefore, even in PRO studies with relatively high participation rates, observed outcomes may represent the healthier patient with better outcomes. [ABSTRACT FROM AUTHOR]

Quand la participation du procureur au jugement des causes est obligatoire, son absence ou la participation d'un procureur incompétent entraîne la nullité absolue de la décision rendue dans le dossier. Le procureur est obligé de vérifier sa propre compétence et participer seulement dans les causes ou l'acte introductif d'instance a été réalisée par le parquet spécialisé dont il fait partie, selon le cas il peut s'agir d'un parquet "normal" ou les parquets spécialisés DIICOT ou DNA. Le respect de ces obligations concernant la participation et compétence du procureur pour instruire des cas liés aux certaines infractions spécialisées (crime organisée pour la DIICOT ou corruption pour la DNA respectivement) représente le respect incontournable du droit a un procès équitable. [ABSTRACT FROM AUTHOR]

Cervical cancer occurs most often in under-screened women. In this nationwide register study, we described differences in sociodemographic characteristics between passive and active non-participants and examined socio-demographic characteristics, reproductive history, and mental and physical health as potential determinants for passive non-participation compared with participation in the Danish cervical cancer screening program. Screening history in women aged 23-49 years invited for cervical cancer screening in 2008-2009 was retrieved from the Danish Pathology Databank with information about dates of invitation and unsubscription. We identified participants (n = 402,984), active non-participants (n = 10,251) and passive non-participants (n = 63,435) within four years following baseline invitation and retrieved data about the study population from high-quality registries. We examined differences in socio-demographic characteristics of passive and active non-participants, and used multiple logistic regression analyses to identify potential determinants of passive non-participation. We found that active and passive non-participants differed in relation to socio-demography. When compared with screening participants, the odds of passive non-participation was increased in women who originated from less developed countries; were unmarried; had basic education or low income; had four or more children; smoked during pregnancy; had multiple induced abortions; or had a history of obesity, intoxicant abuse or schizophrenia or other psychoses. In conclusion, in this nationwide, prospective, population-based study, differences in socio-demographic characteristics between passive and active non-participants were found. Furthermore, sociodemography, reproductive history, and mental and physical health were determinants for passive non-participation. Addressing inequalities in screening attendance may help to further decrease the incidence of and mortality from cervical cancer. [ABSTRACT FROM AUTHOR]

Participation in recreational sports activities is characterized by constraints - spatial, physical and a broad range of other barriers that have yet to be systematically considered. This study concentrated on the perceived psychosocial inhibitors as predictors of non-participation in recreational sports activities among lead city university (LCU) students, Ibadan. The study was anchored on the theory of constraints. Descriptive design of correlational type was adopted for the study. Accidental sampling technique was used to select the sample. One hundred and sixty-three LCU students participated in the study. Perceived psychosocial inhibitors to participation in recreational sports questionnaire with two sub-scales; perceived psychological inhibitors (PPI, r=83) and perceived social inhibitors (PSI, r=87) was used for data collection. Data were analysed using Analysis of variance (ANOVA) and Multiple regression at 0.05 alpha level. Manifold correlations existed between the variables of the study. Results showed positive significant relationships between Non-Participation and Confidence (r=.618**, p(.000)<.01), Skill (r=.513**, p(.000)<.01), Stress (r=.589**, p(.000)<.01), Lack Emotional Attachment (r=.567*, p(.000)<.01) and Security (r=.371**, p(.000)<.01).Results also indicated positive significant relationships between Non-Participation and Convenience (r=.448**, p(.000)<.01), Time (r=.450**, p(.000)<.01), Social Relationship (r=.232**, p(.003)<.01), Cost (r=.260**, p(.001)<.01) and Distance (r=.640**, p(.000)<.01).Consideration of the students' psychosocial interests to make them effective participants in recreational sports activities was therefore recommended. [ABSTRACT FROM AUTHOR]

The management of carob moth is a complex and multidimensional process that is only possible when collective action takes place in the pest-affected areas. The non-participation in carob moth management has led to increasing pest problems which unless managed collectively, they impose a serious limitation on pomegranate production and endanger the future of pomegranate orchards in Arsanjan county, Fars province, Iran. The current study aimed to explore why collective action has not taken place, and grounded theory was found to be the most appropriate method, followed up by a structured survey to gain an in-depth understanding of what is happening and why. Qualitative data collected through interviews were analyzed using Straussian grounded theory procedures and techniques, and quantitative data obtained via questionnaires were analyzed using descriptive statistics. The analysis indicated that individual farmers’ attempts to manage carob moth had limited benefit. The results revealed that inadequate and unsupportive institutions of all types (cognitive, normative and regulative) kept collective action from occurring. The main factors impeding the participation of the farmers in the management of carob moth were: unsupportive environment for agribusinesses, low income from pomegranate production, negative attitudes towards the government, lack of cooperative culture and prevalence of individualistic behavior, and inadequate knowledge about the pest among the growers. The categories and the relationships found among them assist stakeholders in understanding the root causes behind a lack of collective action in the pest management programs. The results provide powerful lessons for other participation projects and pest control interventions. [ABSTRACT FROM AUTHOR]

Background: Failure to include socio-economically deprived or ethnic minority groups in physical activity (PA) trials may limit representativeness and could lead to implementation of interventions that then increase health inequalities. Randomised intervention trials often have low recruitment rates and rarely assess recruitment bias. A previous trial by the same team using similar methods recruited 30% of the eligible population but was in an affluent setting with few non-white residents and was limited to those over 60 years of age.Methods: PACE-UP is a large, effective, population-based walking trial in inactive 45-75 year-olds that recruited through seven London general practices. Anonymised practice demographic data were available for all those invited, enabling investigation of inequalities in trial recruitment. Non-participants were invited to complete a questionnaire.Results: From 10,927 postal invitations, 1150 (10.5%) completed baseline assessment. Participation rate ratios (95% CI), adjusted for age and gender as appropriate, were lower in men 0.59 (0.52, 0.67) than women, in those under 55 compared with those ≥65, 0.60 (0.51, 0.71), in the most deprived quintile compared with the least deprived 0.52 (0.39, 0.70) and in Asian individuals compared with whites 0.62 (0.50, 0.76). Black individuals were equally likely to participate as white individuals. Participation was also associated with having a co-morbidity or some degree of health limitation. The most common reasons for non-participation were considering themselves as being too active or lack of time.Conclusions: Conducting the trial in this diverse setting reduced overall response, with lower response in socio-economically deprived and Asian sub-groups. Trials with greater reach are likely to be more expensive in terms of recruitment and gains in generalizability need to be balanced with greater costs. Differential uptake of successful trial interventions may increase inequalities in PA levels and should be monitored.Trial Registration: ISRCTN.com ISRCTN98538934 . Registered 2nd March 2012. [ABSTRACT FROM AUTHOR]

Background: Research has shown that recruitment to trials is a process that stretches from identifying potentially eligible patients, through eligibility assessment, to obtaining informed consent. The length and complexity of this pathway means that many patients do not have the opportunity to consider participation. This article presents the development of a simple framework to document, understand and improve the process of trial recruitment.Methods: Eight RCTs integrated a QuinteT Recruitment Intervention (QRI) into the main trial, feasibility or pilot study. Part of the QRI required mapping the patient recruitment pathway using trial-specific screening and recruitment logs. A content analysis compared the logs to identify aspects of the recruitment pathway and process that were useful in monitoring and improving recruitment. Findings were synthesised to develop an optimised simple framework that can be used in a wide range of RCTs.Results: The eight trials recorded basic information about patients screened for trial participation and randomisation outcome. Three trials systematically recorded reasons why an individual was not enrolled in the trial, and further details why they were not eligible or approached, or declined randomisation. A framework to facilitate clearer recording of the recruitment process and reasons for non-participation was developed: SEAR - Screening, to identify potentially eligible trial participants; Eligibility, assessed against the trial protocol inclusion/exclusion criteria; Approach, the provision of oral and written information and invitation to participate in the trial, and Randomised or not, with the outcome of randomisation or treatment received.Conclusions: The SEAR framework encourages the collection of information to identify recruitment obstacles and facilitate improvements to the recruitment process. SEAR can be adapted to monitor recruitment to most RCTs, but is likely to add most value in trials where recruitment problems are anticipated or evident. Further work to test it more widely is recommended. [ABSTRACT FROM AUTHOR]

We investigated the impact of demographic and disease related factors on non‐participation and dropout in a cluster‐randomised behavioural trial in cancer patients with measurements taken between hospitalisation and 6 months thereafter. The percentages of non‐participation and dropout were documented at each time point. Factors considered to be potentially related with non‐participation and dropout were as follows: age, sex, marital status, education, income, employment status, tumour site and stage of disease. Of 1,338 eligible patients, 24% declined participation at baseline. Non‐participation was higher in older patients (Odds Ratio [OR] 2.1, CI: 0.6–0.9) and those with advanced disease (OR 2.0, CI: 0.1–1.3). Dropout by 6 months was 25%. Dropout was more frequent with increased age (OR 2.8, CI: 0.8–1.2), advanced disease (OR 3.0, CI: 1.0–1.2), being married (OR 2.4, CI 0.7–1.1) and less frequent with university education (OR 0.4, CI −1.3 to −0.8) and middle income (OR 0.4, CI −0.9 to −0.7). When planning clinical trials, it is important to be aware of patient groups at high risk of non‐participation or dropout, for example older patients or those with advanced disease. Trial designs should consider their special needs to increase their rate of participation. [ABSTRACT FROM AUTHOR]

Copyright of Estudios Económicos is the property of El Colegio de Mexico AC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)